title: The Scope of Behavioral Health Integration in a Pediatric Primary Care Setting.
abstract: The current study examines the scope of integrated behavioral health services provided by behavioral health clinicians in pediatric primary care.
  
  
  
  A cross-sectional electronic health record review was conducted to characterize integrated behavioral health services including consultation types, recommendations, and medical diagnoses. Services were provided over a 6-year period in an urban, residency-training clinic serving a primarily publicly insured population.
  
  
  
  Of the 4,440 patients seen by behavioral health clinicians (BHCs), 2,829 (63.7%) were seen during well-child checks to address a wide array of presenting problems. The five consultation types "Healthy Steps (6%), pregnancy-related depression (17.7%), developmental (19.2%), mental health (53.2%), and psychopharmacology (5%)" were characterized by differences in demographics, presenting problems, recommendations, and medical diagnoses.
  
  
  
  Pediatric BHCs provide a wide range of services to pediatric populations in the context of integrated behavioral health programs. Implications for workforce capacity development, evaluation of outcomes and impact, and sustainability are discussed.
authors.affiliation: Children's Hospital Colorado University of Colorado School of Medicine, Departments of Psychiatry and Pediatrics ayelet.talmi@ucdenver.edu.
authors.forename: Ayelet
authors.initials: A
authors.lastname: Talmi
authors.affiliation: Children's Hospital Colorado University of Colorado School of Medicine, Department of Psychiatry.
authors.forename: Emily F
authors.initials: EF
authors.lastname: Muther
authors.affiliation: Children's Hospital Colorado University of Colorado School of Medicine, Department of Psychiatry.
authors.forename: Kate
authors.initials: K
authors.lastname: Margolis
authors.affiliation: Children's Hospital Colorado University of Colorado School of Medicine, Department of Psychiatry.
authors.forename: Melissa
authors.initials: M
authors.lastname: Buchholz
authors.affiliation: Children's Hospital Colorado.
authors.forename: Ryan
authors.initials: R
authors.lastname: Asherin
authors.affiliation: Children's Hospital Colorado University of Colorado School of Medicine, Department of Pediatrics.
authors.forename: Maya
authors.initials: M
authors.lastname: Bunik
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D002675:Child, Preschool; D003120:Colorado; D003156:Community Mental Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration* / Q000706:statistics & numerical data; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data
keywords: health care services; health promotion and prevention; mental health; primary care; professional and training issues; psychosocial functioning