The Mental and Behavioral Health Services Available to Children With Medical Complexity in Complex Care Programs

We conducted a cross-sectional survey of complex care programs on behavioral health services provided to children with medical complexity (CMC). Quantitative and qualitative data were analyzed by using convergent mixed methods. Rates of CMC receiving behavioral health services were at or above national averages for the general pediatric population and the most reported concerns were externalizing behaviors. Of 25 programs, 7 (28%) reported integrated care and programs with integrated care found the service improved access and were more likely to screen for caregivers’ mental health. Themes included: 1. Current models of care for pediatric mental and behavioral health limits access for CMC; 2. Collaboration is highly desired by medical teams; 3. Providing mental health for family members of CMC is important. Despite high service use and frequent availability of integrated care, complex care programs still report insufficient access to behavioral health services required to meet the needs of CMC.