Funded Projects

Problem:

PCPs provide half of all mental health treatment; yet PCPs frequently feel uncomfortable identifying and treating such concerns. CNMC COR provides an educational forum for pediatricians and psychiatrists to discuss mental health concerns, thus facilitating improved care of youth with mental illness.

Goals and Objectives:

Goal 1: The goal is to establish a collaborative office rounds (COR) for a group of community pediatricians, including pediatric residents, run by a child psychiatrist and a pediatrician. Objective 1: To provide an educational forum in which pediatricians and psychiatrists can discuss emotional and behavioral health problems which commonly present in primary care settings. Objective 2: To discuss common mental health concerns in a case-based format in order to increase pediatricians knowledge and understanding of such concerns. Annual assessment of knowledge to be given. Objective 3: To determine whether education of mental health concerns in a primary care setting effects behavior of pediatricians in clinical practice. Goal to be examined on a yearly basis. Goal 2: Improve primary care pediatricians' knowledge and skills to achieve the proposed mental health competencies. Objective 1: To increase pediatricians' ability to screen for common mental health concerns. Objective 2: To increase pediatricians' ability to treat common pediatric mental health concerns, including initial treatment. Objective 3: Appropriately prescribe medication for the treatment of common pediatric mental health problems. Goal 3: Increase PCPs' ability to describe how variations in family culture impact the effective approach to diagnosis and treatment of mental health concerns. Objective 1: Describe how variations in family culture impact the effective approach to diagnosis and treatment of mental health concerns; Objective 2: Elicit key historical data from patients and family members in a culturally and linguistically competent manner to permit correct diagnosis of common pediatric mental health problems; Objective 3: To improve pediatricians' ability to provide key resources for mental health concerns to patients and their families. Goal 4: To improve PCPs' ability to communicate with patients about mental health concerns. Objective 1: Clearly communicate the diagnosis of a mental health disorder to the patient and family members in a culturally and linguistically competent manner. Objective 2: Discuss treatment options with patients and families for common pediatric mental health problems in a culturally and linguistically competent manner. Objective 3: Identify early signs and symptoms of disturbances that require specialized mental health care from those of transient emotional disorders anticipated at stages of normal life cycle development. Goal 5: Increase PCPs' ability to effectively provide collaborative ongoing care of pediatric patients with a child psychiatrist. Objective 1: To improve communication between pediatricians and psychiatrists to ultimately provide better care for these patients. Objective 2: Refer appropriately to local community-based programs based upon knowledge of the strengths and limitations of local resources designed to help children and families cope with mental health problems.

Methodology:

The main teaching venue will be collaborative case-based discussion held at the primary care pediatric practice site. A minimum of fifteen meetings will take place during the academic year. Participants will be responsible for presenting real cases (concrete experiences) on a rotating basis that are illustrative of core curricular content and that arise in the course of their primary care practice. The pediatrician and psychiatrist moderators will guide the discussion to involve the participants in teaching each other to identify and treat common mental illnesses. Moderators will focus on building the knowledge of resident participants longitudinally. Team based learning will be incorporated and will include individual and group assessments of knowledge. In between sessions, relevant articles and educational resources will be posted on an internet wiki. Discussion around such cases will be encouraged. Educational content will be included regarding interventions focused on family-centered care through a respectful family-professional partnership and in the context of family and community. Training will include a broad range of exemplary, interdisciplinary, comprehensive services which provide family-centered, coordinated care that is responsive to the cultural, social, linguistic and ethnic diversity of the District of Columbia. Training will include how to inform and educate families about mental health issues with special regard to their background and beliefs.