Primary care integration

Abstract

The principles of high-quality healthcare include strategies for prevention, acute care management, and chronic disease management, all of which have been embraced by pediatrics. With the advent of vaccines, anticipatory guidance, and structured well-child visits, children are living longer and healthier lives. Unfortunately, these types of screenings for health and developmental risks have not been applied broadly and systematically to mental health issues. Furthermore, individuals with mental disorders experience disproportionally higher rates of disability and mortality. For example, individuals with major depression and schizophrenia have a 40–60% greater chance of dying prematurely than the general population due to lack of attention of physical health needs and access to preventive healthcare. Conversely, mental health disorders often affect (e.g., through treatment nonadherence) the course of other chronic illnesses (such as diabetes or asthma), thus highlighting the needs for an integrated approach to healthcare. Prevention and early intervention efforts for both psychiatric and other medical conditions are key to promoting the optimal development of children.