The mental health diagnostic range of pediatric integrated care : a scoping review

This is the preregistration protocol for a scoping review on mental health diagnoses addressed in pediatric integrated care settings. Integrated behavioral health care has been increasingly implemented in the pediatric population. Up to half of pediatric patients struggle with mental illness and only 20% of that subset receive psychiatric treatment. It’s recommended to have around 47 Child and Adolescent Psychiatrists per 100,000 patients, however the average nationwide is around 10 per 100,000. (Axelson 2020). Furthermore, the timeliness of identifying appropriate interventions for supporting pediatric behavioral healthcare is imperative given the current national emergency declared in child and adolescent mental health (APA 2022). The current psychiatric work-force is underpowered to provide the behavioral health care alone. Despite institutional efforts to increase focus on mental health treatment, many primary care physicians still perceive a lack of training and confidence when treating mental health conditions (Horwitz et al). However, some studies have shown variability in the levels of provider comfort depending on which mental health diagnosis they are treating (Fremont et al; Pidano et al). While integrative care models have increasingly been studied in recent years, there is not yet a consensus on which mental health diagnoses are typically addressed in these models (Schlesinger et al). Given the wide range of pediatric mental health diagnoses it is crucial to understand the scope of integrative care in order to identify systemic gaps and expand services.