ABSTRACT
Family navigation (FN) and phone-based care coordination may improve linkages from primary care to community-based mental health referrals, but research on their differential impact is limited. This mixed-methods study compared FN and phone-based care coordination in connecting families to mental health services from primary care. Families of children (56.3% male, mean age = 10.4 years, 85.4% Black) were sequentially assigned to either receive FN through a family-run organization or phone-based coordination via the child psychiatry access program (CPAP). Caregiver-reported children's mental health improved in both groups and both groups were satisfied with services. More families in the CPAP group had appointments made or completed (87%) than families in the FN group (71%) though the difference was not statistically significant. Future research with a larger sample that matches family needs and preferences (e.g., level and type of support) with navigation services would be beneficial.
Subject(s)
Primary Health Care , Humans , Male , Female , Child , Community Mental Health Services/methods , Referral and Consultation/statistics & numerical data , Family/psychology , Patient Navigation , Telephone , Adolescent , Health Services Accessibility/statistics & numerical dataABSTRACT
Effective child health advocacy is an essential strategy to improve child health, and can improve access to equitable care. It can also be professionally rewarding and improve career satisfaction. However, while advocacy has been a part of pediatrics since its origins as a specialty, many barriers to engaging in health advocacy exist which can be challenging to navigate. There are a wide range of organizational practice settings, which are each accompanied by unique strengths and limitations. No matter the practice setting, pediatricians can be effective advocates for child health through leveraging organizational, professional, and community resources and partnerships.
Subject(s)
Child Advocacy , Child Health Services , Child , Humans , Child Welfare , Child Health , PediatriciansSubject(s)
Asian/psychology , Hate , Native Hawaiian or Other Pacific Islander/psychology , Racism/ethnology , Racism/prevention & control , Adolescent , COVID-19/epidemiology , Child , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Mental Health , Pandemics , Racism/history , SARS-CoV-2 , Social Determinants of Health , United States/epidemiologyABSTRACT
Early engagement in mental health intervention is critical, yet the vast majority of children who are experiencing mental health concerns are not receiving needed services. Pediatric primary care clinics have been recognized as an ideal setting in which to identify and address mental health problems early, although engagement in mental health services within primary care and in community-based settings remains low. Navigators, or individuals with experience in navigating the mental health system, have been highlighted as promising partners in efforts to improve engagement in mental health services. Navigation has a growing body of research support among adults and in targeting medical concerns, but there has been limited research on integrating family navigators into pediatric primary care settings to address mental health concerns. Despite this gap in the evidence base, we believe there is significant promise for the use of this model in addressing children's mental health needs. In this report, we discuss factors contributing to high levels of unmet mental health needs and low levels of engagement in mental health services, the role that navigators can play in increasing engagement in mental health care, and implications and recommendations related to integrating mental health-focused family navigators into pediatric primary care settings.
Subject(s)
Early Medical Intervention/organization & administration , Mental Disorders/therapy , Mental Health Services/organization & administration , Patient Navigation/organization & administration , Primary Health Care/statistics & numerical data , Adolescent , Adult , Child , Female , Humans , Incidence , Male , Mental Disorders/diagnosis , Mental Disorders/epidemiology , Outcome Assessment, Health Care , Pediatrics , Primary Health Care/methods , Professional-Family Relations , Randomized Controlled Trials as Topic , Severity of Illness Index , United StatesABSTRACT
Poverty is a common experience for many children and families in the United States. Children <18 years old are disproportionately affected by poverty, making up 33% of all people in poverty. Living in a poor or low-income household has been linked to poor health and increased risk for mental health problems in both children and adults that can persist across the life span. Despite their high need for mental health services, children and families living in poverty are least likely to be connected with high-quality mental health care. Pediatric primary care providers are in a unique position to take a leading role in addressing disparities in access to mental health care, because many low-income families come to them first to address mental health concerns. In this report, we discuss the impact of poverty on mental health, barriers to care, and integrated behavioral health care models that show promise in improving access and outcomes for children and families residing in the contexts of poverty. We also offer practice recommendations, relevant to providers in the primary care setting, that can help improve access to mental health care in this population.
