Preventive pediatric mental health care: A co-location model

Current practice recommendations in both the fields of infant mental health and pediatrics support the co-location of mental health professionals into the pediatric setting. Multiple policy reports and statements of the past 5 years have repeatedly argued the need for coordination and integration between mental health care and pediatrics (Halfon, Regalado, McLearn, Kuo, & Wright, 2003; Osofsky, 2004). The pediatric office is recognized as a universally accessed, nonstigmatized setting, ideal for the assessment and treatment of early childhood mental health problems. However, barriers to this type of care are rampant, including time limitations on the part of pediatricians, inadequate reimbursement structures, inadequate training of pediatricians, and insufficient connections between medical and mental health providers. An innovative response to these barriers is the co-location of a mental health professional in the pediatric practice to provide pediatrician education and appropriate screening, assessment, referral, and treatment of young patients. This article describes a successful program of this type situated in the Bronx, NY, where a psychologist with expertise in infant mental health spends 25 hours per week in a large pediatric practice to address the developmental and mental health needs of children aged 0-3 years old. Preliminary descriptive data regarding the patient population, screening scores, and disposition are presented.