Pediatric Mental Health Care Access - Behavioral Health Integration in Pediatric Primary Care: Continuity of Care through Evaluation, Care Coordination, and Training (BHIPP CONNECT) will expand and enhance Maryland’s established statewide PMHCA program, providing telehealth psychological evaluations, post-crisis care coordination, multidisciplinary teleconsultation, provider training, and technical assistance to support the behavioral health needs of youth in rural and underserved areas and increase access to care. Problem: There is a well-documented gap between the need for and availability of pediatric behavioral health services, particularly in rural areas. In Maryland, there is a significant maldistribution of child psychiatrists: 19 of Maryland’s 24 counties have three or fewer, and nine have none. Maryland Behavioral Health Integration in Pediatric Primary Care (BHIPP) was established in 2012, with funding from the Maryland Department of Health, Behavioral Health Administration, to support pediatric primary care providers’ (PCPs) capacity to address their patients’ behavioral health concerns. This statewide initiative, which operates as a multi-university partnership co-led by University of Maryland, Baltimore (UMB) and Johns Hopkins University (JHU), has steadily expanded its training and service scope to meet the growing needs of PCPs, behavioral health providers, emergency medicine providers and the children and adolescents they serve. Goals & Objectives: We seek funding to expand BHIPP’s services for youth ages 0-21 and their providers to include: 1) telehealth psychological evaluations, 2) emergency department post-discharge care coordination (PDCC) to connect youth to care after visiting an ED for a mental health crisis, 3) teleconsultation to pediatric PCPs via a multidisciplinary team, 4) Project ECHO sessions for PCPs and psychiatric mental health nurse practitioners (PMHNPs), 5) a web-based mental health crisis training series for PCPs, behavioral health providers, and emergency medicine providers, 6) an intensive, trauma-informed child mental health curriculum for PCPs (BHIPP CAPES), and 7) technical assistance (TA) to pediatric primary care practices to strengthen their capacity to provide mental health care. In addition, we will expand the existing Project Advisory Committee (PAC) to ensure adequate representation from providers and families who are the target of the expanded services. Methodology: We will achieve project goals by building upon BHIPP’s existing infrastructure. We will continue to utilize the Project ECHO model for web-based longitudinal training. Existing needs assessment data and feedback from recent training offerings will inform ECHO sessions and mental health crisis trainings. We will build upon work done in the previous funding cycle and utilize coaching and a toolkit to provide TA to practices around integrating additional mental health services onsite. Previously piloted psychological evaluations and PD CC will be enhanced and expanded to better meet the needs of providers and families. BHIPP CAPES will be piloted and data will be analyzed and updated to finalize and disseminate the curriculum to PCPs across Maryland. Coordination: UMB will lead program implementation and provide clinical oversight, collaborating with JHU to deliver teleconsultation, training, outreach, technical assistance, and evaluation. The Maternal and Child Health Bureau (MCHB) will serve in an advisory capacity via an expanded Project Advisory Committee (PAC) and support partnerships with other collaborative efforts. Evaluation: Building on existing BHIPP infrastructure, program operation and practice transformation efforts, data collected from providers in target HPSA and MUAs will monitor implementation quality and the impacts of BHIPP CONNECT. Expected outcomes include increased provider confidence, improved clinical practices, and reduced reliance on emergency departments.
