Carson Melissa C, Montaño Zorash, Kelman Alex R, Coffey Dean M, Javier Joyce R
University of Southern California.
Children's Hospital Los Angeles, Los Angeles, California.
Transl Issues Psychol Sci. 2019 Dec;5(4):390-401. doi: 10.1037/tps0000212.
Mental health disparities continue to be a concern for racial and ethnic minorities in the United States. Further, approximately 20% of children in the United States have a mental health disorder with less than half of these youth receiving mental health treatment (Polanczyk, Salum, Sugaya, Caye, & Rohde, 2015; Stancin & Perrin, 2014; U.S. Surgeon General, 1999). Integrated primary care has been identified as an ideal place where youth and families can receive mental health services. There is evidence supporting that when psychologists are in primary care, behavioral health outcomes improve and the costs per patient are reduced (Chiles, Lambert, & Hatch, 1999). The objective of this paper is to describe the steps taken to colocate The Incredible Years Parenting Program (IY; Webster-Stratton & Reid, 2010) an evidence-based parenting group, in a pediatric primary care setting at a major metropolitan children's hospital. The parenting group was delivered as a prevention and early intervention program for an underserved population, specifically focused on parents of children ages 3-6 years, to reduce health disparities and improve access to needed behavioral health care. A case study illustrates the potential benefits to mental health and physical health outcomes through colocation, and ultimately integration, of behavioral health services in primary care. Policy implications for sustainability of group parenting interventions in primary care, the impact on decreasing health disparities, and future directions along this line of research are discussed.
心理健康差距仍然是美国种族和少数族裔群体所关注的问题。此外,美国约20%的儿童患有心理健康障碍,但接受心理健康治疗的青少年不到半数(波兰奇克、萨卢姆、杉谷、凯伊和罗德,2015年;斯坦辛和佩林,2014年;美国卫生局局长,1999年)。综合初级保健已被视为青少年及其家庭能够获得心理健康服务的理想场所。有证据表明,当心理学家参与初级保健时,行为健康结果会得到改善,每位患者的费用也会降低(奇利斯、兰伯特和哈奇,1999年)。本文的目的是描述在一家大型都市儿童医院的儿科初级保健机构中,如何将循证育儿小组项目“不可思议的岁月育儿项目”(IY;韦伯斯特-斯特拉顿和里德,2010年)安排在同一地点。该育儿小组作为一项针对服务不足人群的预防和早期干预项目开展,特别针对3至6岁儿童的父母,以减少健康差距并改善获得所需行为健康护理的机会。一项案例研究说明了通过在初级保健中安排并最终整合行为健康服务,对心理健康和身体健康结果可能带来的益处。本文还讨论了初级保健中集体育儿干预措施可持续性的政策影响、对减少健康差距的影响以及这一研究方向的未来发展。