Pediatric Provider Processes for Behavioral Health Screening, Decision Making, and Referral in Sites With Colocated Mental Health Services

Hacker, Karen; Goldstein, Joel; Link, David A.; Sengupta, Nandini; Bowers, Rachael; Tendulkar, Shalini; Wissow, Larry

doi:10.1097/01.dbp.0000437831.04723.6f

Cited by 34 publications

(25 citation statements)

References 28 publications

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“…49 PCPs place greater weight on parental concerns than validated depression screening tools when making clinical decisions about mental health referral. 50 PCPs in this study expressed the desire for interventions which assist them to improve communication with parents around depression diagnosis and treatment for adolescents including those interventions which increase parents’ mental health literacy 10, 11 and address perceived complex parental barriers to care. Future research should investigate whether interventions with substantial parental barrier components are effective at increasing participation in adolescent mental health care.…”

Section: Discussionmentioning

confidence: 99%

Parents' Role in Adolescent Depression Care: Primary Care Provider Perspectives

Radovic

Reynolds

McCauley

et al. 2015

The Journal of Pediatrics

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Objective To understand how primary care providers (PCPs) perceive barriers to adolescent depression care to inform strategies to increase treatment engagement. Study design We conducted semi-structured interviews with 15 PCPs recruited from community pediatric offices with access to integrated behavioral health services (i.e., low system-level barriers to care) who participated in a larger study on treating adolescent depression. Interviews addressed PCP perceptions of barriers to adolescents’ uptake of care for depression. Interviews were audio-recorded, transcribed, and coded for key themes. Results Although PCPs mentioned several adolescent barriers to care, they thought parents played a critical role in assisting adolescents in accessing mental health services. Important aspects of the parental role in accessing treatment included transportation, financial support, and social support. PCP’s perceived that parental unwillingness to accept the depression diagnosis, family dysfunction and trauma were common barriers. PCPs contrasted this with examples of good family support they believed would enable adolescents to attend follow-up appointments and have a “life coach” at home to help monitor for side effects and watch for increased suicidality when starting antidepressants. Conclusions In this PCP population, which had enhanced access to mental health specialists, PCPs primarily reported attitudinal barriers to adolescent depression treatment, focusing mainly on perceived parent barriers. The results of these qualitative interviews provide a framework for understanding PCP perceptions of parental barriers to care, identifying that addressing complex parental barriers to care may be important for future interventions.

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Section: Discussionmentioning

confidence: 99%

Parents' Role in Adolescent Depression Care: Primary Care Provider Perspectives

Radovic

Reynolds

McCauley

et al. 2015

The Journal of Pediatrics

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“…32 Information provided by patients about preferences is also deliberately included in SDM (Line 9). 217,218,220,230 PCPs' deci-sions about test ordering, [231][232][233] referrals, 230,[234][235][236] and medication prescriptions 237,238 can be influenced by patient requests (Line 10). Similarly, patient resistance may influence decisions regarding testing, 142,232,239 referrals, 234 and advice provision.…”

Section: Part 3: Influencementioning

confidence: 99%

Comprehensive process model of clinical information interaction in primary care: results of a “best-fit” framework synthesis

Veinot

Senteio

Hanauer

et al. 2017

Journal of the American Medical Informatics Association

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“…But even though these collaborations and extensions of care beyond the identified patient have long been recognized as important, they receive less emphasis in training programs and frequently are not factored into funding schemes. There are few incentives for mental health clinicians not to fill their agendas with already-ill individuals in need of treatment, and few incentives for non-mental health clinicians to expand their scope of work to include early intervention for mental health problems [ 17 ]. One hope for the future is that new structures in health care will be able to improve integration between medical, social, and public health sectors.…”

Section: Commentarymentioning

confidence: 99%

Speeding the growth of primary mental health prevention

Wissow

2015

Isr J Health Policy Res

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While there is a strong case for primary prevention of mental health problems, relatively little mental health scholarship has been devoted to it in the last decade. Efforts to accelerate prevention scholarship could potentially benefit from strengthening pathways for interdisciplinary research; developing new training and working models for mental health professionals; developing a common language for public, policy, and scientific discussion of prevention; learning how to measure the common outcomes of heterogeneous interventions tailored to diverse communities.

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Pediatric Provider Processes for Behavioral Health Screening, Decision Making, and Referral in Sites With Colocated Mental Health Services

Cited by 34 publications

References 28 publications

Parents' Role in Adolescent Depression Care: Primary Care Provider Perspectives

Parents' Role in Adolescent Depression Care: Primary Care Provider Perspectives

Comprehensive process model of clinical information interaction in primary care: results of a “best-fit” framework synthesis

Speeding the growth of primary mental health prevention

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