Regional Teams Enhance Ability of Primary Care Clinicians Throughout Massachusetts to Serve Children and Adolescents With Mental Health Issues

Service Delivery Innovation Profile

Regional Teams Enhance Ability of Primary Care Clinicians Throughout Massachusetts to Serve Children and Adolescents With Mental Health Issues

Snapshot

Summary

With funding from the state government, the Massachusetts Child Psychiatry Access Project uses regional teams of mental health professionals to support pediatric primary care clinicians throughout the state in diagnosing and treating patients with mental health issues. The teams provide telephone consultations during visits and, as needed, follow-up, face-to-face consultations with patients. Based on these interactions, they provide recommendations to the physician on how to manage the patient's mental health issues going forward. If needed, the team assists in securing and coordinating additional specialized mental health services. The program has been broadly accepted by primary care clinicians and enhanced their ability to treat children and adolescents with mental health issues. Future studies will evaluate its cost-effectiveness.

Evidence Rating

Moderate: The evidence consists of pre- and post-implementation comparisons of participating clinicians' perceptions of their ability to meet the mental health needs of patients and to access consults in a timely manner. The evidence also includes data on the proportion of primary care practices using the program, clinician perceptions of program usefulness and willingness to continue monitoring patients' mental health problems, and anecdotal feedback from members of the regional teams.

Use By Other Organizations

Several other states are in various stages of adopting a similar model. Washington State's Partnership Access Line (or PALS) program supports clinicians in several counties in the eastern part of Washington. (Because Washington covers a broad geography—including many sparsely populated rural areas—this program relies heavily on telemedicine rather than face-to-face meetings.) Arkansas, Maine, Texas, Illinois, Iowa, Ohio, and New York have put in place similar programs on a limited basis. Connecticut is planning to implement a program modeled after Massachusetts beginning in January 2014. Stakeholders in Oregon and New Jersey are currently trying to secure funding for this type of initiative.

Information provided in June 2014 indicates that 28 other states have child psychiatry consultation programs, most modeled after Massachusetts. The National Network of Child Psychiatry Access Programs supports collaboration among these programs. The latest list of programs, including several other states working to create similar programs, is available at nncpap.org.

Date First Implemented

2005

July

Problem Addressed

Children and adolescents with mental health issues often face difficulties accessing appropriate treatment. Pediatric primary care providers frequently lack the time, expertise, and resources to identify and manage such conditions effectively on their own. Child and adolescent psychiatry providers can help, but often are in short supply.

  • Limited access to treatment: The majority of children with mental health conditions severe enough to impair their functioning do not receive any treatment for these conditions.,,,
  • Limited ability of primary care to help: Pediatric primary care providers are ideally suited to identify and address mental health issues in children and adolescents. Such problems present frequently in the primary care setting, and these physicians often have long-standing, trusting relationships with the children and their families. Consequently, they are in a position to recognize problems and assess needs before the illness can cause major comorbidities. However, these clinicians typically lack the training, time, and resources to perform these tasks on their own, and hence often feel unable to adequately manage children's mental health problems. As a result, many do not try to identify or address such issues during patient visits.
  • Shortage of specialists: Many geographic areas lack an adequate supply of specialists in adolescent and child psychiatry. As a result, pediatric primary care providers often have no place to seek consultation or refer their patients with mental illness, thus reinforcing the inclination not to spend time on these issues during time-pressed routine visits.

Patient Population

The program serves individuals up to age 21 with mental health issues being seen in the pediatric primary care setting, regardless of insurance status. In some cases, the program may serve older patients if a participating pediatric provider continues to care for that individual after he or she becomes an adult.

