Meadows Institute leads Pediatric Collaborative Care discussion at the American Psychiatric Association’s 2023 Mental Health Services Conference

The Collaborative Care Model is the integrated behavioral health model with the strongest evidence base to effectively address the needs of our beleaguered mental health care system, including for youth and children, Dr. Andrew Carlo told an audience of psychiatrists and other mental health professionals at the American Psychiatric Association’s 2023 Mental Health Services Conference in Washington, D.C.

Carlo, the Meadows Institute’s vice president of health system integration, was joined on stage Oct. 13 by Meadows Institute Vice President of Primary Care Innovation Clare McNutt and Dr. Laura Richardson, a professor of pediatrics at the University of Washington, for a panel discussion titled “Pediatric Collaborative Care (CoCM): Established Components, Emerging Strategies and Future Directions.”

Currently, primary care and pediatrics are the “de facto mental health providers” for most people in the United States, Carlo said, due to a lack of access to specialty mental health care, especially in rural parts of the country, inadequate insurance and stigma.

However, Carlo said, while most primary care providers are willing to provide mental health care, “they often lack the resources or training to provide longitudinal care at scale, and that’s one of the things that leads primary care mental health outcomes and pediatric mental health outcomes to not be as good as they could be.”

Collaborative Care, which integrates mental health care into primary care and pediatric settings, increases access to mental health care and has been shown by over 90 randomized clinical trials to be effective in the early identification and treatment of mental health conditions such as depression in adults, Carlo said.

As the only integrated mental health care model with its own billing codes, it’s a financially sustainable intervention, he added.

While Pediatric Collaborative Care has not yet been studied to the same extent as adult Collaborative Care, the Meadows Institute is leading efforts to expand the evidence base, said McNutt. To that end, the Institute recently convened the Inaugural Pediatric and Adolescent Collaborative Care Roundtable, a gathering of 20 of the nation’s preeminent experts in Pediatric Collaborative Care. Richardson, who was among those experts, said the data on Pediatric Collaborative Care is promising.

She pointed to several encouraging studies, including a 2014 study in JAMA showing that among adolescents with depression seen in pediatric primary care, Collaborative Care resulted in greater improvement in depressive symptoms at 12 months than usual care, suggesting that mental health services for adolescents with depression can be integrated into primary care.

At the conclusion of the panel, a long line of questioners queued up in the Capital Hilton’s presidential ballroom to ask the experts how to ramp up implementation of Pediatric Collaborative Care.

It’s critical to engage parents and caregivers and be transparent at the outset regarding costs, expectations, privacy and Collaborative Care team member roles.– Clare McNutt

“Don’t underestimate the importance of champions” within pediatric practices to encourage pediatricians to incorporate it into their practices, Carlo advised.

Richardson said a new approach to marketing Pediatric Collaborative Care is key. “A ton of pediatricians want to do behavioral health. They do a lot of training on promoting healthy development. We should lean into promoting this as healthy development, like sleep.

“We need to bridge that language to bring them there.”