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In-house behavioral health care may improve screening for mental health, substance use

Adolescents who received care from either a pediatrician or a behavioral health care practitioner embedded in a pediatric office were more likely to be screened for substance use and mental health conditions, according to recently published data.

“Health care professionals in both intervention arms administered more assessments and brief interventions than those in usual care. However, overall pediatrician attention to behavioral health concerns was low,” the researchers wrote.

Researchers conducted a randomized study of 1,871 patients among 47 pediatricians to compare screening, brief intervention and referral to treatment (SBIRT) implementation for substance use in pediatric primary care among pediatricians, pediatric practices with embedded behavioral health care practitioners (BCHP) and usual care. Patients were aged 12 to 18 years.

Results demonstrated that compared with patients receiving usual care, patients in the pediatrician-only (adjusted OR = 10.37; 95% CI, 5.45–19.74) or BCHP (aOR = 18.09; 95% CI, 9.69–33.77) cohorts had higher odds of receiving SBIRT.

Receiving brief interventions was more likely in patients in the BCHP group, compared with patients in the pediatrician-only group (aOR = 1.74; 95% CI, 1.31–2.31).

Patients in the BHCP group were less likely to receive a referral, compared with patients in the pediatrician-only or usual-care groups.

The researchers noted that rather than pediatricians providing SBIRT to patients, a cost-effective alternative may be to embed behavioral health care practitioners into pediatric primary care practices. 

“Consistent with literature, we found that training pediatricians can significantly improve screening and intervention, but barriers to implementing SBIRT remain, including the belief among many pediatricians that other health care professionals are better situated to address behavioral health problems,” the researchers concluded. – by Casey Hower

Disclosures: The researchers report no relevant financial disclosures.