Behavioral Health Integration in Pediatric Primary Care: Considerations and Opportunities for Policymakers, Planners, and Providers

Nearly one in seven children aged 2 to 8 years in the United States has a mental, behavioral, or develop­mental disorder. Among children and adolescents aged 9 to 17 years, as many as one in five may have a diagnosable psychiatric disorder. Yet not a single state in the country has an adequate supply of child psychiatrists, and 43 states are considered to have a severe shortage.

Models exist, however, for treating many of these children effectively in primary care settings that offer integrated, family-centered care.  In this Milbank-sponsored report, Elizabeth Tobin Tyler, JD, MA, of Brown University, and Rachel L. Hulkower, JD, MSPH, and Jennifer W. Kaminski, PhD, of the Centers for Disease Control and Prevention, explore the prevalence of childhood behavioral health problems; describe the need for, barriers to, and models of behavioral health integration (BHI) in pediatrics; and offer BHI policy and implementation considerations for policymakers, planners, and providers.

The report is intended for anyone interested in improving the welfare of children in the health care system. It is the latest of several reports on BHI published by the Milbank Memorial Fund. Other reports have covered BHI for adults and BHI for people with serious and persistent mental illness. All of these reports aim to help policymakers and providers who are looking for research-supported models of care that address these conditions.