Improving the Coordination of Mental Health Services in a Pediatric Care Clinic


Book Description

Depression is one of the most common mental health issues facing adolescents today. Screening for depression is recommended as part of well exams for adolescents in primary care, but screening alone is not enough. As with other chronic conditions, regular follow-up care is important. The purpose of this project was to improve the follow-up and coordination of mental health services for adolescents who screen positive for depression during well child visits in a pediatric primary care clinic. This quality improvement project utilized the Plan-Do-Study-Act model. Retrospective chart audits collected data on the use of the PHQ-9 depression screen and documentation of treatment, follow-up and referrals. Data collected guided the implementation of strategies to improve screening, provider documentation, and follow-up for adolescents with positive depression screens. Follow-up recommendations and provision of community resources were implemented as interventional strategies. Audit data reflected improvement in both PHQ-9 screening and follow-up documentation in those adolescents with positive screens. There are several implications for future practice. Continued evaluation of strategies implemented will confirm effectiveness. Additional strategies may be needed to ensure consistent follow-up for adolescents with positive depression screens. Methods utilized for follow-up included use of the patient portal. The development of additional strategies to enhance portal usage can improve the efficacy of portal use for communication and information.




Improving the Quality of Health Care for Mental and Substance-Use Conditions


Book Description

Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.




Pediatric Mental Health for Primary Care Providers


Book Description

The purpose of this book is to provide a children’s mental health resource tailored to the needs of physicians working with children. There are currently no such texts, despite the fact that there are patient care, healthcare systems, and workforce factors that indicate a strong need for such a resource. Approximately 1 in 5 children are diagnosed with a mental illness by the age of 18. Additionally, mental health conditions, including Attention Deficit Hyperactivity Disorder, are consistently among the most common chronic conditions in pediatric clinical populations. Delays in both diagnosis and treatment increase the morbidity associated with these conditions. These delays expose the child to negative ramifications of his/her illness and can impact rates of poor academic performance, substance use disorders and criminal justice system involvement – potentially impacting long-term life trajectories. Early identification of mental illness and appropriate intervention is critical to the healthy development of youth, though physicians in primary care and pediatrics are seldom trained to detect and treat such illnesses. The importance of recognizing mental illness is reflected in practice guidelines for pediatric primary care providers as well as in how service delivery is being structured, but this does not offer in-depth clinical guidelines. Additionally, integrated care and medical home models include mental health as key components, though yet again physicians are often not trained to work with these models. While clearly indicated clinically, these requirements do not come with significant increases in reimbursement and are added to an already demanding schedule. Increasingly, providers are also expected to use evidence based screening instruments without exposure to this body of literature. Some guidance on using those instruments in context will help them to use those tools more effectively. Finally, primary care providers and even some adult psychiatrists and psychologists are operating in a healthcare system with a severe, nationwide shortage of child and adolescent psychiatrists and mental healthcare providers. While a text certainly cannot single-handedly compensate for such a workforce shortage, it could potentially help to mitigate the negative impact on patients by facilitating early identification and treatment in the primary care setting. Additionally, with more effective treatment in pediatric settings, less complex cases may be addressed before specialty care is needed, and the expertise of child and adolescent psychiatrists can be more effectively used for more complex cases. Pediatric Psychiatry in Primary Care is the ultimate resource for clinicians working with children, including pediatricians, family physicians, general psychiatrists, psychologists, early career child psychiatrists, social workers, nurses, school counselors, and all clinical professionals who may encounter children struggling with psychiatric disorders.




Crossing the Quality Chasm


Book Description

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.




Pediatric Integrated Care, An Issue of Child and Adolescent Psychiatric Clinics of North America, E-Book


Book Description

This issue of Child and Adolescent Psychiatric Clinics of North America, edited by Drs. Gregory Fritz, Tami Benton, and Gary Maslow, will focus on issues surrounding Integrated Care in child and adolescent psychiatry. Topics covered in these articles will include: Telephonic Service and Telemedicine; the Massachusetts Access Program; Integrated Care Model for Adolescent Substance Use; Combined Training for Pediatrics and Psychiatry; Integrated care within a rural setting; Interdisciplinary Training for Integrated Care; Emergency Department Interventions; Economic Considerations for Integrated Care; A Lifespan Approach to Integrated Care; and Essential Elements of a Collaborative Mental Health Training Program for Primary Care, among others.




