J Adolesc Health. 2020 Aug;67(2):302-306. doi: 10.1016/j.jadohealth.2020.05.016. Epub 2020 Jul 3.
Problems related to mood, substance use, anxiety, body image issues, post-traumatic stress, and suicidality are common in adolescence and become even more common in young adulthood. Integrated behavioral health (IBH) in primary care has shown great promise in identifying and treating adolescents and young adults who have these problems. Treatment outcomes in IBH settings outperform those in usual primary care settings where a primary care provider may identify behavioral health problems and refer youth to colocated or outside behavioral health specialists. Despite the success of IBH care systems, limited training opportunities and inadequate financial compensation for these services jeopardize the wide scale expansion and universal adoption of IBH. To optimize patient care, providers from all disciplines in adolescent primary care settings should have dedicated professional training in IBH. This should include incorporating IBH professional competencies into each discipline's formal training program and building interprofessional, multidisciplinary IBH training settings. Likewise, payers should work with primary care systems to create and implement reimbursement models for IBH services. Efforts to expand the footprint of IBH would pay off significantly by building more worldwide BH systems with increased efficacy at identifying and treating adolescents with BH conditions.
与情绪、物质使用、焦虑、身体形象问题、创伤后应激和自杀倾向相关的问题在青少年中很常见，在青年期更为普遍。初级保健中的综合行为健康（IBH）在识别和治疗有这些问题的青少年和青年方面显示出巨大的前景。IBH环境中的治疗效果优于普通初级保健环境，在普通初级保健环境中，初级保健提供者可能识别出行为健康问题，并将年轻人转介给同地或外部的行为健康专家。尽管IBH护理系统取得了成功，但这些服务的培训机会有限和经济补偿不足危及了IBH的大规模扩展和普遍采用。为了优化患者护理，青少年初级保健环境中所有学科的提供者都应该接受IBH方面的专业培训。这应该包括将IBH专业能力纳入每个学科的正规培训计划，并建立跨专业、多学科的IBH培训环境。同样，支付方应该与初级保健系统合作，创建并实施IBH服务的报销模式。通过建立更多在识别和治疗有行为健康状况的青少年方面更有效的全球行为健康系统，扩大IBH覆盖范围的努力将带来显著回报。