Description of the Innovative Activity

Regional teams of mental health professionals support pediatric primary care clinicians in diagnosing and treating patients with mental health issues. The teams provide telephone consultations during visits and, as needed, followup, face-to-face consultations with patients. Based on these interactions, they provide recommendations to the physician on how to manage the patient's mental health issues going forward. If needed, the team assists in securing and coordinating additional specialty mental health services. The program also sponsors periodic educational programs on managing mental health conditions. Key program elements include the following:

  • Regional teams to support providers: The program's developers divided the state of Massachusetts into six regions with roughly 250,000 youth each, with a team assigned to each region. As of December 2010, 401 practices participated in the program; these practices collectively serve 98 percent of Massachusetts youth. Each of the six teams includes several part-time child psychiatrists, a licensed child and family psychotherapist (psychologist or social worker), and a care coordinator; two teams also have an advanced practice registered nurse working under supervision in a role similar to a child psychiatrist. (See the Resources Used section for more details.)
  • Assessment and treatment support: The teams support primary care providers in diagnosing and treating children and adolescents who present with mental health issues. Physicians access the service by calling a hotline answered by the care coordinator of the team in that region. As of the end of 2010, the program typically handled 1,600 or more encounters with clinicians and/or patients a month. These calls can lead to any of a variety of services, as outlined below:
    • Telephone consultations: The initial consultation between the primary care clinician and the team occurs by phone while the patient is still in the primary care provider's office. The nature of the call varies depending on patient and clinician needs:
      • Referrals to community resources: The care coordinator typically handles cases in which the doctor needs a referral to local community mental health services; between mid-2005 and the end of 2008, roughly one-fourth (27 percent) of telephone consultations were for this purpose.
      • Clinical questions: If the physician has clinical questions, the care coordinator sends the call to the appropriate team member. Depending on physician preference and team member availability, the psychiatrist, advance practice nurse, or psychotherapist handles questions about family functioning, behavior management, crisis management, and/or treatment planning. The psychiatrist typically handles discussions about psychiatric medications and/or diagnostic questions; these issues accounted for roughly 60 percent of calls during the 3.5-year period outlined above. Consultations often lead to the provisional diagnosis of one or more mental health conditions. (Diagnoses not based on a face-to-face meeting cannot be considered definitive.) The most common diagnoses include attention-deficit/hyperactivity disorder (representing 32 percent of all diagnoses made during the 3.5-year period outlined above), depression (24 percent), and anxiety (23 percent). In rare instances, the consultations identify severe conditions, such as bipolar disorder or psychosis, that require immediate crisis services or hospitalization.5
      • As-needed specialty referrals: During most calls, the team supports the clinician in maintaining ongoing responsibility for management and treatment of the mental health condition(s). However, as necessary, the team member may recommend specialty services, such as outpatient therapy, specialized child psychiatry followup, crisis services, and/or acute inpatient treatment, with the care coordinator providing support in arranging them as necessary. (See care coordination bullet for more details.)
    • Face-to-face consultations: Approximately 26 percent of telephone consultations end with a recommendation for a face-to-face consultation between a team member—the child psychiatrist, advanced practice nurse, or psychotherapist/social worker—and the patient. These sessions typically take place for patients requiring further evaluation to determine how the pediatric primary care clinician should manage/treat their mental health issues going forward. More details on these sessions follow:
      • Scheduling and logistics: If possible, the appointment is scheduled during the initial call, typically within 2 weeks. The care coordinator keeps the primary care clinician informed of when it will take place. Patients travel to the team member for the appointment. In more heavily populated parts of the state (e.g., in and around Boston), required travel times generally do not exceed 30 minutes. In less densely populated areas, travel times can be much longer—as long as 90 minutes in sparsely populated western Massachusetts and as much as 2 hours in the southeast region of the state, which includes the islands of Nantucket and Martha's Vineyard.
      • Focused psychiatric evaluation: The 60-minute, inperson evaluations focus on mental health issues raised by the physician during the telephone consultation. The therapist first meets with both parent and child and then separately with just the child. The session generally concludes with the therapist outlining and explaining his or her impressions and recommendations for ongoing care by the primary care clinician, and then urging the patient/parent to make an appointment with that doctor for followup. The team member may recommend that the patient have his or her mental health issues managed by a specialist, in which case the care coordinator assists in arranging such services, as outlined in the care coordination bullet below. Although the therapist often will recommend psychotherapy, the primary care provider can provide ongoing medical management and needed medications roughly half the time.
      • Prompt feedback to physician: Within 48 hours of the session, the primary care clinician receives a consultation letter with detailed recommendations on appropriate treatment, along with information on best practices for the ongoing care of the patient's specific condition(s). Often these narrative recommendations provide decision support, outlining not only first-line treatments but also secondary recommendations if the initial treatment proves ineffective or suboptimal.
    • Care coordination: If the team recommends specialized mental health services during either the telephone or face-to-face consultation, the care coordinator supports the primary care clinician and, as needed, the patient's family in identifying, accessing, and coordinating these services, as outlined below:
      • Support to physician: As part of the telephone consultations described above, the team member will give advice on appropriate resources, intake procedures, insurance authorization, and other issues related to accessing needed mental health services.
      • Outreach support to families: As necessary, the psychiatrist or psychotherapist may refer the patient/family for an outreach call by the care coordinator at the conclusion of a telephone consult or face-to-face consultation. The care coordinator then calls to offer direct support in securing appointments for difficult-to-access services. The coordinator maintains close working relationships with intake coordinators at community mental health agencies and keeps up-to-date information on waiting times and clinician availability for specialized services in the region.
      • Interim therapy: If the wait for a needed service is unacceptably long, the psychotherapist may provide interim outpatient therapy until the service becomes available (although this tends to happen infrequently).
  • Ongoing education for primary care clinicians: The program offers ongoing education for primary care clinicians on child and adolescent mental health issues, as outlined below:
    • Consultation calls and letters: During the telephone consultations, team members educate the primary care clinicians through discussions of relevant research, best-practice guidelines, and interviewing/assessment methods. As noted above, the same approach is taken in the consultation letters following face-to-face sessions.
    • Web-based resources: The program provides Web-based educational resources, including a comprehensive public Web site with original content, an online blog, and links to vetted sources of clinical information, practice guidelines, patient and family handouts, and clinical rating scales.
    • Periodic conferences: The teams periodically organize regional half- and full-day conferences on children's mental health in primary care.

