Briggs Rahil D, Racine Andrew D, Chinitz Susan
Children's Hospital at Montefiore.
Albert Einstein College of Medicine.
Infant Ment Health J. 2007 Sep;28(5):481-495. doi: 10.1002/imhj.20149.
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.
婴儿心理健康和儿科学领域当前的实践建议都支持心理健康专业人员进驻儿科机构。过去5年的多份政策报告和声明都反复强调了心理健康护理与儿科学之间进行协调和整合的必要性（哈尔丰、雷加拉多、麦克勒恩、郭和赖特，2003年；奥索夫斯基，2004年）。儿科诊所被认为是一个普遍可及、无污名化的场所，非常适合评估和治疗幼儿心理健康问题。然而，这类护理的障碍普遍存在，包括儿科医生的时间限制、报销结构不合理、儿科医生培训不足，以及医疗和心理健康服务提供者之间的联系不够。针对这些障碍的一个创新举措是在儿科诊所安排一名心理健康专业人员，为儿科医生提供培训，并对年轻患者进行适当的筛查、评估、转诊和治疗。本文介绍了纽约布朗克斯区一个此类成功项目，一名在婴儿心理健康方面有专长的心理学家每周在一家大型儿科诊所工作25小时，以满足0至3岁儿童的发育和心理健康需求。文中还给出了有关患者群体、筛查分数和处置情况的初步描述性数据。
