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. 2024 Aug;60(6):1055-1067.
doi: 10.1007/s10597-024-01258-7. Epub 2024 Mar 20.

Examining Patient- and Community-Level Factors Associated with Pediatric Mental Healthcare Access Within a Patient Navigation Program

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Examining Patient- and Community-Level Factors Associated with Pediatric Mental Healthcare Access Within a Patient Navigation Program

Caitlin Koob et al. Community Ment Health J. 2024 Aug.

Abstract

In 2021, national leaders in the United States declared a "national youth mental health crisis." Still, only 1-in-4 children receive adequate mental healthcare access. Patient Navigator Programs (PNPs) can improve children's referral-to-connection to mental health services. We examined patient- and community-level factors associated with pediatric mental healthcare access. Pediatric Support Services (PSS) is a PNP that triages mental and behavioral health referrals within a large health system in a southeastern state. This study analyzes PSS data from September 2017-March 2023 and Child Opportunity Index 2.0 state-normed zip-code level data to assess social drivers of health estimates. Structural equation modeling was conducted between patient- and community-level factors and connection to mental health services. Overall, 62.7% of children connected to mental health services since PSS' inception. Regardless of SDOH, as children get older, they are more likely to connect with mental health services (β = .053, SE = .010, p < .001). Children with greater number of referral needs are more likely to connect with mental health services (β = .034, SE = .011, p = .002). Further, children who live in communities with higher opportunity levels are more likely to connect with mental health services (β = .016, SE = .008, p = .040), suggesting that children who live in low-income communities experience more barriers to mental healthcare. Social drivers may inform referral practices and tiered navigation support for optimal mental healthcare access among children. Further research should demonstrate the effectiveness of PNPs integrated within healthcare and community-based settings.

Keywords: Community health; Health equity; Pediatric mental health; Social drivers of health; Systems navigation.

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Conflict of interest statement

The authors have no conflicts of interest relevant to this article to disclose.

Figures

Fig. 1
Fig. 1
Density of geographic distribution of Pediatric Support Services’ reach in South Carolina by patient-level zip code of residence
Fig. 2
Fig. 2
SEM of patient-and community-level factors with connection to mental health services among children triaged through PSS (from September 2017 through March 2023). β indicates standardized regression coefficient. Dashed lines indicate non-significant results (p  > .05)

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