A generous philanthropic gift has made it possible to implement a culturally sensitive pediatric Behavioral Health Integration Program (BHIP) in the Pediatric Clinic at Harborview, providing a tremendous opportunity to adapt the Collaborative Care model to younger patients.

BHIP uses the Collaborative Care model developed in our department to provide mental health services in primary care clinics. The program is based on the realization that there are too few mental health professionals to meet all the needs of a primary care population and that many patients and families are most comfortable receiving mental health care in familiar primary care settings. With support from a care manager, a consulting psychiatrist and a shared registry of patients, primary care clinicians can manage many common mental or behavioral health concerns.

While BHIP has been operating in an increasing number of UW Medicine adult clinics, there are numerous unique challenges to implementing the model at the Pediatric Clinic at Harborview. Children have a wider range of behavioral health concerns than do adult primary care patients, so finding staff with skills to serve children and families from age 0 to 21 can be challenging. The clinic patients come from diverse backgrounds: many are immigrant or refugee children who have experienced developmental trauma that may manifest as depression, anxiety and other behavioral health concerns. Harborview is also a Foster Care Center of Excellence, serving a group of children with increased mental health needs. And today every family is reeling from the stress of the current pandemic, disease and death in their community and homes, the loss of school connections or childcare, and the economic fallout of the crisis.

Despite these challenges, Anisa Ibrahim, MD, medical director of the Harborview Pediatric Clinic, and Brian Johnston, MD, MPH, chief of pediatrics at Harborview, are optimistic that with new care coordination codes and the ability to hire a care manager to coordinate the primary care team, social worker, psychologist and child psychiatrist (Will French, MD), the program will bring much needed behavioral health care to their patients. They look forward to collaborating with colleagues at Seattle Children’s and with the communities they serve to guide them in the design and modification of the program. The pilot program will launch in early 2021.