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Promoting Earlier Access to Pediatric Behavioral Health Services with Colocated Care

Valleley, Rachel J., PhD*; Leja, Ashley, PhD*; Clarke, Brandy, PhD*; Grennan, Allison, PhD*; Burt, Jennifer, PhD*; Menousek, Kathryn, PhD*; Chadwell, Mindy, PhD*; Sjuts, Tara, PhD*; Gathje, Rebecca, PhD; Kupzyk, Kevin, PhD; Hembree, Kristen, PhD*

Journal of Developmental & Behavioral Pediatrics: May 2019 - Volume 40 - Issue 4 - p 240–248
doi: 10.1097/DBP.0000000000000662
Original Article

Objective: This study aimed to determine whether youth access behavioral health (BH) care earlier (i.e., when problems are less severe) when receiving services in colocated pediatric primary care clinics.

Methods: Six primary care clinics in the Midwest with a colocated BH provider participated in this study. Data on number of sessions attended/not attended with the BH provider, BH symptom severity as measured by the Child Behavior Checklist, parent report of length of presenting problem, and improvement ratings were collected and compared for on-site referrals and off-site referrals. Descriptive, independent sample t tests and regression analyses compared those referred from on-site physicians versus off-site referral sources.

Results: Results demonstrated that youth receiving BH services at their primary care physician's office accessed services when problems were less severe and had been impacting their functioning for a shorter duration.

Conclusion: This study is among the first to explore whether youth receiving BH services in primary care are accessing those services earlier than those who are referred from outside sources, resulting in improved patient outcomes.

*Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE;

University of Wisconsin, Stevens Point, WI;

Nebraska Medical Center, Omaha, NE.

Address for reprints: Rachel J. Valleley, PhD, Department of Psychology, 985450 Nebraska Medical Center, Omaha, NE 68198-5450; e-mail:

All phases of this study were supported by HRSA Grants D40HP02597-08-00 and M01HP25184-01-00.

Disclosure: The authors declare no conflict of interest.

See the Video Abstract at

Received August 28, 2018

Accepted January 16, 2019

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