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AAP recommendations address mental health care for low-income families

The American Academy of Pediatrics recently published recommendations to improve mental health care access for low-income children and families in primary care settings.

“There is a clear and growing consensus across the fields of pediatrics, psychiatry, psychology, and child advocacy that integrating mental health services into existing service settings, including pediatric primary care, is the most promising means of increasing access to mental health care, particularly for children from low-income families. However, optimal implementation requires changes in policies, workforce development, health care financing, community service system infrastructure, clinical workflow, and provider practices,” Stacy Hodgkinson, PhD, of the Children’s National Health System, Washington, D.C., and colleagues wrote.

Researchers developed recommendations for provider-level change to improve access to mental health care for low-income families based on a review of mental health care delivery research, expert opinion and policy recommendations from the American Academy of Pediatrics and other institutions. Scientific and lay literature were analyzed, with a particular focus on evidence-based expert recommendations that have been implemented in various settings.

Recommendations were grouped into three categories: education and training, clinical infrastructure, and multidisciplinary teams. Some include:

• Increasing the ability of providers and staff to address practical, logistical and psychological barriers to patient engagement in mental health care;
• Training and education to help primary care providers identify and address emerging issues prior to diagnosis and increase their comfort and competency in prevention, management and treatment of common lower-acuity pediatric mental health problems;
• Establishing collaborative relationships between pediatric clinicians and mental health services, including referral protocols;
• More effective channels for communication and co-management between primary care providers, mental health professionals, school personnel and case managers;
• Integrating care coordination services in clinical settings to better address needs of children and families;
• Increasing use of paraprofessionals, such as family navigators and family support workers, in pediatric settings to facilitate access to care; and more.

“These recommendations are not intended to be fully comprehensive but are targeted toward high-impact interventions that can be achievable in the typical primary care setting through a stepwise approach. Providers are encouraged to assess their own practices, implement small, incremental changes with continual reassessment, and partner with their local professional societies to improve access to mental health care for low-income families,” the researchers concluded. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.