Coordinating mental health care across primary care and schools: ADHD as a case example

Abstract

Although primary care practices and schools are major venues for the delivery of mental health services to children, these systems are disconnected, contributing to fragmentation in service delivery. This paper describes barriers to collaboration across the primary care and school systems, including administrative and fiscal pressures, conceptual and linguistic differences between health care and educational professionals, role restrictions among professionals, and privacy laws. Strategies for overcoming these barriers, which can be applied in both primary care and school settings, are described in this paper. This paper has a primary focus on children with attention-deficit/hyperactivity disorder, but the principles and strategies described are applicable to children with a range of mental health and health conditions.

Keywords:

• primary care
• schools
• mental health
• coordination
• ADHD

Acknowledgements

Preparation of this article was supported by grants from Health Resources and Services Administration, Maternal and Child Health Bureau (R40MC08964), and the Department of Education, Office of Special Education Programs (H325D100019). Also, this project was supported in part by Projects T77MC00012 and T73MC00051 from the Maternal Child Health Bureau (Public Health Service Act, Section 399BB(e)(1)(A), as amended by the Combating Autism Act of 2006), Health Resources and Services Administration. In addition, this project was supported by a grant from the National Institute of Mental Health (K23MH065696).