343 - Advancing behavioral health equity through policy and advocacy levers to promote integrated pediatric primary care

Poster Number: 343
Publication Number: 343.448

Jessica Kenny, University of Colorado School of Medicine, Aurora, CO, United States; Emma Gilchrist, Farley Health Policy Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Bahroze Rakeen, University of Colorado School of Medicine, Denver, CO, United States; Stephanie Gold, Eugene S. Farley, Jr. Health Policy Center, Denver, CO, United States; Shale L. Wong, University of Colorado/Farley Health Policy Center, Aurora, CO, United States

Background: The burden of mental health needs is high and inadequate access to behavioral health treatment is universal. However, there are notable disparities for youth and families of color, including Black, Asian, Hispanic, Native American, and multiracial communities (CDC, 2021). Structural barriers, biased delivery, and lack of culturally centered care perpetuate systemic inequities and contribute to worse health outcomes. Integrating behavioral health into pediatric primary care is the gold standard for addressing population-level behavioral health concerns, reducing health disparities, and improving treatment engagement. Federal policy action is needed to promote integrated primary care and advance behavioral health equity across the United States.

Objective: Identify policies and case studies to inform the development of federal policy recommendations to improve equity in behavioral health via integrated pediatric primary care.

Design/Methods: A policy and environmental scan was conducted, guided by the Intersectionality-Based Policy Analysis Framework (Hankivsky et al., 2014). A national advisory panel was also consulted.

Results: Six cross cutting policy principles were developed: adapt sufficient and sustainable funding mechanisms, disaggregate data by race/ethnicity, establish equity and quality measures, prioritize community-driven solutions and strengths, address stigmatizing language in laws and policies, and create more equitable governance structures and policy making processes. Policy recommendations to specifically promote integrating behavioral health in pediatric primary care: increase access to the full continuum of care within primary care beginning with prevention, identification, and early intervention and inclusive of crisis services; universally screen for and address social determinants of health; develop incentives, accountability mechanisms, and risk-adjusted population-based payment models to support behavioral health integration; expand insurance coverage and reimbursable services for overall family well-being so that caregiver behavioral health can be fully addressed within pediatric primary care; and recognize the impact of power differentials on minoritized communities due to racism and trauma, systematic oppression, and minority stress to enable policy actions toward equitable culture shifts.

Conclusion(s): Advancing behavioral health equity requires a multi-pronged approach of policy and advocacy. Policies that promote integrating behavioral health in primary care are an important lever in addressing the current health disparities in the United States.