Context of the Innovation

The Massachusetts Child Psychiatry Access Project began in June 2005, when the Massachusetts legislature passed a budget that included funding for the program. This funding represented the culmination of advocacy work over a long period of time led by several broad-based coalitions of professional and consumer stakeholders working in collaboration with policy makers. These stakeholders—including educators/academicians, community representatives, local and state government agencies, legislators, pediatricians, child psychiatrists, school nurses, and insurance companies—came together to find solutions to serious problems in securing access to needed mental health services for Massachusetts youth. Program leaders modeled the initiative on several other successful pilot programs, including one at the University of Massachusetts Medical School. The goal was to create a system for effective collaboration between primary care and child psychiatry across the entire state.

Results

The program has been broadly accepted by primary care clinicians and enhanced their ability to treat children and adolescents with mental health issues. Future studies will evaluate its cost-effectiveness.

  • Broad acceptance and reach: In 2012, approximately 80 percent of the 421 primary care practices in Massachusetts use the program each quarter, with these practices collectively serving roughly 98 percent of children in the state. As of June 2013, over 10,000 youth have been served with over 20,000 total encounters.
  • Enhanced ability to handle mental health conditions: Multiple statistics point to the program's positive impact on the ability of pediatric primary care clinicians to provide ongoing care for children and adolescents with mental health issues:
    • Better able to meet needs: The percentage of clinicians who felt they could meet patients' mental health needs rose from 8 percent before implementation to 65 percent in 2010. Anecdotal reports from the regional teams suggest that primary care clinicians now ask much more sophisticated questions about their patient's mental health than they did at the start of the program, suggesting a possible increase in their knowledge.
    • Better access to specialized expertise: The percentage of primary care clinicians able to consult with a child psychiatrist in a timely manner jumped from 8 to 80 percent over the time period outlined above. The percentage feeling that their patients had adequate access to child psychiatry jumped from 5 to 30 percent. In addition, pediatric primary care clinicians have shown a strong willingness to participate in the recently enacted Massachusetts screening program for pediatric mental health; program leaders believe this enthusiasm stems from these doctors now knowing how to help patients who screen positive. (Before the launch of this program, these clinicians complained about not having any way to help these patients, thus making them less willing to screen for problems.)
    • High satisfaction: Roughly 90 percent of participating clinicians found the consultations with the regional teams to be useful. Program developers believe that these high levels of satisfaction stem from the program's quick response to requests for assistance (usually in less than 30 minutes) and close mentoring with primary care physicians.
  • Often willing to take ongoing responsibility: Roughly one-fourth of initial telephone encounters resulted in the primary care clinician serving as the clinician with primary responsibility for caring for the patient's mental health issues going forward. After the telephone and (if necessary) face-to-face encounters, primary care clinicians agreed to monitor, coordinate, and generally be involved in the mental health care of roughly 50 percent of patients, with some doing so in collaboration with other nonprescribing mental health specialists (e.g., psychologists, social workers).
  • Unknown impact on overall healthcare costs : Future studies will evaluate the program's impact on use of inpatient and other acute psychiatric treatment, with the goal of determining if program-generated savings from reduced use of such services outweigh program expenses. Other potential cost-savings benefits, including the program's ability to improve school and job performance and/or reduce substance abuse, chronic medical problems, and other healthcare utilization, may also be studied in the future.

