Maryland Behavioral Health Integration Program in Primary Care (B-HIPP)
Nationally and in Maryland, there is a gap between the need for and availability of child mental health services. The gap is attributable to a number of factors, including a lack of trained specialists, geographic maldistribution of the existing workforce, variations in insurance coverage (or other means of financing services), and family concerns about the benefits and appropriateness of the services they can access. Of the many possible solutions to these problems, expansion of the child mental health capacity of primary care providers has been proposed as one of the most feasible and scalable solutions.
Primary care providers (PCPs) are widely distributed around the state; using primary care sites to deliver mental health services, or serve as gateways to services, offers increased possibilities for integrating mental health and somatic care. PCPs are often well known to families and offer the possibility of discussing sensitive issues in an accepting and non-stigmatizing setting.
Twenty-six states have now implemented programs to support an expanded role in child mental health for PCPs. Components of these programs include informal telephone consultation to providers, assistance with matching families with community and specialty resources, training for PCPs in various aspects of mental health diagnosis and treatment, and technical assistance with aspects of providing mental health care including help implementing screening, monitoring, and co-location of mental health personnel. Massachusetts has had a lead in developing this sort of program. Initial evaluations suggest that it has had good uptake by primary care providers and that, over time, the kinds of questions asked by providers have become more sophisticated, indicating a growing level of mental health expertise and a wider range of children served. For more information, visit the National Network of Child Psychiatry Access Programs website.