Straus John H, Sarvet Barry
John H. Straus (
Barry Sarvet is chief of child psychiatry and vice chair of the Department of Psychiatry at Baystate Health, in Springfield, Massachusetts, and a clinical professor of psychiatry at the Tufts School of Medicine, in Boston, Massachusetts.
Health Aff (Millwood). 2014 Dec;33(12):2153-61. doi: 10.1377/hlthaff.2014.0896.
Access to behavioral health care for children is essential to achieving good health care outcomes. Pediatric primary care providers have an essential role to play in identifying and treating behavioral health problems in children. However, they lack adequate training and resources and thus have generally been unable to meet children's need for behavioral health care. The Massachusetts Child Psychiatry Access Project has addressed this problem by delivering telephone child psychiatry consultations and specialized care coordination support to over 95 percent of the pediatric primary care providers in Massachusetts. Established in 2004, the project consists of six regional hubs, each of which has one full-time-equivalent child psychiatrist, licensed therapist, and care coordinator. Collectively, the hubs are available to over 95 percent of the 1.5 million children in Massachusetts. In fiscal year 2013 the Massachusetts Child Psychiatry Access Project served 10,553 children. Pediatric primary care providers enrolled in the project reported a dramatic improvement in their ability to meet the psychiatric needs of their patients. Telephone child psychiatry consultation programs for pediatric primary care providers, many modeled after the Massachusetts project, have spread across the United States.
为儿童提供行为健康护理对于实现良好的医疗保健成果至关重要。儿科初级保健提供者在识别和治疗儿童行为健康问题方面发挥着重要作用。然而,他们缺乏足够的培训和资源,因此通常无法满足儿童对行为健康护理的需求。马萨诸塞州儿童精神病学接入项目通过为该州95%以上的儿科初级保健提供者提供电话儿童精神病学咨询和专门的护理协调支持,解决了这一问题。该项目成立于2004年,由六个区域中心组成,每个中心都有一名相当于全职的儿童精神病医生、持牌治疗师和护理协调员。这些中心总共服务于马萨诸塞州150万儿童中的95%以上。2013财年,马萨诸塞州儿童精神病学接入项目为10553名儿童提供了服务。参与该项目的儿科初级保健提供者报告称,他们满足患者精神科需求的能力有了显著提高。许多以马萨诸塞州项目为蓝本的针对儿科初级保健提供者的电话儿童精神病学咨询项目已在美国各地推广开来。