Pediatrician Perspectives on Children’s Access to Mental Health Services: Consequences and Potential Solutions

Abstract

This paper examines pediatricians' perspectives regarding access to children's mental health care. In response to a question about factors that help or hinder coordination of care 190 respondents voluminously wrote about mental health access barriers. Responses were qualitatively analyzed to understand pediatricians' perspectives. Four thematic areas emerged: Insurance issues; availability of mental health specialty providers; state mental health systems; and pediatricians' attempts to improve access to mental health services. Pediatricians' responses included educating themselves, using telemedicine, and hiring co-located mental health specialists. Recommendations are made to address pediatricians' treatment of children with mental illnesses and their access to treatment resources.

Barriers to managing child and adolescent mental health problems: a systematic review of primary care practitioners’ perceptions

“…Children’s mental health resources are lacking in comparison with the adult services in terms of collaboration with other professionals, 48 sometimes resulting in practitioners not being aware of services that may be available to their patients 56 …”

“…A lack of providers of specialist services was the most highly endorsed barrier overall, with primary care practitioners expressing a clear desire for decreased waiting times and increased resources for referral, particularly in rural areas. 56 , 61 – 64 As all of the facilitators that were identified were the inverse of identified barriers, the discussion focuses on barriers from here on, unless explicitly stated otherwise.…”

“…Excluding specific populations, such as those with a primary health diagnosis other than a mental health problem, may limit the generalisability of the review beyond ‘general’ populations. Studies also differed markedly in the age range of children and young people being considered, focusing specifically on pre-adolescen ts, 49 , 52 , 55 , 56 , 58 , 66 , 67 , 70 , 73 – 76 adolescents, 50 , 53 , 57 , 61 , 77 , 78 or a combination of the two, 48 , 51 , 54 , 59 , 60 , 62 – 65 , 68 , 69 , 71 , 72 , 79 – 91 limiting the extent to which the needs of each group can be identified.…”

A scoping literature review of service-level barriers for access and engagement with mental health services for children and young people

“…This included eight qualitative studies, six cross sectional studies, two studies using mixed methods, four audits of service data, and one case study. Long waiting times was the most commonly endorsed barriers cited by service users [37,45,48,50,53], healthcare professionals [54,55] and service managers [56]. In a study by McCann et al [48] adolescents reported long wait time for an initial appointment a major obstacle for getting MH support.…”

The Impact of Long-Acting Medications on Attention-Deficit/Hyperactivity Disorder Treatment Disparities

“…More in-depth communication can also be supported through higher reimbursement for consultation. Providers have cited low reimbursement for consultation from Medicaid as a barrier to the delivery of high quality, patient-centered ADHD care (Pfefferle 2007). Empowering patients and their families to discuss their concerns, and providing support and follow-up over the long term could improve medication continuity, and contribute to the elimination of disparities.…”