Building a Model to Understand Youth Service Access: The Gateway Provider Model

Abstract

Enhancing the functioning of parents, teachers, juvenile justice authorities, and other health and mental heal professionals who direct children and adolescents to services is a major mental health services concern. The Gateway Provider Model is an elaborated testable subset of the Network-Episode Model (NEM; B. A. Pescosolido & C. A. Boyer, 1999) that synthesizes it with Decision (D. H. Gustafson, et al., 1999) and organizational theory (C. Glisson, 2002; C. Glisson & L. James, 1992, 2002). The Gateway Provider Model focuses on central influences that affect youth's access to treatment, i.e., the individual who first identifies a problem and sends a youth to treatment (the "gateway provider"); and the need those individuals have for information on youth problems and relevant potential resources. Preliminary studies by the authors and other applicable studies (D. Carise & O. Gurel, 2003) show that providers' perception of need, and their knowledge of resources, and their environment are related to the decision to offer or refer to services, supporting key aspects of the Model.

Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use: Updates and Recommendations 2007–2013

“…To enhance the effectiveness of SBIRT within complex systems, two modifications are required that would transform SBI[RT] into SBI [LT] and place new emphasis on Linking and Tracking. The first is rule-driven referral, by which (a) screening results and other assessment outcomes map formulaically onto system-specific referral procedures via resource guides and decision trees (e.g., McGovern, Clark, & Samnaliev, 2007); (b) structured protocols are used for accessing neighbor systems and moving clients between settings (i.e., ''referral handoffs''; Arora & Johnson, 2006); and (c) standardized procedures are used for sharing relevant clinical and referral information with clients= families and among service partners (i.e., data-infused linking processes; see Stiffman, Pescosolido, & Cabassa, 2004). The second modification is treatment progress tracking, which entails documenting treatment practices used by local service providers, prompting providers to supply regular updates on client participation in their services, and collecting data on bona fide markers of targeted clinical outcomes.…”

A Common Factors Approach to Improving the Mental Health Capacity of Pediatric Primary Care

“…The Network Episode Model (Costello et al 1998) and the Gateway Provider Model (Stiffman et al 2004) propose that the social context of the child, parent, family, and clinician influence help-seeking for mental health problems and the processes and outcomes of mental health services. In particular, child and parent knowledge and attitudes about mental health problems, and interactions among family members and friends, influence decisions to seek help or disclose problems to health professionals.…”

Why Do Parents Seek Help When Their Children’s Behavior Is Within Normative Levels?

“…However, the great majority of children who display these behaviors do not receive help from mental health professionals (Rooke et al 2004). This is in large part because parents, who serve as a primary gateway through which children receive treatment (Stiffman et al 2004), do not seek help. The decision to engage in help-seeking behavior is a complex process (Schnitzer et al 2011) which is best predicted by the parents' concern and perceptions of their child's behavior as problematic and warranting intervention (Morrissy-Kane and Prinz 1999; Shanley et al 2008;Skeat et al 2010;Stiffman et al 2004).…”

“…This is in large part because parents, who serve as a primary gateway through which children receive treatment (Stiffman et al 2004), do not seek help. The decision to engage in help-seeking behavior is a complex process (Schnitzer et al 2011) which is best predicted by the parents' concern and perceptions of their child's behavior as problematic and warranting intervention (Morrissy-Kane and Prinz 1999; Shanley et al 2008;Skeat et al 2010;Stiffman et al 2004). However, even professionals have difficulty distinguishing clinically significant disruptive behavior from normative levels of behavior in young children (Wakschlaq et al 2007).…”