For these practices, an Integrated Psychiatry approach—directly informed by the Primary Care Behavioral Health (PCBH) model—provides a flexible, population‑focused alternative. PCBH emphasizes rapid access, same‑day consultation, brief interventions, and team‑based care embedded directly within primary care workflows. Applying these principles, Integrated Psychiatry brings psychiatric expertise into the pediatric medical home, enhancing access, reducing stigma, strengthening collaboration, and embedding mental health as a routine part of whole‑child care.

Setting Goals

Integrated Psychiatry aims to:

• Provide preventative, upstream mental health care that identifies concerns early and addresses symptoms before they escalate.
• Ensure that children and families have timely and reliable access to psychiatric expertise when they need it.
• Increase awareness of the connection between mental and physical health, emphasizing how both must be addressed to improve outcomes.
• Reduce stigma by normalizing mental health as a routine aspect of pediatric care.
• Strengthen communication between behavioral health and primary care to improve quality, continuity, and coordination.
• Offer accessible psychiatric consultation, case discussion, and education for primary care providers.

Building the Role

Within a PCBH‑informed model, the psychiatry provider partners closely with the pediatric team to deliver rapid, flexible, population‑based support. Key elements of the role include:

• Providing in‑the‑moment support and consultation to pediatricians when questions or urgent needs arise.
• Identifying areas where additional education or system navigation support may help the clinical team (e.g., testing options, community resources).
• Asking pediatricians what would be most useful—whether brief medication guidance, a cross‑taper schedule, or support with diagnostic clarification.
• Offering multiple tiers of support, such as quick conversations, chart reviews, one‑time evaluations with treatment recommendations, or short‑term stabilization for acute symptoms.
• Returning the patient to the PCP for ongoing care, while remaining available for follow‑up consultation as needed.
• Determining when a patient requires long‑term specialty care and helping families transition smoothly to community providers.
• Setting expectations with families so they understand the time‑limited nature of the service, how the psychiatrist remains involved “behind the scenes,” and how future re‑referral works.
• Maintaining an open schedule with ongoing availability rather than holding a long‑term caseload, ensuring all patients can access timely support.
• Collaborating closely with behavioral health team members to distribute resources, follow up with families, and support PCPs.
• Building relationships with community providers and staying aware of who has openings to support warm handoffs.

Overcoming Barriers

• Focusing on the Positive

Creating and sharing a clear vision of how this role strengthens pediatric care helps build buy‑in across the practice. Emphasizing shared responsibility, improved stabilization of acute symptoms, medication support, and streamlined communication with community resources helps staff understand the model’s value from the start.

• Gradual Implementation

Integrated models work best when introduced thoughtfully. Setting realistic goals, piloting workflows, and adjusting based on early experience allows the system to grow sustainably. Because patient needs and clinic dynamics evolve, ongoing flexibility ensures the model remains responsive and effective.

• Frequent Communication

Open, ongoing communication builds trust and reduces anxiety around treating behavioral health conditions. Regular forums for feedback, staff questions, case discussions, and educational opportunities keep the team aligned. A scheduled touchpoint with administration creates a reliable pathway for addressing barriers and sharing progress.

• Staying Focused

Embedding Integrated Psychiatry within a pediatric practice is a long‑term, iterative process. Challenges are expected, and workflows will evolve as the practice learns what best meets the needs of children, families, and providers. Staying grounded in the overall vision—accessible, population‑based psychiatric support within primary care—helps teams remain committed even when the process feels difficult.