Integrating behavioral health services in pediatric primary care could reduce psychosocial symptoms

Research led by the Transforming and Expanding Access to Mental Health Care Universally in Pediatrics (TEAM UP) Scaling and Sustainability Center of Boston Medical Center (BMC) finds that children who receive behavioral health services delivered through the TEAM UP Model of integrated behavioral health care have fewer behavioral health symptoms.

The findings, published in JAMA Network Open, offer new hope for addressing the children’s mental health crisis.

“Several prior studies demonstrate that TEAM UP improves access to behavioral services for kids seen in pediatrics. This study takes the next step: we demonstrated that when they use TEAM UP’s behavioral health services, kids and their parents or caregivers report fewer symptoms over time,” says R. Christopher Sheldrick, Ph.D., research and evaluation co-director of TEAM UP at BMC and senior author of this study.

TEAM UP equips primary care practices to integrate behavioral health care to ensure all children and youth have access to services using a team-based approach.

Co-developed with pediatric practices, the model includes a fully integrated multidisciplinary care team—behavioral health clinicians, community health workers, and primary care providers—to promote healthy development and ensure early identification of behavioral health issues.

Led by Jihye Kim, Ph.D., the observational study included 942 children aged 4 to 18 with an identified behavioral health concern at four Massachusetts federally qualified health centers that implemented the TEAM UP model.

The team measured children’s behavioral health symptoms before and after they received behavioral health treatment—which included encounters with behavioral health clinicians or medications prescribed by their primary care providers —using the PSC-17, a common screening tool for psychosocial symptoms in pediatrics.

The researchers found that PSC-17 scores were lower after treatment, which suggests that behavioral health symptoms improved.

“TEAM UP practices see first-hand the success of integrating mental and physical health care in a single, convenient setting,” notes Megan Bair-Merritt, MD, MSCE, Chief Scientific Officer for BMC Health System and past director of TEAM UP’s research team.

“TEAM UP’s approach of fully integrating behavioral health care into pediatric primary care not only addresses challenges children face in accessing mental health services but also seems to provide significant symptom improvement.”

“It means that TEAM UP is better prepared to scale and to continue to enhance the rigor of its scientific evaluation.”

TEAM UP is currently expanding its services across Massachusetts and beyond. The Center recently launched a new cohort of practices that will implement the TEAM UP Model, expanding its reach to an additional 40,000 children across the state.

The Center is also working with local partners in New York City and Atlanta, Georgia, to begin to scale the model nationally.