Referral and Follow-Up After Mental Health Screening in Commercially Insured Adolescents

Hacker, Karen; Arsenault, Lisa; Franco, Idalid; Shaligram, Deepika; Sidor, Mardoche; Olfson, Mark; Goldstein, Joel

doi:10.1016/j.jadohealth.2013.12.012

Cited by 69 publications

(51 citation statements)

References 31 publications

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“…Retrospective reviews have found that mental health screening increases referral to, but not necessarily usage of mental health services (Hacker et al, 2014). In SBHC, retrospective chart reviews have been used to track the impact of a SBHC on emergency room use (Young, D'Angelo, & Davis, 2001), risk and protective factors related to sexually transmitted infections in middle school youth (Woodhead, Chung, & Joffe, 2009), and utilization patterns in an elementary school center over a five-year period (Johnson & Hutcherson, 2006).…”

Section: The Present Studymentioning

confidence: 99%

Addressing the health and mental health needs of unaccompanied immigrant youth through an innovative school-based health center model: Successes and challenges

Schapiro

Gutierrez

Blackshaw

et al. 2018

Children and Youth Services Review

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Section: The Present Studymentioning

confidence: 99%

Addressing the health and mental health needs of unaccompanied immigrant youth through an innovative school-based health center model: Successes and challenges

Schapiro

Gutierrez

Blackshaw

et al. 2018

Children and Youth Services Review

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“…Accordingly, it is reasonable to suspect that rates of clinical service access and utilization may be quite low among adolescents screened as high-risk for SUD and referred to treatment by PC physicians. Although virtually no empirical data exist on RT’s effectiveness with adolescents, findings by Hacker and colleagues (2014) indicated that fewer than one-fifth of adolescents referred by PC physicians for mental health problems detected during wellness visits received any face-to-face services despite ample availability of in-network treatment providers. Service utilization results such as these underscore the challenges of linking high-risk youth screened in PC settings to necessary clinical services even when communication channels between physicians and treatment providers are in place and referral procedures are well established.…”

Section: Referral To Treatmentmentioning

confidence: 99%

SBIRT-A: Adapting SBIRT to Maximize Developmental Fit for Adolescents in Primary Care

Ozechowski

Becker

Hogue

2016

Journal of Substance Abuse Treatment

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The Screening, Brief Intervention and Referral to Treatment (SBIRT) model is widely recommended as part of routine visits in pediatric primary care despite a dearth of evidence on its effectiveness, feasibility, and developmental appropriateness for adolescents in this setting. The purpose of this article is to explicate ways that SBIRT may be tailored to better serve adolescents in primary care under a set of recommended adaptations that we refer to collectively as SBIRT-A or Screening, Brief Intervention, and Referral to Treatment for Adolescents. Each component of the SBIRT-A framework incorporates recommendations to optimize developmental fit with adolescents based on extant empirical research, developmental theory, and well-documented barriers to service delivery in primary care. Commonalities across proposed adaptations include reliance upon proactive methods to identify and engage youth; innovation in service delivery aimed at improving the consistency and reach of interventions; and a family-focused approach to engagement, assessment, and intervention. Specific recommendations include taking advantage of every clinical encounter with the family to screen, involving caregivers in assessments and brief interventions, leveraging technology to administer brief interventions and booster sessions, and patient- and family-centered procedures for treatment referral and engagement. The adaptations proposed in this article have the potential to enhance the detection of adolescents with SU problems in primary care, the consistency of intervention provision, and engagement of this typically recalcitrant population into appropriate treatment.

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“…7 A recent primary care study shows that although half of adolescents with a positive mental health screen are referred for mental health services, one-third will refuse the referral, and less than 20% of those screening positive will be seen by a mental health professional. 8 Primary care interventions addressing barriers to care with the goal of increasing adolescent engagement with mental health services are urgently needed.…”

mentioning

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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Referral and Follow-Up After Mental Health Screening in Commercially Insured Adolescents

Cited by 69 publications

References 31 publications

Addressing the health and mental health needs of unaccompanied immigrant youth through an innovative school-based health center model: Successes and challenges

Addressing the health and mental health needs of unaccompanied immigrant youth through an innovative school-based health center model: Successes and challenges

SBIRT-A: Adapting SBIRT to Maximize Developmental Fit for Adolescents in Primary Care

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

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