Primary care pediatrician perceptions towards mental health within the primary care setting

Imfeld, Samantha; Darang, Dyan M.; Neudecker, Mandy; McVoy, Molly

doi:10.1038/s41390-020-01349-7

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…Previous work related to pediatric primary care HCPs' perceptions of mental health identified similar patterns of discrepancy between perceived need and reduced access to integrated care (19). Similarly, training and knowledge of mental health needs among primary care HCPs and HCPs' stigma related to mental health have been proposed as barriers to integrated care within primary care clinics (19). Imfeld and colleagues found that variation in mental health training and familiarity impacted pediatricians' perceptions and practice (ie, a pediatrician with more exposure to mental health concerns was more likely to feel comfortable discussing these concerns).…”

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 94%

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Pediatric GI Health Care Professionals’ Perceptions of and Engagement With Psychosocial Providers in Pediatric IBD Care

et al. 2023

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Objectives: Multidisciplinary care is recommended for optimal pediatric inflammatory bowel disease (IBD) care, including psychosocial providers (eg, psychologists). However, health care professionals’ (HCPs) perceptions of and engagement with psychosocial providers in pediatric IBD is lacking. Methods: Cross-sectional REDCap surveys were completed by HCPs (eg, gastroenterologists) across American ImproveCareNow (ICN) centers. Demographics and self-reported perceptions of and engagement with psychosocial providers were collected. Data were analyzed at participant and site levels through descriptives, frequencies, an independent t test, and exploratory analyses of variance. Results: A total of 101 participants from 52% of ICN sites participated. Participants were 88% gastrointestinal physicians, 49% identifying as female, 94% non-Hispanic, and 76% Caucasian. Of ICN sites, 75% and 94% of sites reported outpatient and inpatient psychosocial care, respectively. Participants referred for various clinical reasons to psychosocial providers (eg, illness adjustment). At the participant level, 92% of HCPs reported psychosocial care was very important and 64% reported their clinical thresholds shifted to engage psychosocial providers earlier in care. Barriers to psychosocial care included limited psychosocial providers (92%), psychosocial providers availability (87%), and IBD patients’ lack of openness to psychosocial care (85%). One-way analyses of variance by HCP length of experiences were not statistically significant on perceived understanding of psychosocial providers or perceived changes in clinical threshold over time. Conclusion: HCPs overall reported positive perceptions of and frequent engagement with psychosocial providers in pediatric IBD. Limited psychosocial providers and other notable barriers are discussed. Future work should continue interprofessional education of HCPs and trainees and efforts to improve access to psychosocial care in pediatric IBD.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 94%

Pediatric GI Health Care Professionals’ Perceptions of and Engagement With Psychosocial Providers in Pediatric IBD Care

et al. 2023

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“…Given that children may not adequately express their emotions, may present with symptoms that differ from those in adults, and there may be a lack of awareness and knowledge among primary care physicians about pediatric mental illness, using a diagnostic system to identify these disorders among HS patients may underestimate the true prevalence and incidence of depression and anxiety. [36][37][38] In addition, the relationship between the disease severity of HS and anxiety or depression in pediatric populations was not studied. 39 Finally, clinical, methodological, and statistical heterogeneity characterized by variations in participant characteristics, interventions, outcomes, study design, and statistical results proposes challenges such as misleading or biased conclusions to data pooling, therefore, pooling of the data and metaanalyses could not be conducted.…”

Section: Limitationsmentioning

confidence: 99%

“…Furthermore, all studies utilized a diagnostic coding system to collect clinically diagnosed mental illnesses. Given that children may not adequately express their emotions, may present with symptoms that differ from those in adults, and there may be a lack of awareness and knowledge among primary care physicians about pediatric mental illness, using a diagnostic system to identify these disorders among HS patients may underestimate the true prevalence and incidence of depression and anxiety 36–38 . In addition, the relationship between the disease severity of HS and anxiety or depression in pediatric populations was not studied 39 .…”

Section: Limitationsmentioning

confidence: 99%

The presentation of anxiety and depression among children and youth diagnosed with hidradenitis suppurativa: A review

Shojaei,

Liu,

Lam

2023

Pediatric Dermatology

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition with painful lesions in friction‐prone areas, impacting patients' physical and mental well‐being. Adults with HS experience higher rates of depression, anxiety, and reduced quality of life. Children with HS may also face these challenges, but a comprehensive review of their mental health implications is lacking. A narrative review was conducted using PubMed and Ovid Medline databases to investigate the association between HS and anxiety or depression in pediatric populations. A total of 4498 pediatric patients from six studies were included in this study: six examined depression alone, and three also studied anxiety. Two studies found a significant correlation between HS and depression in pediatric patients (p < .001), while two reported statistical significance for anxiety (p < .001). Two studies comparing pediatric and adult populations also reported a higher prevalence and incidence of depression among pediatric populations (p < .05). Another study found no incidences of depression or anxiety in HS or control patients. Despite heterogeneity in control groups, methodologies, and health system databases, the included studies suggest that pediatric patients with HS have a higher likelihood of developing depression compared to healthy pediatric patients and exhibit higher depression rates and lower anxiety rates compared to adults. These findings and the limited availability of data regarding this topic underscore the imperative for increased screening, evaluation, and reporting of psychiatric disorders among pediatric populations. This can help understand the connection between HS and depression or anxiety and ultimately enhance the mental well‐being and quality of life for affected children.

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“…PPC is almost universal, with 84% of children aged 0 to 17 receiving a well-child visit at least once in the past year (Larson et al, 2016 ). Pediatricians are highly trusted by families, providing opportunities to address stigma and embarrassment about mental health issues (Imfeld et al, 2021 ). The existing emphasis on prevention and healthy development in PPC can readily incorporate emotional and behavioral health issues.…”

Section: Introductionmentioning

confidence: 99%

Provider Perspectives on an Integrated Behavioral Health Prevention Approach in Pediatric Primary Care

Rybak

Herbst

Stark

et al. 2023

J Clin Psychol Med Settings

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The purpose of this study was to use qualitative interviews to ascertain the perspective of pediatric primary care providers on the implementation of Integrated Behavioral Health (IBH) as provided by psychologists within an expanded HealthySteps™ model, and with a particular focus on prevention of behavioral health symptoms in the first five years. A semi-structured interview guide was used to assess medical providers’ perceptions of behavioral health integration into their primary care clinics. A conventional qualitative content analysis approach was utilized to identify patterns of meaning across qualitative interviews. Four themes were identified: (1) practice prior to IBH and initial concerns about integration, (2) psychologist’s role and perceived added value, (3) what integration looks like in practice, and (4) perceived families’ response to and experiences with IBH. Despite initial concerns about potential disruptions to clinic flow, providers indicated that adoption of IBH was seamless. The distinct roles of the psychologist were clear, and both treatment and prevention services provided by IBH were valued. Multidisciplinary collaboration and real-time response to family needs was seen as especially important and primary care providers reported that families were accepting of and highly valued IBH.

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Primary care pediatrician perceptions towards mental health within the primary care setting

Cited by 6 publications

References 22 publications

Pediatric GI Health Care Professionals’ Perceptions of and Engagement With Psychosocial Providers in Pediatric IBD Care

Pediatric GI Health Care Professionals’ Perceptions of and Engagement With Psychosocial Providers in Pediatric IBD Care

The presentation of anxiety and depression among children and youth diagnosed with hidradenitis suppurativa: A review

Provider Perspectives on an Integrated Behavioral Health Prevention Approach in Pediatric Primary Care

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