Massachusetts Child Psychiatry Access Project

1. Massachusetts Child Psychiatry Access Project John H. Straus, MD Massachusetts Behavioral Health Partnership Michael Yogman, M.D. Susan Betjemann, LICSW Yogman Pediatric Associates

2. MCPAP Vision • 2003 - Address shortage of child psychiatrists by increasing ability of primary care providers to manage and prescribe for less complex youth with behavioral health issues while helping to find resources for more complex youth. • 2014 – Support the integration of behavioral health into the patient centered medical home, especially when clinician co-located

3. 6 MCPAP “HUBS” Mass General Hospital Lauren Hart, MPH Leah Grant, MSW LICSW Jeff Bostic, MD EdD Betty Wang, MD Elizabeth Pinsky, MD Paul Hammerness, MD UMass Memorial Med Ctr Kelly Chabot Deanna Pedro, LICSW Danette Mucaria, LICSW Mary Jeffers-Terry, CNS MatthieuBermingham, MD William O’Brien, MSW Northshore Children’s Hospital Brianna Roy Tracey Terrazzano, LICSW Jennifer McAdoo, LMHC Jefferson Prince, MD Lisa D’Silva, MD Michele Reardon, MD Joseph DiPietro, PsyD * * Tufts Med Ctr Children’s Hospital Boston Rachael Roy Gorton Alexis Hinchey Davis, LICSW Sigalit Hoffman, MD Neha Sharma, DO Eric Goepfert MD Mimi Thein, MD Lauren Mckenna * * Baystate Med Ctr Arlyn Perez Jodi Devine, LICSW Barry Sarvet, MD Bruce Waslick, MD ShadiZaghloul, MD Sara Brewer, MD John Fanton, MD Marjorie Williams-Kohl, CNS * * * * * * * McLean Hospital/Brockton Amanda Carveiro Carla Fink, MSSA LICSW Charles Moore, MD Tracy Mullare MD Mark Picciotto, PhD *

4. MCPAP Services • Telephonic child psychiatry consultation to PCPs within 30 minutes, Monday thru Friday. Last quarter response time met target for 89% of consultations. • Face to face consultations (18% of youth served) • Care Coordination • Transitional support when youth waiting for behavioral health services • PCP education - newsletter, practice meetings, website, CME

5. MCPAP Program Overview • Begun in 2005 • Supported by state funds through the Department of Mental Health • All youth covered regardless of insurance • 438 practices with 2,991 individual clinicians • Over 98% of Commonwealth’s youth covered • 20,641 encounters, 10,553 youth served in FY2013 • Prescriber level care remains with PCP 70% of time.

6. MCPAP Expanding Services • Perinatal/postpartum depression screening and management. • Improved screening and management of teen substance use. • Creating the availability of the evidence based practice, Triple P, that supports parent training for disruptive behavior in children under 6 by training behavioral health clinicians, especially those co-located with PCPs.

7. Outcome 65% Medical Follow Up with PCPs

8. An idea that has caught on…. • Alaska • Arkansas • California • Colorado • Connecticut • Delaware • Florida • Illinois • Iowa • Louisiana • Maine • Maryland • Massachusetts • Michigan • Minnesota • Missouri • Texas • Vermont • Virginia • Washington • Washington DC • Wyoming • Wisconsin • Nebraska • New Hampshire • New Jersey • New York • North Carolina • Ohio • Oregon • Pennsylvania NNCPAP.org

9. MCPAP Supporting Integration • Michael Yogman, Primary Care Pediatrician • Susan Betjemann, Co-located social worker

10. Questions? More information: MCPAP.org. Improving Access to Mental Health Care for Children: The Massachusetts Child Psychiatry Access Project. Sarvet et al. Pediatrics, December 2010.