Building Independent Mental Health Practice Through Collaborative Care

Area of Science:

• Pediatric mental health care delivery
• Integrated care models
• Health services research

Background:

• Pediatricians manage most US youth mental health care but often lack confidence.
• Integrated care, like collaborative care, can enhance pediatrician competence.
• These models may increase pediatrician autonomy in managing mental health.

Purpose of the Study:

• To evaluate the impact of a collaborative care program on pediatrician management of pediatric anxiety and depression.
• To compare mental health care practices between pediatricians in a collaborative care program and those in a control group.

Main Methods:

• A four-year retrospective cohort study compared two groups of pediatric practices.
• Group 1 (15 pediatricians) participated in an off-site collaborative care program.
• Group 2 (15 pediatricians) did not participate; outcomes included diagnosis, treatment, and visit frequency.

Main Results:

• Collaborative care was linked to higher odds of annual (OR=2.35) and thrice-annual (OR=2.98) visits for anxiety/depression.
• Pediatricians in the program were more likely to prescribe antidepressants (OR=6.33) and ADHD medications (OR=1.31).

Conclusions:

• Participation in collaborative care increased pediatrician diagnosis and management of anxiety and depression.
• The program facilitated independent management beyond formal consultations.