Pediatric Mental Health Care Access - This proposal will sustain and expand a statewide Pediatric Mental Health Care Access (PMHCA) program that helps pediatric primary care clinicians better identify, assess, treat, and connect children and adolescents with behavioral health needs to appropriate care. Our state encompasses a large geographic footprint with two urban centers and both rural and frontier areas; all but a few urban zip codes in the state are HRSA mental health professional shortage areas. This proposal addresses major barriers to pediatric mental health access, including shortages of child and adolescent behavioral health specialists, long wait times for specialty services, geographic barriers, and difficulty navigating available treatment and community resources. The PMHCA program extends child psychiatry and behavioral health expertise to pediatric primary care settings through real-time psychiatric consultation, video consultation, care coordination, referral navigation, telehealth support, and provider education. This proposal includes program expansion to implement an asynchronous consultation pathway, designed to support primary care clinicians who are often the first point of contact for children and families experiencing mental health concerns. By helping clinicians manage common behavioral health conditions in the primary care setting, the program improves access while strengthening the pediatric behavioral health system. Since implementation, this program has served more than 1,500 youth and families, provided more than 3,100 psychiatric consultations, completed more than 670 video consultations, and delivered more than 15,500 care coordination encounters. Feedback from PMHCA utilizers is guiding our proposed expansion plan. Continued funding will support several key activities to strengthen and expand the program. The project will develop a secure, HIPAA-compliant asynchronous consultation pathway. It will also expand and evaluate a rapid-access behavioral health Bridge Clinic model to support children and adolescents who need timely assessment, short-term stabilization, treatment recommendations, and connection to ongoing care. In addition, the program will enhance a public-facing referral database to improve access to accurate, up-to-date information about behavioral health services and community resources. The project will continue workforce training through Project ECHO and related educational activities. These trainings will increase primary care clinicians’ knowledge, confidence, and comfort in addressing pediatric behavioral health concerns, including screening, diagnosis, treatment planning, medication management, referral decision-making, and care coordination. Training and consultation activities will be informed by clinician needs, program data, family and provider feedback, and ongoing quality improvement efforts. The PMHCA program will use program data, consultation records, care coordination outcomes, provider feedback, training evaluations, and referral linkage information to guide implementation and improvement. Evaluation activities will assess program reach, service utilization, provider engagement, consultation response time, care coordination completion, referral outcomes, provider-reported changes in knowledge and practice, and the impact of rapid-access services when applicable. Findings will be used to improve service delivery, identify gaps in access, strengthen partnerships, and support long-term sustainability. By expanding consultation, telehealth support, care coordination, referral navigation, rapid-access services, and provider education, this project will improve timely access to pediatric behavioral health expertise for children, adolescents, and families across the state. The project will strengthen the capacity of primary care clinicians, reduce barriers to care, improve linkage to services, and support a more coordinated and sustainable pediatric behavioral health system.
