Which Model Fits? Evaluating Models of Integrated Behavioral Health Care in Addressing Unmet Behavioral Health Needs among Underserved Sociodemographic Groups

ABSTRACT

Unmet behavioral health care needs are especially pronounced among underserved sociodemographic groups based on socioeconomic status, race/ethnicity, English language proficiency, sex, and age. To increase access to care, it is necessary to utilize evidence-based strategies to effectively expand provision of behavioral health services outside of traditional settings to contexts in which help-seeking for child behavioral health care needs is taking place. We retrospectively examined two specific models (consultation and colocation) that comprised an integrated behavioral health program in an inner-city pediatric primary care clinic in order to better understand strategies to feasibly and effectively increase access to care among underserved populations. Results from program evaluation data (that included a sample of 188 patients) support a multi-tiered integrated behavioral health care program of (1) joint consultation encounters delivered by primary care providers (PCPs) and behavioral health clinicians and (2) colocation of behavioral health services. Variations in feasibility, workforce and space considerations, and recommendations for integrating behavioral health programs in inner-city pediatric primary care clinics are discussed.

KEYWORDS:

• Integrated care
• primary care
• collaborative care
• consultation
• colocation
• health disparities
• underserved
• inner-city
• patient centered medical home
• pediatrics and behavioral health

Acknowledgments

The authors gratefully acknowledge the efforts of Kristen Thomson, PhD for her initial contributions to program development as a postdoctoral fellow and the psychology program training directors for our APA approved internship and postdoctoral fellowships and for support in the development of the psychology consult program. A special thank you to the PCC PCPs and care staff who supported us in the integration of psychological services and for entrusting to us the collaborative care of the patients. Thank you for partnering with us.

Disclosure statement

This is to acknowledge that the author has no financial interest or benefit that has arisen from the direct applications of this research.

Notes

¹ We use the terms Hispanic and Latino as they are the most recognized by the communities served in the current study. However, as noted in previous research (see Vidal-Ortiz & Martínez, 2018), the term “Latino” is currently under debate for failure to acknowledge gender diversity (including gender nonconformity.

Additional information

Funding

No funds were received in support of this program development or the current manuscript by the authors.