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Opportunities to Promote Children's Behavioral Health Health Care Reform and Beyond: Workshop Summary (2015) / Chapter Skim
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8 The Research Landscape for Primary Care and Children's Behavioral Health
Pages 61-66

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From page 61...
... RESEARCH ON INTEGRATED SERVICES As noted throughout the workshop, behavioral health problems among children and adolescents are common in primary care. These patients also are heavy users of primary care -- for example, children who keep coming back with stomachaches and headaches.
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From page 62...
... Trials that enhanced the primary care provider as a resource were more effective than colocated care interventions, which resonated with Asarnow. The bottom line, said Asarnow, is "integrated primary medical and behavioral health care provides at least part of the solution for addressing the behavioral health needs of children." The effects are small to medium, so there is room for improvement.
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From page 63...
... The care manager then briefed the primary care provider so he or she could come up with a shared treatment plan and consider whether specialty mental health consultation was required, which was something that physicians often felt they needed. "We don't want kids to die because somebody has missed something," said Asarnow.
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From page 64...
... But there are common features that produce positive outcomes and can be taught, including • Nurturance and reinforcement • Emotion regulation • Supervision, control, and discipline • Supporting behaviors that promote effective adaptation to devel opmentally relevant demands (both academic and social) • Discouraging behaviors that hinder positive adaptation, such as aggression, self-harm, association with deviant peers, and drug use The range of positive outcomes that effective parenting can have is impressive, Landsverk said, including • Sustained attention, improved executive function, and regular sleep • Increased language and higher vocabulary • Social skills and school readiness • Less externalizing behavior • Safer home environments • Less abuse and neglect • Less involvement in juvenile justice • Less incarceration and hospitalization • Higher grade point average and better mathematics and reading achievement • Reduced peer aggression and association with delinquent peers • Fewer mental health symptoms • Less drug and alcohol use Structured reviews have been proposed as a method for assisting the translational process, moving from discovery and testing to dissemination and implementation (Glasgow et al., 2012)
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From page 65...
... Few examples exist of models in full primary care settings that use screens, behavioral health treatments, and primary care personnel. Also, no evidence was seen of cost measurement in randomized controlled trials, and there was little focus on implementation other than feasibility.
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Key Terms

  • care manager
  • care provider
  • integrated care
  • collaborative care
  • leading cause

  • colocated care
  • primary medical
  • health consultation
  • care settings
  • health treatments

  • controlled trials
  • randomly selected
  • selected kid
  • randomized controlled
  • weaker effect

  • implementation studies
  • cost measurement
  • care services
  • improve care
  • care makes

  • adolescent behavioral
  • care trials
  • clinical care
  • coordinated care
  • usual primary

  • health symptoms
  • health prevention
  • usual care
  • care program
  • care provides


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