Point-of-Care Child Psychiatry Expertise: The Massachusetts Child Psychiatry Access Project

Abstract

OBJECTIVE: Since 2005, after a pilot program, the Massachusetts Child Psychiatry Access Project (MCPAP) has provided point-of-care psychiatry expertise and referral assistance by telephone to primary care providers. We examined its adoption and use and the practice characteristics associated with different adoption timelines and use patterns. METHODS:We merged data on calls to MCPAP in 2005 to 2011 with practice data (enrollment year, panel size, regional team assignment). We categorized practices' days from enrollment to first call (adoption) (0-100, 101-365, .365 days) and quartile of call frequency (use) (annual highest, middle, and lowest quartiles of number of calls per 1000 empanelled patients). We determined associations between adoption and use and practice characteristics using multivariate models. CONCLUSIONS: Adoption and use of MCPAP varied widely. Timing of enrollment, assignment to the team from the program's pilot site, and panel size were associated with patterns of adoption and use. Findings may help other programs design effective implementation strategies. WHAT'S KNOWN ON THIS SUBJECT:A program to support pediatric primary care providers in mental health care using point-of-care, telephone-based advice from specialists has been available since 2005 in Massachusetts. Other US states are implementing similar models. Little is known about how providers use this service. WHAT THIS STUDY ADDS:There is wide variability in adoption and use of this program. Patterns are associated with panel size, enrollment timing, and assignment to the program team at the pilot site. Findings will help new programs establish expectations and design implementation interventions.

Pharmacogenomic testing: aiding in the management of psychotropic therapy for adolescents with autism spectrum disorders

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“… 43 About half of all pediatric patients who are provided a psychiatric referral actually see a mental health provider within 6 months. 27 These delays are due to an acute shortage of psychiatric providers who are comfortable providing care to adolescents with autism. 44 …”

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