Literature Collection

Recent literature, public policy, and funding opportunities call attention to the need for better increased integration of health and mental health care services in primary care settings so as to best meet the needs of children and families. There are many benefits to such integration, but pediatric primary care providers (PCPs) face multiple barriers to identifying and managing patients with mental health difficulties. One way to address this problem is through the integration of psychologists into primary care settings who can collaborate with PCPs to provide integrated behavioral health care to youth and families. However, there are challenges to collaboration, which include differences in training, professional cultures, and expectations held by professionals from various disciplines. Effective communication is a key component in supporting interprofessional collaboration between primary care providers and psychologists working in primary care settings. This paper reviews aspects of pediatric medicine culture, critical components of communication, and strategies to improve communication. Three case examples are presented in which some of these challenges have been successfully addressed. Implications and future directions are discussed.

INTRODUCTION: Primary care providers need to be able to effectively recognize and treat common mental health concerns. Foundational mental health training is typically embedded into physician assistant (PA) didactic training; while essential, students in didactic training may not yet recognize the relevance and clinical nuances of these presentations. To better prepare university-based PA students to address mental health in primary care, a 4-session interdisciplinary psychosocial skills enhancement group was developed for second-year students and conducted over 3 years. This weekly virtual group was facilitated by a doctoral-level student in clinical psychology and attended by PA students in their family medicine rotation (n = 204). Students presented patient cases, provided feedback to fellow students, developed case conceptualizations, and engaged in didactics. METHODS: After completing the group, participants received a survey assessing their satisfaction, perceived improvements in behavioral health knowledge and comfort, and suggestions for refining the group. Descriptive analyses and qualitative content analyses were conducted. RESULTS: Survey results were overall positive, indicating that students felt more prepared to treat behavioral health conditions and enjoyed having a group facilitator from outside their program with expertise in psychology. Qualitative results suggested the benefits of increased reflective practice, improved peer support, and appreciation for didactic psychosocial content. DISCUSSION: Given the prevalence of behavioral health concerns in primary care, incorporating an interdisciplinary training and supervision component may be an effective way of increasing clinical competencies, enhancing professional well-being, and better meeting future patient needs.