UCSF Expands Behavioral Health Support Program for Families Statewide
A UCSF-developed program that integrates behavioral health support for children and caregivers into routine pediatric care is poised to extend across California with a $17 million investment from the California Department of Health Care Services (DHCS).
Known as dyadic care, the approach equips primary care clinicians to identify and address concerns ranging from child development and caregiver depression to family stress and basic needs — connecting families with help in a setting they already know and trust.
Piloted at the Children’s Health Center at Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG), the program has reached 40% of eligible families at the safety-net hospital. The new state investment will enable UCSF’s Center for Advancing Dyadic Care in Pediatrics (CADP) to build on that experience and expand the model across California.
“With 13 routine visits in the first three years of life, pediatric primary care represents a unique opportunity to identify challenges earlier and help families build a healthier foundation for the years ahead,” said UCSF Professor Kate Margolis, PhD, UCSF professor and director of the Center for Advancing Dyadic Care in Pediatrics and Division of Integrated Behavioral Health at ZSFG.
The statewide effort builds on a decade of collaboration among the UCSF Departments of Psychiatry and Behavioral Sciences and Pediatrics, ZSFG’s Children’s Health Center and the San Francisco Health Network, the city’s public healthcare system. ZSFG is owned and operated by the San Francisco Department of Public Health (SFDPH).
“Infants’ development depends on the environments they grow up in, making the health and wellbeing of their parents and caregivers a critical vital sign for babies,” said Margolis. “Supporting caregivers of young children is an urgent population health need and an important strategy for advancing child health equity.”
Overcoming barriers to behavioral health
For many families, a child’s pediatrician is one of their most trusted and consistent connections to the health care system. Dyadic care uses routine visits to identify concerns that might otherwise go untreated and connect families with support earlier.
That can be particularly important for families who face barriers to accessing behavioral health care separately.
“Rather than asking caregivers to navigate another system or make another appointment, dyadic care brings support into a setting families already know and use,” Margolis said.
The longstanding partnership between UCSF and the ZSFG Children’s Health Center has provided a real-world setting for developing and testing ways to integrate dyadic care into everyday clinical practice. UCSF researchers contribute expertise in behavioral health prevention science and Medicaid policy and financing, while ZSFG clinicians bring experience caring for families in San Francisco’s public health care system. Feedback from patients, families and clinicians has helped refine the model and develop tools that can be adopted by other health care organizations.
One example is electronic medical record documentation, an essential part of incorporating a new model of care into clinical practice. When standardized documentation for dyadic care did not exist, CADP translated guidance from DHCS policy into templates clinicians could use during patient visits. The Children’s Health Center piloted and refined the templates before UCSF made them available to other practices. They are now being used in electronic medical records at sites across California.
“Over the past decade at ZSFG, we’ve learned that meaningful innovation has to work not just in theory, but in the realities of everyday care experienced by families, clinicians, and the health systems that support them,” said Shonul Jain, MD, UCSF professor and vice chair of pediatrics at ZSFG. “Now we are ready to share those lessons across the state.”
The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health, which serves as UCSF's primary academic medical center, includes top-ranked specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area. UCSF School of Medicine also has a regional campus in Fresno. Learn more at ucsf.edu, or see our Fact Sheet.