    Evidence Rating

    Moderate: The evidence consists of pre- and post-implementation comparisons of participating clinicians' perceptions of their ability to meet the mental health needs of patients and to access consults in a timely manner. The evidence also includes data on the proportion of primary care practices using the program, clinician perceptions of program usefulness and willingness to continue monitoring patients' mental health problems, and anecdotal feedback from members of the regional teams.

    Planning and Development Process

    Key steps included the following:

    • Forming teams: Six academic medical centers (Baystate Medical Center, McLean Hospital, Massachusetts General Hospital, North Shore Medical Center, Tufts Medical Center and Children's Hospital Boston, and the University of Massachusetts Medical Center) agreed to provide staffing for the teams, with each center taking responsibility for a specific region of the state.
    • Building relations with primary care clinicians: Each team received a list of all primary care practices serving children and adolescents in their region, including pediatricians, family practice physicians, and nurse practitioners. A representative from each discipline on the team (child psychiatrist, psychotherapist, and care coordinator) conducted onsite orientation sessions at each practice, where they met with all clinicians (and sometimes support staff) to introduce and orient them to the program. Both parties discussed their mutual expectations for the program (e.g., the team's expectation that primary care clinicians will maintain involvement in their patients' mental health followup). During the sessions, physicians often brought up individual cases, with the team then performing de facto consultations with clinicians on these patients, thus demonstrating the program's potential value. Team members stressed that the program would not substitute for a crisis team or represent a general referral line, but rather would serve as a consultation service to help them better manage their patients' mental health conditions.
    • Enrolling and orienting practices: For those practices interested in participating, the aforementioned meeting concluded with the forging of a formal agreement. Shortly after the meeting, the practice leader completed and returned a formal enrollment document.

    Resources Used and Skills Needed

    • Staffing: The 6 teams collectively have 18 full-time equivalent (FTE) staff. Each has a full-time psychotherapist or social worker and a full-time care coordinator, along with three to five part-time clinical psychiatrists who share program-related duties and together constitute a single FTE position. (Two teams have a part-time advanced practice registered nurse who performs similar duties as the psychiatrist.) Psychiatrists tend to be faculty members at the sponsoring academic medical center in the region. Collectively, the teams are available during normal business hours Monday to Friday. Two medical directors oversee the overall initiative on a part-time basis, one at the program level and one at the state level.
    • Costs: Total annual program costs, including administrative expenses, are approximately $3.2 million, and will allow all teams to respond Monday through Friday. Previously, budget pressures caused the program to reduce its budget by roughly 20 percent (from $3 million annually), which created some time periods during the week when the teams are not available.

    Funding Sources

    The Commonwealth of Massachusetts Department of Mental Health funds the program, reimbursing the six academic medical centers for the direct and indirect operational expenses of the teams according to the terms of contracts signed with the centers. Massachusetts Medicaid's behavioral health vendor, the Massachusetts Behavioral Health Partnership, administers the program. After several years of a 20-percent reduction in funding because of the recession, the Massachusetts legislature has restored the program to full funding by requiring the commercial insurers to fund their share of the program costs (60 percent based on encounters). (Updated June 2014.)

    Tools and Resources

    More information on the program can be found at http://mcpap.com/.

    For additional information on similar programs, please visit the National Network of Child Psychiatry Access Programs at nncpap.org.

    Getting Started with This Innovation

    • Generate awareness of problem: Major stakeholders may not be aware of the problem that children face in accessing mental health services, especially psychiatry. Consequently, those interested in addressing this problem need to broadly share data documenting the problem, such as number of children with mental health problems and the shortage of qualified individuals to diagnose and treat them.
    • Form broad-based coalition to lobby for funding: Once awareness has been generated, recruit stakeholders to participate in a broad-based coalition to lobby for funding. As noted, the Massachusetts program came into existence only after several years of effort by a coalition that included representatives from many different stakeholder groups. This group made the case for funding program services (which are not generally covered by third-party insurance) to the State legislature. In the absence of (or in addition to) state funding, would-be adopters can consider approaching foundations, insurance companies, local governments, and/or other potential funding sources.
    • Identify charismatic, effective leader: A charismatic, persistent, and highly respected individual led the Massachusetts coalition. His talent for bringing and keeping stakeholders together at the negotiating table proved to be quite valuable in getting the program up and running.

    Sustaining This Innovation

    • Set and monitor team goals: To keep program costs under control, set productivity goals for each team (e.g., monthly encounters) and monitor and regularly share data with the teams on their performance versus these goals.
    • Track and share outcomes data: Funders may not continue to support the program in the absence of hard data showing that it works. To that end, collect and analyze relevant data on the program's impact. To the extent possible, this evaluation should cover not only the impact on primary care clinicians' ability to provide or secure appropriate mental health services for patients, but also the long-term impact on patients' mental health, overall health status, academic performance, health care utilization and costs, and/or other relevant metrics.
    • Consider use of telemedicine: As noted, travel times for face-to-face sessions can be quite long and may represent a barrier for some families. Telemedicine can potentially reduce these costs and improve the efficiency and productivity of the mental health teams. Massachusetts program leaders are considering introducing telemedicine to cover patients in more remote regions of the state.
    • Conduct regular outreach to encourage continued use: Participating practices need to be reminded about the program, as high turnover and competing priorities may reduce use of the program by clinicians over time. For example, the Massachusetts program sends out regular e-mail reminders and newsletters highlighting program-related changes and updates. Program leaders also call the medical directors of practices that have not used the program recently to address any questions or concerns they may have. They also occasionally provide “reorientation” sessions at practices that have brought on many new clinicians.
    • Remind clinicians about purpose of program: As part of outreach efforts, remind participating clinicians about the program's intended purpose, so as to ensure they use it appropriately. Although the Massachusetts program has generally not experienced widespread problems, some resource-constrained practices frequently request care coordination/referral support for children without special mental health needs. In these instances, program leaders need to remind the clinicians that care coordination is meant to serve only patients who need, and face barriers to accessing, specialty mental health services.

    Use By Other Organizations

    Several other states are in various stages of adopting a similar model. Washington State's Partnership Access Line (or PALS) program supports clinicians in several counties in the eastern part of Washington. (Because Washington covers a broad geography—including many sparsely populated rural areas—this program relies heavily on telemedicine rather than face-to-face meetings.) Arkansas, Maine, Texas, Illinois, Iowa, Ohio, and New York have put in place similar programs on a limited basis. Connecticut is planning to implement a program modeled after Massachusetts beginning in January 2014. Stakeholders in Oregon and New Jersey are currently trying to secure funding for this type of initiative.

    Information provided in June 2014 indicates that 28 other states have child psychiatry consultation programs, most modeled after Massachusetts. The National Network of Child Psychiatry Access Programs supports collaboration among these programs. The latest list of programs, including several other states working to create similar programs, is available at nncpap.org.


    Contact the Innovator

    Note: Innovator contact information is no longer being updated and may not be current.

    Barry Sarvet, MD Division of Child
    and Adolescent Psychiatry
    Baystate Medical Center
    3300 Main St., 4th Floor
    Springfield, MA 01199
    E-mail: barry.sarvet@baystatehealth.org

    John H. Straus, MD
    Massachusetts Behavioral Health Partnership
    1000 Washington Street, Suite 310
    Boston, MA 02118
    E-mail: john.straus@valueoptions.com



    Innovator Disclosures

    Dr. Sarvet and Dr. Straus reported having no financial interests or business/professional affiliations relevant to the work described in this profile other than the funders listed in the Funding Sources section.

    References/Related Articles

    Sarvet B, Gold J, Bostic JQ. Improving access to mental health care for children: the Massachusetts Child Psychiatry Access Project. Pediatrics. 2010;126(6):1191-2002. Published Online November 8, 2010. [PubMed]

    Footnotes

    1. US Public Health Service. Report of the Surgeon General's Conference on Children's Mental Health: A National Action Agenda. Washington, DC: Department of Health and Human Services; 2000.

    2. Kataoka S, Zhang L, Wells K. Unmet need for mental health care among U.S. children: variation by ethnicity and insurance status. Am J Psychiatry. 2002;159(9):1548-55. [PubMed]

    3. Burns BJ, Costello EJ, Angold A, et al. Children's mental health service use acr oss service sectors. Health Aff (Millwood). 1995;14(3):147–159. [PubMed]

    4. Owens PL, Hoagwood K, Horwitz SM, et al. Barriers to children's mental health services. J Am Acad Child Adolesc Psychiatry. 2002;41(6):731–738. [PubMed]

    5. Sarvet B, Gold J, Bostic JQ. Improving access to mental health care for children: the Massachusetts Child Psychiatry Access Project. Pediatrics. 2010;126(6):1191-2002. Published Online November 8, 2010. [PubMed]

    6. Thomas CR, Holzer CE III. The continuing shortage of child and adolescent psychiatrists. J Am Acad Child Adolesc Psychiatry. 2006;45(9):1023–1031. [PubMed]

    Funding Sources

    Massachusetts Department of Mental Health

    Developers

    Massachusetts Department of Mental Health

    Comments

    By Gary Rosenberg MD on
    The MCPAP is a truly remarkable and effective program that addresses the shortage of child psychiatrists and the reality that most children and adolescents with mental health problems receive treatment from their primary care physician. Primary care physician offices are the de facto child mental health system in the US. This model needs to be replicated in every state in the country. Both the Academy of Pediatrics and Family Practice support the need to integrate mental health and primary care services. In New Jersey the collaborative task force is now actively working with State agencies and insurance providers to develop a program within a very difficult financial climate

    By Sandra Fritsch, MD on
    Sustainability across the nation is essential for services such as the MCPAP. The value and need for these services must be understood by payors, policy makers, and employers. The shortage of child and adolescent psychiatrists is not a problem that is easing and families are suffering. Our colleagues in primary care are suffering with limitations to their time and expertise.

    By Lauren Agoratus on
    Thank you for the opportunity to comment on the AHRQ Innovation Profile "Regional Teams Enhance Ability of Primary Care Clinicians throughout Massachusetts to Serve Children and Adolescents With Mental Health Issues." Family Voices is a national network that advocates on behalf of children with special healthcare needs and works to "keep families at the center of children's healthcare." Our NJ State Affiliate is housed at the Statewide Parent Advocacy Network (SPAN), NJ's federally designated Parent Training and Information Center, Family-to-Family Health Information Center, and chapter of the Federation of Families for Children's Mental Health. The Family Voices Coordinator also serves as a board member of the local chapter of the National Alliance on Mental Illness. Under Summary, we support the telephone consultation (including telemedicine) model with face-to-face appointments as needed. Regarding Problem Addressed, we agree that "child psychiatry providers …often in short supply". We also agree that "the majority of children …do not receive treatment". We support the use of PCPs (primary care providers) who have established relationships with families but agree they may "lack the training, time, and resources …" Thus, we agree that this is a significant problem that requires innovative approaches to address. Under Description of the Innovative Activity, we agree that the use of regional teams as supports to providers is an innovative approach to addressing the identified need. It is very efficient to have the telephone consult and set appointments while the patient is in the PCP's office. We agree that having a care coordinator who can make referrals to community resources, support the provider, and refer to interim services if needed, is an important component of the model. We like the flexibility of having "the psychiatrist, advance practice nurse, or psychotherapist handles questions about family functioning, behavior management, crisis management, and/or treatment planning" as well as the idea that the "team member may recommend special services." We agree that 48 hour feedback to the physician is timely and appropriate, except when exigent circumstances require an earlier feedback loop. We appreciate the model's flexibility of ongoing PCP education which included consultation (either by phone or in writing), web-based learning, and conferences. Regarding Results, we were pleased to see 70% of PCPs using the program, jumps from 8-65% on feeling they could meet mental health needs, and increases from 8-80% being able to consult with a child psychiatrist in a timely manner. Most notable was the statement that "Before the launch of this program, these clinicians complained about not having any way to help these patients, thus making them less willing to screen for problems." Research indicates early intervention is not only cost-effective, but key to best outcomes, and screening is the first component of timely early intervention. We appreciated the details on set up (regional teams, outreach), implementation (staffing needs), funding (sources), and outcomes (data tracking) and are part of a collaborative effort to pilot a similar program in our state, New Jersey.

    By Catherine Francis, MPP on
    MCPAP is the gold standard for psychiatric consultation programs throughout the nation. Based on the well documented shortage of child mental health specialist and the large numbers of children with a diagnosable mental illness that are not receiving treatment, many states have turned to primary care for help. MCPAPs innovation is not just that they were one of the first with a psychiatric consultation program, but that there model is so effective at reaching PCCs. Illinois is moving towards a more regional model to develop more relationships with PCCs outside of Chicago and the surrounding counties. Illinois DocAssist is modeling its expansion after MCPAP.

    By Irene Tanzman on
    You may find the results of the 2011 ( July 1, 2010 through June 30, 2011) MCPAP satisfaction survey at www.mcpap.com or download directly at http://www.mcpap.com/pdf/MCPAPSurveyAnalysisFY11.pdf

    By Kitty O'Hare, MD on
    My community health center is grateful for all the support we receive from MCPAP. This is a wonderful program.

    By Susanna (Xana) Locke, LCSW on
    MCPAP is a necessary and invaluable service to children, adolescents, and their families. As a social worker and medical home care coordinator in a pediatric primary care office, I am aware of how often families come straight to the primary care office for help/advice for both acute and chronic mental health issues. These are almost always complex, multifaceted situations that require thoughtful consultation. MCPAP gracefully partners with the clinicians in our office to address the needs of the whole person (and family) so that we can provide the best quality healthcare possible. MCPAP is huge support to our clinicians and families.

    By Darlene Vittori-Marsell on
    MCPAP is an irreplaceable program that helps those of us in primary care safely and effectively deal with mental illness amoung our young patients. It is an invaluable necessity and resource. Those prgram is staffed with amazing and caring professionals who have been and continue to be helpful guides, screeners, evaluators and supports to patients, families and primary care providersThank you!Darlene Vittori-Marsell PediatricNurse Practitioner

    By Bella Montgomery, NP on
    MCPAP set the example of an organization that not only created a sucessful program, but is always willing to share information with any program wanting to establish a similar program with the goal of moving our healthcare into a 21st century of innovation and cooperation.

    By Julianne Nemes Walsh, MS, PNP-BC, Nurse Practitioner on
    MCPAP has been a remarkable and invaluable service to all pediatric primary care providers who need immediate access to mental health consults and care for their patients. On multiple occasions I have managed complicated mental health patients with the assistance of MCPAP. These patients may have had unfortunate outcomes if the care they received was not so readily available to the via MCPAP. Patients and families alike have all provided positive feedback to me regarding the comprehensive, timely, and compassionate care they received through MCPAP. Thank You!

    By Matthew Tirelli, RN on
    MCPAP is a pioneering innovation that helps bridge the gap between primary care and psychiatry, bringing the fields closer together and ensuring comprehensive and effective care for the children of Massachusetts with mental health needs.
    Original Publication: 04/27/11

    Original publication indicates the date the profile was first posted to the Innovations Exchange.

    Last Updated: 07/02/14

    Last updated indicates the date the most recent changes to the profile were posted to the Innovations Exchange.

    Date verified by innovator: 06/10/14

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