Do On-Site Mental Health Professionals Change Pediatricians' Responses to Children's Mental Health Problems?

Sarah McCue Horwitz, Amy Storfer-Isser, Bonnie D. Kerker, Moira Szilagyi, Andrew S. Garner, Karen G. O'Connor, Kimberly E. Hoagwood, Cori M. Green, Jane M. Foy, Ruth E.K. Stein

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Objective To assess the availability of on-site mental health professionals (MHPs) in primary care; to examine practice/pediatrician characteristics associated with on-site MHPs; and to determine whether the presence of on-site MHPs is related to pediatricians' comanaging or more frequently identifying, treating/managing, or referring mental health (MH) problems. Methods Analyses included American Academy of Pediatrics (AAP) members who participated in an AAP Periodic Survey in 2013 and who practiced general pediatrics (n = 321). Measures included sociodemographics, practice characteristics, questions about on-site MHPs, comanagement of MH problems, and pediatricians' behaviors in response to 5 prevalent MH problems. Weighted univariate, bivariate, and multivariable analyses were performed. Results Thirty-five percent reported on-site MHPs. Practice characteristics (medical schools, universities, health maintenance organizations, <100 visits per week, <80% of patients privately insured) and interactions of practice location (urban) with visits and patient insurance were associated with on-site MHPs. There was no overall association between colocation and comanagement, or whether pediatricians usually identified, treated/managed, or referred 5 common child MH problems. Among the subset of pediatricians who reported comanaging, there was an association with comanagement when the on-site MHP was a child psychiatrist, substance abuse counselor, or social worker. Conclusions On-site MHPs are more frequent in settings where low-income children are served and where pediatricians train. Pediatricians who comanage MH problems are more likely to do so when the on-site MHP is a child psychiatrist, substance abuse counselor, or social worker. Overall, on-site MHPs were not associated with comanagement or increased likelihood of pediatricians identifying, treating/managing, or referring children with 5 common child MH problems.

Original languageEnglish (US)
Pages (from-to)676-683
Number of pages8
JournalAcademic Pediatrics
Volume16
Issue number7
DOIs
StatePublished - Sep 1 2016

Keywords

  • child psychosocial problems
  • on-site mental health
  • primary care

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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