TRAINING THE FUTURE
CHILD HEALTH CARE
WORKFORCE
to Improve the Behavioral Health of
Children, Youth, and Families
PROCEEDINGS OF A WORKSHOP
Steve Olson and Sarah M. Tracey, Rapporteurs
Forum on Promoting Children’s Cognitive,
Affective, and Behavioral Health
Board on Children, Youth, and Families
Division of Behavioral and Social Sciences and Education
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
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This activity was supported by contracts between the National Academy of Sciences and the American Academy of Pediatrics (unnumbered award); the American Board of Pediatrics (unnumbered award); the Assistant Secretary for Planning and Evaluation (HHSP23337021); Autism Speaks (unnumbered award); the Centers for Disease Control and Prevention (200-2011-38807, TO #42); the Conrad N. Hilton Foundation (20150118); the Robert Wood Johnson Foundation (74234); the Substance Abuse and Mental Health Services Administration (HHSP23337029); and the U.S. Department of Justice Office of Juvenile Justice and Delinquency Prevention (2013-MU-MU-0002). Additional support came from the American Psychological Association, the Community Anti-Drug Coalitions of America, Global Alliance for Behavioral Health and Social Justice, the Hogg Foundation for Mental Health, the Society for Child and Family Policy and Practice, the Society of Clinical Child and Adolescent Psychology, and the Society of Pediatric Psychology. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-46461-1
International Standard Book Number-10: 0-309-46461-7
Digital Object Identifier: https://doi.org/10.17226/24877
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Copyright 2017 by the National Academy of Sciences. All rights reserved.
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. (2017). Training the Future Child Health Care Workforce to Improve Behavioral Health Outcomes for Children, Youth, and Families: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/24877.
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PLANNING COMMITTEE FOR THE WORKSHOP ON TRAINING THE FUTURE CHILD HEALTH CARE WORKFORCE TO IMPROVE BEHAVIORAL HEALTH OUTCOMES FOR CHILDREN, YOUTH, AND FAMILIES
THOMAS F. BOAT (Cochair), University of Cincinnati College of Medicine (dean emeritus) and Department of Pediatrics, Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center
LAUREL K. LESLIE (Cochair), American Board of Pediatrics and Department of Medicine and Pediatrics, Tufts University School of Medicine
HAROLYN M.E. BELCHER, Johns Hopkins University School of Medicine and Kennedy Krieger Institute
GREGORY FRITZ, Bradley Hasbro Children’s Research Center
BIANCA K. FROGNER, University of Washington
ELIZABETH HAWKINS-WALSH, Catholic University of America
KIMBERLY EATON HOAGWOOD, Society of Clinical Child and Adolescent Psychology; American Psychological Association; Department of Child and Adolescent Psychiatry, New York University School of Medicine
MARSHALL “BUZZ” LAND, JR., American Board of Pediatrics and University of Vermont
MARY ANN McCABE, Society for Child and Family Policy and Practice; Society of Pediatric Psychology; Department of Pediatrics, George Washington University School of Medicine; Department of Applied Developmental Psychology, George Mason University
FORUM ON PROMOTING CHILDREN’S COGNITIVE, AFFECTIVE, AND BEHAVIORAL HEALTH
WILLIAM R. BEARDSLEE (Cochair), Baer Prevention Initiatives; Department of Psychiatry (chairman emeritus), Boston Children’s Hospital; Department of Child Psychiatry, Harvard Medical School
C. HENDRICKS BROWN (Cochair), Departments of Psychiatry, Behavioral Sciences, and Preventive Medicine, Feinberg School of Medicine, Northwestern University
KAREEMAH ABDULLAH, National Community Anti-Drug Coalition Institute and Community Anti-Drug Coalitions of America
DARA BLACHMAN-DEMNER, Crime, Violence, and Victimization Research Division, National Institute of Justice
THOMAS F. BOAT, University of Cincinnati College of Medicine (dean emeritus) and Department of Pediatrics, Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center
FELESIA R. BOWEN, Center for Urban Youth School of Nursing, Rutgers, The State University of New Jersey
DAVID A. BRENT, Department of Psychiatry, Pediatrics, and Epidemiology, University of Pittsburgh School of Medicine
LAUREN CALDWELL, Children, Youth and Families Office, Public Interest Directorate, American Psychological Association
ALEXA EGGLESTON, Conrad N. Hilton Foundation
COSTELLA GREEN, Division of Community Programs, Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration
RICK HARWOOD, National Association of State Alcohol and Drug Abuse Directors
J. DAVID HAWKINS, School of Social Work, University of Washington
KIMBERLY EATON HOAGWOOD, Society of Clinical Child and Adolescent Psychology; American Psychological Association; Department of Child and Adolescent Psychiatry, New York University School of Medicine
COLLEEN HORTON, Hogg Foundation for Mental Health, University of Texas at Austin
JENNIFER KAMINSKI, Division of Human Development and Disability, Centers for Disease Control and Prevention
KELLY J. KELLEHER, Center for Innovation in Pediatric Practice, Health Services Research and Community Health and Services Research, The Research Institute at Nationwide Children’s Hospital
