As mental health concerns skyrocket among children and teens, pediatricians say there’s a shortage of available pediatric psychiatrists – which means delays in finding the right medication and treatment.
“Any friction is going to be an obstacle to seeking help,” said Dr. Scott Moore of Green Tree Pediatrics. “It takes a lot of time, energy and effort to get in front of a pediatric psychiatrist.”
A growing number of pediatric primary care practices in Michigan are flipping the script on behavioral health care for patients by adopting a new collaborative treatment model backed and supported by Blue Cross Blue Shield of Michigan.
The Behavioral Health Collaborative Care Model provides a team structure in the primary care practice that includes psychiatric consultants and dedicated care managers to support primary care physicians. It means patients seeing their primary care doctor may not need to be referred to an outside specialist for help with behavioral health concerns, like finding the right medication to manage their anxiety or depression. The model is twice as effective in treating depression in adults when compared to more traditional care – and now it’s being expanded to pediatric practices.
Dr. Jeffrey VanGelderen of Children's Medical Group of Saginaw Bay said the Behavioral Health Collaborative Care Model allows the children and teens he treats faster access to the medication and treatment they need to manage conditions like anxiety and depression.
“They’re getting everything they need right out of our office,” VanGelderen said of his pediatric patients. “They’re getting treated quicker, and they’re getting their questions answered.”
Previously, some pediatric patients would have been referred out of VanGelderen’s office to a pediatric psychiatrist to manage their medication and treatment plan – a common process that could take several months and prolong issues.
Now, care managers on staff at VanGelderen’s office reach out directly to the families of pediatric patients to ensure the medications are working, questions are answered and any needed therapy is secured.
Dr. Moore has been using the Collaborative Care Model at Green Tree Pediatrics locations in Ann Arbor and Chelsea since July 2021.
“It’s proving itself to be a good solution for patients with anxiety and depression,” Moore said. “Access to care is really challenging for psychiatry. I think it’s a good model to help with that issue, and potentially a model that could be used in other diseases as well.”
The in-house team approach that the Collaborative Care Model provides is the biggest benefit Moore sees. Now, Moore can rely on the expertise of the care managers and psychiatrist on staff at the practices to help develop a treatment plan – especially when it comes to finding the right medication for a pediatric patient.
Primary care providers prescribe 75% of the antidepressants in the U.S. Moore said the relationship between patients and providers at a primary care practice can help ease the conversation around mental health treatment.
“When you have that relationship already with a provider, it makes for an easier conversation no matter what the medical issue is,” Moore said.
Dr. William Beecroft, medical director of behavioral health at Blue Cross, said the adoption of the Collaborative Care Model for Behavioral Health by pediatric practices in Michigan is coming at just the right time. Requests for mental health services for children are flooding mental health agencies in the state, outpacing requests for adults.
As stress and isolation issues continue to linger from the pandemic, children, teens and young adults are engaged in social media where feedback can be “instant, negative and overwhelming,” Beecroft said.
Beecroft is encouraged by the power of the Collaborative Care Model to transform the function of primary care practices by expanding access to behavioral health services.
“Providers are seeing results. They feel empowered going to work,” Beecroft said.
Blue Cross has aided in accelerating the adoption of this new model of care due in part to the incentives it offers to practices. In 2019, 25 practices were using the model in the state. Thanks to training efforts and ongoing setup support, 180 practices are now using the model in Michigan, including 20 involved in pediatric care.
As a result of this work, Blue Cross has been recognized nationally as a leader in integrating behavioral health treatment into a primary care setting. Beecroft is sharing the results of the program with experts in health care across the country in the hopes that it can be duplicated in other states through other health plans.
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