Integrating mental health services into your practice: the “how and why”

Jay Rabinowitz, MD, FAAP, MPH, began in his session on Integrating Mental Health Services into Pediatric Practice at the 2021 AAP Virtual Conference & Exhibition, noting, “Because the need for mental health care is becoming greater than a pediatrician’s ability To expand these services, integrating behavioral/mental health services into own practice and expanding through ‘colocation’ with other healthcare professionals becomes necessary.”

Rabinowitz emphasized how integrating mental health care into a practice can be good for the practice itself, the patients and the healthcare provider. “There are more behavioral and mental health problems today,” Rabinowitz emphasized. “One in five children has a psychiatric diagnosis and there are not enough psychiatrists to see all these children. Seeing these patients in your office lessens the stigma, provides a familiar environment with a family provider. Nationally, 50% of families do not make an appointment with an external mental health care provider if they have been referred by their pediatrician. In addition, while 50% of children who do see a psychiatrist do not return for a second visit, 96% of patients do return to their pediatrician for a second mental health visit. Plus, it’s usually more convenient to see a pediatrician for these services: You’ll get faster appointments, get a comorbid diagnosis (such as abdominal pain), better follow-up and better outcomes, Rabinowitz noted.

Rabinowitz shared the results of a patient satisfaction survey recently conducted in his own office. He pointed out that 89% of parents said it is important that their children receive mental health care in the same location as their medical care; 95% were satisfied with mental health in the office (which was with a psychologist); and 93% said the services were beneficial to their child. In addition, 91% of those who had not seen psychologists in Rabinowitz’s office said they would rather go to the service in his office if they had to.

For the mental health providers in the office, Rabinowitz notes that there is more convenience, improved satisfaction, better communication (since the electronic health records (EHR) are shared on site) and better follow-up when a mental health provider works with a pediatrician at his or her own discretion. or her office. Integrating mental health services into a pediatric practice provides greater efficiency, can attract new patients and meet the needs of the families involved.

Rabinowitz noted the dramatic drop in visits to his office during the first month of the lockdown (50%), yet mental health visits remained at 100%. “Since then,” says Rabinowitz, “mental health visits have continued at or above these rates.”

To make this happen (the “how”), Rabinowitz listed 9 steps including commitment (hold a partner meeting to assign responsibilities/develop timeline); choosing your type of healthcare provider (psychologists, social workers, psychiatric nurses, etc.); physical space (reserving a space for consulting rooms); develop office protocols (who will be the planners, what will be the duration of the appointment, who will call the patients, who will do the billing, etc.), and others.

Finally, Rabinowitz gave some important tips to keep things running smoothly. “Have an important planner,” he suggested. “Keep your progress notes short and consider scanning your paper notes into your EHRs and then creating templates. Keep 90% full on schedules and no show fee to be charged. Finally, be aware of seasonality: Spring is the busiest season for mental health appointments.”


Rabinowitz J. Integrating Mental Health into Your Practice: “The How and Why.” American Academy of Pediatrics 2021 National Conference and Exhibition; virtual. Accessed October 8, 2021.

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