UMA KOTAGAL, Department of Pediatrics, University of Cincinnati, and James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center
LAUREL K. LESLIE, American Board of Pediatrics; Department of Medicine and Pediatrics, Tufts University School of Medicine
MARY ANN McCABE, Society for Child and Family Policy and Practice; Society of Pediatric Psychology; Department of Pediatrics, George Washington University School of Medicine; Department of Applied Developmental Psychology, George Mason University
JENNIFER NG’ANDU, Robert Wood Johnson Foundation
LAWRENCE A. PALINKAS, Department of Social Policy and Health and Behavior, Health and Society Research Cluster, University of Southern California School of Social Work
MARY JANE ROTHERAM-BORUS, Child Psychiatry and Biobehavioral Sciences, Global Center for Children and Families, Center for HIV Identification, Prevention, and Treatment Services, Department of Psychiatry, University of California, Los Angeles
JOYCE K. SEBIAN, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration
PAT SHEA, Office of Technical Assistance, National Association of State Mental Health Program Directors
ANDY SHIH, Scientific Affairs, Autism Speaks
JOSÉ SZAPOCZNIK, Department of Public Health Sciences, Miami Clinical Translational Science Institute, Center for Family Studies, University of Miami
VERA FRANCIS “FAN” TAIT, Department of Child Health and Wellness, American Academy of Pediatrics
JENNIFER TYSON, Office of Juvenile Justice and Delinquency Prevention, U.S. Department of Justice
DEBORAH KLEIN WALKER, Global Alliance for Behavioral Health and Social Justice and Abt Associates
Forum Staff
WENDY KEENAN, Forum Director
SARAH M. TRACEY, Associate Program Officer
EMILY BACKES, Associate Program Officer (August 2016–February 2017)
ANTHONY JANIFER, Senior Program Assistant
SYLVIA NCHA, Intern, George Washington University (March–May 2017)
Board on Children, Youth, and Families Staff
NATACHA BLAIN, Director
LISA ALSTON, Financial Officer
PAMELLA ATAYI, Program Coordinator
Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings: Eric Holmboe, Milestone Development and Evaluation, Accreditation Council for Graduate Medical Education; Christen Johnson, Student National Medical Association, Dublin, Ohio; Bernadette Melnyk, College of Nursing, Ohio State University; José Szapocznik, Department of Public Health Sciences, University of Miami Miller School of Medicine; and Lawrence Wissow, Bloomberg School of Public Health, Johns Hopkins University.
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by Patrick H. Deleon, F. Edward Hébert School of Medicine and the Graduate School of Nursing, Uniformed Services University of the Health Sciences. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.
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Contents
Making Connections with Patients and Families
Partnering with Behavioral Health Care Providers
3 THE NATIONAL LANDSCAPE OF HEALTH CARE TRAINING AND WORKFORCE PROCESSES
The Behavioral Health Workforce: Supply, Demand, Challenges, and Opportunities
Nurses and Schools as Providers of Behavioral Health Services
A Medical Student’s Perspective
Improving Pediatric and Adolescent Behavioral Health Services and Education at Ohio State University
Interprofessional Training in Cleveland’s MetroHealth Medical Center
Preparing Social Workers at the University of North Carolina
Integrated Primary Behavioral Care at Cherokee Health Systems
Training Models with Chronically Ill Children and Their Families
5 ACCREDITATION, CERTIFICATION, AND CREDENTIALING
An Overview of Physician Training, Licensure, and Certification
Certification of Pediatric Nurses
Certification and Maintenance of Certification
Curricular Change Driven by Accreditation
Accreditation and the Training of Clinical Psychologists
Training and Credentialing Family Peer Advocates
Accreditation of Patient-Centered Medical Homes
6 OTHER CHILD-SERVING SETTINGS
Individualized Service Plans for Children
Training Supported by the Maternal and Child Health Bureau
Evidence-Based Practices as Levers for Change
Foundation Support for Implementing Evidence-Based Practices
Integrating Care Through Payment and Policies
Financing and Reimbursement to Improve Training
8 POSSIBLE NEXT STEPS AND REFLECTIONS ON THE WORKSHOP
Behavioral Health Promotion and Risk Prevention Through Multigenerational Surveillance
Fostering Integrated Interprofessional Care
Meeting the Needs of Children with Disabilities and Complex Health Conditions
Accreditation, Certification, and Credentialing
Reimbursement for Training and Clinical Care
D Biographical Sketches of Planning Committee Members, Workshop Speakers, and Moderators
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Boxes, Figures, and Tables
BOXES
6-1 Possible Professionals in Multidisciplinary School Behavioral Health Teams
FIGURES
3-1 Distribution of the behavioral health workforce
3-2 Maldistribution of the behavioral health workforce that limits access to care
3-3 Overall staffing at school-based health centers
3-4 Mental health care staffing at school-based health centers
3-5 A continuum of helping relationships
5-1 Physician licensure and certification process in the United States
TABLES
3-1 National Projections of Supply and Demand for Selected Behavioral Health Practitioners by 2025
