title: The Five S's: A Communication Tool for Child Psychiatric Access Projects.
abstract: Given the gap in child psychiatric services available to meet existing pediatric behavioral health needs, children and families are increasingly seeking behavioral health services from their primary care clinicians (PCCs). However, many pediatricians report not feeling adequately trained to meet these needs. As a result, child psychiatric access projects (CPAPs) are being developed around the country to support the integration of care for children. Despite the promise and success of these programs, there are barriers, including the challenge of effective communication between PCCs and child psychiatrists. Consultants from the Maryland CPAP, the Behavioral Health Integration in Pediatric Primary Care (BHIPP) project, have developed a framework called the Five S's. The Five S's are Safety, Specific Behaviors, Setting, Scary Things, and Screening/Services. It is a tool that can be used to help PCCs and child psychiatrists communicate and collaborate to formulate pediatric behavioral health cases for consultation or referral requests. Each of these components and its importance to the case consultation are described. Two case studies are presented that illustrate how the Five S's tool can be used in clinical consultation between PCC and child psychiatrist. We also describe the utility of the tool beyond its use in behavioral health consultation.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD; Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Joyce
authors.initials: J
authors.lastname: Harrison
authors.affiliation: Division of Child & Adolescent Psychiatry, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Kate
authors.initials: K
authors.lastname: Wasserman
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Janna
authors.initials: J
authors.lastname: Steinberg
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD; Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Rheanna
authors.initials: R
authors.lastname: Platt
authors.affiliation: Division of Child & Adolescent Psychiatry, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Kelly
authors.initials: K
authors.lastname: Coble
authors.affiliation: Department of Community/Public Health, Johns Hopkins University School of Nursing, Baltimore, MD.
authors.forename: Kelly
authors.initials: K
authors.lastname: Bower
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000628:therapy; D002662:Child Health Services / Q000458:organization & administration*; D003142:Communication; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D007400:Interprofessional Relations; D008605:Mental Health Services / Q000458:organization & administration*; D012017:Referral and Consultation / Q000458:organization & administration; D012449:Safety; D014481:United States