Behavioral health conditions among children and youth today occur at a disturbing rate, impacting their overall growth and develop- ment and leading to higher mortality rates as they reach adulthood. In fact, studies have shown that adults with mental illness who are served in the public mental health system have a shortened life expectancy of 11 to 25 years on average when compared to the general population. Key to disrupting this phenomenon is the development of preventive and early identification strategies, including integrating care systems for children with behavioral health conditionsb that address the primary care, behavioral health, specialty care, and social support needs of children and youth with behavioral health issues in a manner that is continuous and family-centered. This paper outlines different models for organizing the delivery of services, describes five core competencies of the integrated care systems for children with behavioral health issues, and describes financing mechanisms that can be used to support the approach of integrated care systems for children with behavioral health conditions.
Today’s behavioral health landscape for children and youth is grim, with rising rates of youth and adolescent depression and illicit drug use. The rates of mental illness and substance use rise as youth move into young adulthood, while studies show that people with serious mental illnesses and substance use disorders die earlier than the general population, in large part due to unmanaged physical health conditions.
To close the early mortality gap, there must be a shift in focus from treatment of chronic disorders to prevention, and greater emphasis on identifying early onset of behavioral health concerns among children and youth. Many factors point to the need for prevention and early identification strategies by primary care clinicians (PCC) in integrated care systems.