Screening for pediatric behavioral health in primary care in rural and urban clinics.

Abstract

Introduction:The prevalence of behavioral health disorders in children is approximately 15%-20%, yet less than half of the children ever receive treatment for these conditions. The lack of access to behavioral health care is common in urban areas but even more difficult to access in rural areas. Screening for behavioral health in a primary care setting is one of the first strategies to reduce this problem and improve access to care. The primary goal of this study was to examine behavioral health screening practices of pediatric primary care providers in a rural midwestern state. Method: A survey that queried family practice/internal medicine and pediatric providers who provide care to pediatric patients was delivered to over 300 primary care providers across the state. The number of surveys returned was 112. Results: The Modified Checklist for Autism tool was administered by 80% of pediatric providers and 30% of family practice primary care providers. The Patient Health Questionnaire for depression was administered by 72% of pediatric and 80% of family practice providers. Most of the primary care providers had a behavioral health provider present in the clinic, which likely resulted in higher screening rates compared to the national average. Discussion: The screening practices of the family practice and pediatric subspecialities reflect their respective current professional organization recommendations. Although most providers believe it is important to screen for developmental and behavioral disorders, further system changes are

If you build it who will come? Case mix data of a new rural paediatric outpatient clinic

“…The finding that over 40% and almost 20% of patients were accessing AH professionals and support services, respectively, confirms they are a critical component of paediatric care and should be included in any integrated health care models. Integration and colocation of paediatric services can also decrease travel time for patients, improve access to care and reduce the stigma rural patients have reported when accessing mental health or social support services 19 . The latter is an important consideration as carers and patients from rural communities have indicated that a barrier to accessing services is a fear they may be recognised 20 …”

“…Integration and colocation of paediatric services can also decrease travel time for patients, improve access to care and reduce the stigma rural patients have reported when accessing mental health or social support services. 19 The latter is an important consideration as carers and patients from rural communities have indicated that a barrier to accessing services is a fear they may be recognised. 20 Moreover, the percentage of patients who were accessing or referred to an AH professional is higher than in previous studies, with a recent study reporting 11.2% of patients were referred to an AH service.…”