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. 2016 Sep-Oct;16(7):676-83.
doi: 10.1016/j.acap.2016.03.010. Epub 2016 Apr 6.

Do On-Site Mental Health Professionals Change Pediatricians' Responses to Children's Mental Health Problems?

Sarah McCue Horwitz  1 , Amy Storfer-Isser  2 , Bonnie D Kerker  3 , Moira Szilagyi  4 , Andrew S Garner  5 , Karen G O'Connor  6 , Kimberly E Hoagwood  7 , Cori M Green  8 , Jane M Foy  9 , Ruth E K Stein  10
Affiliations

Do On-Site Mental Health Professionals Change Pediatricians' Responses to Children's Mental Health Problems?

Sarah McCue Horwitz et al. Acad Pediatr. 2016 Sep-Oct.

Abstract

Objective: To assess the availability of on-site mental health professionals (MHPs) in primary care; to examine practice/pediatrician characteristics associated with on-site MHPs; and to determine whether the presence of on-site MHPs is related to pediatricians' comanaging or more frequently identifying, treating/managing, or referring mental health (MH) problems.

Methods: Analyses included American Academy of Pediatrics (AAP) members who participated in an AAP Periodic Survey in 2013 and who practiced general pediatrics (n = 321). Measures included sociodemographics, practice characteristics, questions about on-site MHPs, comanagement of MH problems, and pediatricians' behaviors in response to 5 prevalent MH problems. Weighted univariate, bivariate, and multivariable analyses were performed.

Results: Thirty-five percent reported on-site MHPs. Practice characteristics (medical schools, universities, health maintenance organizations, <100 visits per week, <80% of patients privately insured) and interactions of practice location (urban) with visits and patient insurance were associated with on-site MHPs. There was no overall association between colocation and comanagement, or whether pediatricians usually identified, treated/managed, or referred 5 common child MH problems. Among the subset of pediatricians who reported comanaging, there was an association with comanagement when the on-site MHP was a child psychiatrist, substance abuse counselor, or social worker.

Conclusions: On-site MHPs are more frequent in settings where low-income children are served and where pediatricians train. Pediatricians who comanage MH problems are more likely to do so when the on-site MHP is a child psychiatrist, substance abuse counselor, or social worker. Overall, on-site MHPs were not associated with comanagement or increased likelihood of pediatricians identifying, treating/managing, or referring children with 5 common child MH problems.

Keywords: child psychosocial problems; on-site mental health; primary care.

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Conflict of interest statement

None

References

    1. Haggerty RJ. The changing role of the pediatrician in child health care. Am J Dis Child. 1974;127(4):545–549. - PubMed
    1. Ginsburg S, Foster S, Santoro K, Schoeman J, Chockley N. Strategies to support the integration of mental health into pediatric primary care. United States Department of Health and Human Services; 2009. pp. 19–21.
    1. Satcher D. Mental health: A report of the Surgeon General--Executive summary. Prof Psychol Res Pr. 2000;31(1):5. - PMC - PubMed
    1. Coury DL, Berger SP, Stancin T, Tanner JL. Curricular guidelines for residency training in developmental-behavioral pediatrics. J Dev Behav Pediatr. 1999;20(2 Suppl):S1. - PubMed
    1. Jellinek M, Patel BP, Froehle MC, editors. Bright Futures in Practice: Mental Health—Volume II. Tool Kit. Arlington, VA: National Center for Education in Maternal and Child Health; 2002.

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