21 Going upstream in pediatric mental health care

<h3>Background</h3> Youth mental health care access has been an escalating crisis in the United States. The number of youths using emergency services for behavioral health has been rising for decades and has further increased immediately following the pandemic. Early identification and timely connection to care continue to be significant barriers. <h3>Objective</h3> We will review upstream approaches to pediatric mental health care delivery, including working with primary care providers and schools. We will examine the impact of the pandemic and how to centralize resources within an organization. <h3>Methods</h3> Our school and collaborative care programs provide immediate access to child psychiatry expertise through our partnerships with school districts and our integration of behavioral health resources in primary care to provide evaluations, short term stabilization (Tier 3), consultations, clinical guidance and care coordination to ongoing care (Tier2) as well as professional development to school staff and pediatricians and community education and support to parents and youth (Tier 1). <h3>Results</h3> See figure 1. <h3>Conclusion</h3> The school and collaborative care programs are effective in supporting screening efforts, helping youth avoid the emergency department and access psychiatric care in the community, while providing primary prevention, education and support for school clinicians, pediatricians and families to ensure connection to the right care, at the right time in the right place.