The System of Care Handbook


Book Description

Address the urgent need for individualized, coordinated mental health care with this book--the only one-stop reference for establishing, evaluating, and improving services and systems of care for children and adolescents with mental health challenges and their families. The new cornerstone of the highly respected Systems of Care for Children's Mental Health series, this comprehensive volume helps administrators, program developers, and clinicians from mental health and partner child-serving systems skillfully navigate every key issue they may encounter on the road to effective service delivery. Weaving all the latest research and best practices into a single accessible handbook, more than 60 expert contributors give readers the in-depth, practical knowledge they need to develop comprehensive, community-based, coordinated systems of care for youth with mental health challenges and their families avoid duplication and fragmentation of services across mental health and other child-serving systems develop individualized care plans for children with complex needs and implement the "wraparound" approach to service delivery incorporate evidence-based practices into systems of care use smart financing strategies that make the most of multiple funding streams ensure the full participation of families and youth in service planning and delivery improve services and care coordination across a variety of systems--schools, child welfare, juvenile justice work effectively with youth and families from diverse backgrounds and communities conduct accurate program evaluation and continuous quality improvement use the best professional development strategies to ensure a skilled and dedicated workforce Throughout the book, extended case studies of children, youth, families, and successful programs take readers beyond the abstract and reveal in vivid detail how high-quality services can transform the lives of children and youth--from early childhood to their transition to adulthood--as well as their families and caregivers. A must-own compendium of knowledge for anyone involved in shaping the future of mental health services, this book is the new blueprint for systems of care that truly respond to the needs of children, youth and families. Learn more about the Systems of Care for Children's Mental Health series.




Report of the Surgeon General's Conference on Children's Mental Health


Book Description

Conference held Sept. 18-19, 2000, Washington, DC. The purpose of the conference was to engage a group of citizens in a thoughtful, meaningful dialogue about issues of prevention, identification, recognition, and referral of children with mental health needs to appropriate, evidence-based treatments or services.




Closing the Quality Gap


Book Description




Opportunities for Improving Programs and Services for Children with Disabilities


Book Description

Although the general public in the United States assumes children to be generally healthy and thriving, a substantial and growing number of children have at least one chronic health condition. Many of these conditions are associated with disabilities and interfere regularly with children's usual activities, such as play or leisure activities, attending school, and engaging in family or community activities. In their most severe forms, such disorders are serious lifelong threats to children's social, emotional well-being and quality of life, and anticipated adult outcomes such as for employment or independent living. However, pinpointing the prevalence of disability among children in the U.S. is difficult, as conceptual frameworks and definitions of disability vary among federal programs that provide services to this population and national surveys, the two primary sources for prevalence data. Opportunities for Improving Programs and Services for Children with Disabilities provides a comprehensive analysis of health outcomes for school-aged children with disabilities. This report reviews and assesses programs, services, and supports available to these children and their families. It also describes overarching program, service, and treatment goals; examines outreach efforts and utilization rates; identifies what outcomes are measured and how they are reported; and describes what is known about the effectiveness of these programs and services.




From Case Management to Service Coordination for Children with Emotional, Behavioral, Or Mental Disorders


Book Description

"This resource keeps pace with the increasingly rapid changes in service coordination for child and adolescent mental health, examining the current state of the field and detailing the shift to more collaborative, family-centered service delivery. Advocating system-level change, this volume describes how to develop links among providers and among agencies. Also included are case studies drawn from successful programs that illustrate how to translate innovative ideas into practice." "Pulling together the work of professionals around the country, this comprehensive resource gives professionals a cohesive framework for building on the developments of the last decade. Directors of family centers, community clinics, child agencies, and outreach programs, as well as social workers, psychologists, nurses, family members, advocates, and policy makers will use this detailed volume for information, guidance, and support."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved