Resource Link: 10 years community-based experience in integrating mental health services into health care for children

Resource Link, first presented at APHA in 2004, developed to integrate mental health training, psychiatric consultation and care coordination into a centralized infrastructure for identification, early intervention and treatment of pediatric mental illness. An external centralized hub provides coordinated systems of care (e.g., screening, mental health training, care coordination for families, telephone/in-person psychiatric consultation, and increased collaborative associations among mental health professions/physicians).  Patient, parent and physician surveys, mailed at case closing, gather information about service satisfaction and perceptions of patient improvement.  Over 9 years, the program has served more than 4000 children (60-70 referrals/month). Outcome evaluations showed positive behavior changes and symptom reduction for most patients (80%-93% of PCP assessments indicated improvement across 5 measures). Most (97%) parents were "very satisfied/satisfied" with services. Physicians reported that use of Resource Link changed the way they cared for index patients and other patients. This model successfully addresses key deficits in mental health services for children. By training (through academic detailing), a more effective team approach to screening and identification of mental health needs is possible, leading to earlier diagnosis and more efficacious treatment.  Psychiatric phone consultations make best use of a scarce resource--the child and adolescent psychiatrist—while providing individualized mentoring opportunities to PCPs using case-based examples preparing them for their expanding role as major providers of mental health services.  Care coordination addresses patient/family and system level barriers and links families to appropriate local mental health services and provides support to ensure patients engage/adhere to treatment recommendations.