Integrated Behavioral Health Services: A Collaborative Care Model for Pediatric Patients in a Low-Income Setting
Integrated Behavioral Health Services: A Collaborative Care Model for Pediatric Patients in a Low-Income Setting
复制标题
DOI：
10.1177/0009922812470744
复制
发表时间：
2013-12-01
影响因子：
1.6
通讯作者：
Carrion, Victor G.
中科院分区：
文献类型：
--
作者：
Aguirre, Jarrad;Carrion, Victor G.
结果IBHS服务于低收入儿童和青少年谁正在经历或有风险的行为挑战。它寻求广泛撒网，向尽可能多的病人提供短期心理社会服务，而不是提供长期的专门服务。这种区别将行为健康与心理健康区分开来。IBHS与儿科办公室位于同一地点，并作为儿科医生和家庭的直接和纵向资源。IBHS的主要目标如下：·参与以人口为基础的教育，预防，并对RFHC患者进行早期干预;·与儿科医生合作，识别，治疗和管理精神障碍和心理问题;·培训儿科医生，以提高他们对行为健康问题的理解和干预技能;·提供重点干预措施，以改善患者的功能和福祉;以及·在有需要时让患者参与简短的治疗途径和/或简短的心理治疗。当儿科医生发现问题时，儿童和青少年被转介到IBHS。这些问题并不严重，不值得转诊，但却构成了发展障碍。根据具体情况，IBHS提供社会服务，心理教育支持小组，临床咨询，危机稳定和/或个人治疗和咨询。IBHS接受保险，包括医疗补助，并为未投保的患者提供滑动比例。转介的例子包括在学校有行为问题的儿童和目睹家庭暴力的儿童。在紧急情况下，儿科医生联系项目主任，然后安排当天与临床医生见面。紧急情况的例子包括虐待儿童和自杀意念。在不太紧急的情况下，儿科医生提交IBHS转诊表进行预约。项目主任根据语言需求、服务类型和时间表将患者与IBHS临床医生匹配。当IBHS临床医生看到病人时，他或她会在病历中写下“进展记录”。为了促进沟通和沟通，儿科医生可以获得进展记录。
ResultsIBHS serves low-income children and adolescents who are experiencing or are at risk for behavioral challenges. It seeks to cast a wide net and provide brief psychosocial services to as many patients as indicated, instead of providing longer-term, specialized services. This distinction separates behavioral health from mental health. IBHS is colocated with the pediatric offices and serves as an immediate and longitudinal resource for pediatricians and families. The primary objectives of IBHS are the following:• to engage in population-based education, prevention, and early intervention with the patients of RFHC;• to work as a team with the pediatricians in the identification, treatment, and management of mental disorders and psychosocial issues;• to train pediatricians in order to increase their understanding and skill in intervening on behavioral health issues;• to provide focused interventions to improve patients’ functioning and well-being; and• to engage patients in brief treatment pathways and/or brief psychotherapy when indicated.As pediatricians identify issues, children and adolescents are referred to IBHS. These issues are not severe enough to merit outside referral but present as developmental barriers. Depending on the case, IBHS provides social services, psychoeducational support groups, clinical consultations, crisis stabilization, and/or individual therapy and counseling. IBHS accepts insurance, including Medicaid, and offers a sliding scale for uninsured patients. Examples of referrals include children with behavioral issues at school and children who have witnessed domestic violence. In urgent scenarios, pediatricians contact the program director who then arranges a same-day visit with a clinician. Examples of urgent scenarios include child abuse and suicidal ideation. In less urgent scenarios, pediatricians submit an IBHS referral form for an appointment. The program director matches the patient with an IBHS clinician based on language needs, service type, and schedule. When the IBHS clinician sees the patient, he or she writes a “progress note” within the medical chart. To facilitate communication and comanagement, pediatricians have access to progress notes.