Burkhart Kimberly, Asogwa Kenneth, Muzaffar Nida, Gabriel Mary
UH Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
University Hospitals of Cleveland, Cleveland, OH, USA.
Clin Pediatr (Phila). 2020 Feb;59(2):148-153. doi: 10.1177/0009922819890004. Epub 2019 Nov 24.
Psychiatric disorders are becoming more frequently diagnosed within the pediatric primary care setting. Despite increased diagnosis within primary care, only a minority of patients receive further psychiatric or specialty care. The integrated/collaborative care treatment model was designed to improve access within primary care. The purpose of this review is to identify randomized controlled trials and quasi-experimental studies that have investigated whether increased access improves treatment engagement, satisfaction, and improved mental health outcomes. Six studies met inclusion criteria. Studies reviewed indicated increased access to behavioral health treatment through use of the integrated/collaborative care model and improved mental health outcomes. Recommendations for screening and treatment are provided. Limitations of the reviewed studies include lack of generalizability to urban populations, minority youth, and youth younger than 4 years of age. Practice recommendations to address these limitations are identified.
精神疾病在儿科初级保健机构中的诊断越来越频繁。尽管初级保健中的诊断有所增加，但只有少数患者接受进一步的精神科或专科护理。综合/协作护理治疗模式旨在改善初级保健中的就诊机会。本综述的目的是确定随机对照试验和准实验研究，这些研究调查了增加就诊机会是否能改善治疗参与度、满意度和心理健康结果。六项研究符合纳入标准。所审查的研究表明，通过使用综合/协作护理模式增加了行为健康治疗的就诊机会，并改善了心理健康结果。提供了筛查和治疗建议。所审查研究的局限性包括缺乏对城市人口、少数族裔青年和4岁以下青年的普遍性。确定了解决这些局限性的实践建议。
