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Targeted Child Psychiatric Services: A New Model of Pediatric Primary Clinician—Child Psychiatry Collaborative Care

Department of Psychiatry, Division of Child and Adolescent Psychiatry and Pediatrics, University of Massachusetts Medical School, Worcester, MA.

Thomas J. McLaughlin, ScD

Department of Psychiatry, Division of Child and Adolescent Psychiatry and Pediatrics, University of Massachusetts Medical School, Worcester, MA.

Mary Jeffers-Terry, RN CS

Department of Psychiatry, Division of Child and Adolescent Psychiatry and Pediatrics, University of Massachusetts Medical School, Worcester, MA.

William H. O’Brien, MSW

Department of Psychiatry, Division of Child and Adolescent Psychiatry and Pediatrics, University of Massachusetts Medical School, Worcester, MA.

Christopher J. Stille, MD, MPH

Department of Psychiatry, Division of Child and Adolescent Psychiatry and Pediatrics, University of Massachusetts Medical School, Worcester, MA.

Lynda M. Young, MD

Department of Psychiatry, Division of Child and Adolescent Psychiatry and Pediatrics, University of Massachusetts Medical School, Worcester, MA.

Richard C. Antonelli, MD, MS

Department of Psychiatry, Division of Child and Adolescent Psychiatry and Pediatrics, University of Massachusetts Medical School, Worcester, MA.

Between 15% and 25% of children and adolescents seen in pediatric primary care have a behavioral health disorder with significant psychopathology, high functional impairment, and frequent psychiatric diagnostic comorbidity. Because child psychiatry services are frequently unavailable, primary care clinicians are frequently left managing these children without access to child psychiatry consultation. We describe Targeted Child Psychiatric Services (TCPS), a new model of pediatric primary clinician-child psychiatry collaborative care, and describe program utilization and characteristics of children referred over the first 18 months of the program using a retrospective chart review. The TCPS model can serve a large number of pediatric primary care practices and provide collaborative help with the evaluation and treatment of complex attention deficit hyperactivity disorder, depression, anxiety disorders, and pediatric psychopharmacology.

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