Abstract
Pediatric primary care providers (PCPs) play a critical role in caring for children with mental health concerns. Some states have introduced programs to support PCPs in managing these patients more independently. The Massachusetts Child Psychiatry Access Project consultation program is one example. This study compared responses from PCPs in Massachusetts (n = 73) with PCPs in Indiana (n = 33), a state without a consultation program, to vignettes about children with possible attention-deficit/hyperactivity disorder or depression. Participants from MA indicated a stronger interest in behavioral health issues and were more likely to screen patients. PCPs from IN were more likely to have completed a rotation in developmental and behavioral pediatrics during residency. IN respondents were also more likely to choose the correct diagnosis for vignettes and less likely to refer to a psychiatric provider for psychotropic medication. Results suggest greater independence for PCPs in IN.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Academy of Child Adolescent Psychiatry. (2013a). Indiana: Practicing child and adolescent psychiatrists. Retrieved from https://www.aacap.org/aaCaP/Advocacy/Federal_and_State_Initiatives/Workforce_Maps/Indiana.aspx.
American Academy of Child Adolescent Psychiatry. (2013b). Massachusetts: Practicing child and adolescent psychiatrists. Retrieved from https://www.aacap.org/aaCaP/Advocacy/Federal_and_State_Initiatives/Workforce_Maps/Massachusetts.aspx.
American Academy of Pediatrics Committee on Psychological Aspects of Child and Family Health and Task Force on Mental Health. (2009). The future of pediatrics: Mental health competencies for pediatric primary care. Pediatrics, 124(1), 410–421. doi:10.1542/peds.2009-1061.
Assurance NCfQa. (2014). Patient-centered medical home (PCMH) 2014 standards. Retrieved from http://www.ncqa.org/Programs/Recognition/Practices/PatientCenteredMedicalHomePCMH/PCMH2011PCMH2014Crosswalk.aspx.
Center for Health Care Strategies Inc. (2013). Comparison matrix: Telephonic psychiatric consultation programs. Retrieved from http://www.chcs.org/media/Telephonic-Psychiatric-Consultation-Programs_FINAL.pdf.
Centers for Disease Control and Prevention. (2014). Health, United States. Retrieved from http://www.cdc.gov/nchs/data/hus/2014/070.pdf.
Fremont, W. P., Nastasi, R., Newman, N., & Roizen, N. J. (2008). Comfort level of pediatricians and family medicine physicians diagnosing and treating child and adolescent psychiatric disorders. The International Journal of Psychiatry in Medicine, 38(2), 153–168.
Glascoe, F. P. (1998). Collaborating with parents: Using parents’ evaluation of developmental status to detect and address developmental and behavioral problems. Nolensville, TN: Ellsworth & Vandermeer Press.
Goyette, C. H., Conners, C. K., & Ulrich, R. F. (1978). Normative data on revised Conners parent and teacher rating scales. Journal of Abnormal Child Psychology, 6(2), 221–236.
Green, M. (1994). Bright futures: Guidelines for health supervision of infants, children, and adolescents. McLean, VA: National Maternal and Child Health Clearinghouse.
Hilt, R. J., Romaire, M. A., McDonell, M. G., Sears, J. M., Krupski, A., Thompson, J. N., et al. (2013). The partnership access line: Evaluating a child psychiatry consult program in Washington State. JAMA Pediatrics, 167(2), 162–168.
Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440. doi:10.1007/s10608-012-9476-1.
Holt, W. (2010). The Massachusetts Child Psychiatry Access Project: Supporting mental health treatment in primary care. New York: Commonwealth Fund.
Jellinek, M. S., Murphy, J. M., Robinson, J., Feins, A., Lamb, S., & Fenton, T. (1988). Pediatric symptom checklist: Screening school-age children for psychosocial dysfunction. The Journal of Pediatrics, 112(2), 201–209.
Kolko, D. J., & Perrin, E. (2014). The integration of behavioral health interventions in children’s health care: Services, science, and suggestions. Journal of Clinical Child & Adolescent Psychology, 43(2), 216–228.
Olfson, M., Blanco, C., Wang, S., Laje, G., & Correll, C. U. (2014). National trends in the mental health care of children, adolescents, and adults by office-based physicians. JAMA Psychiatry, 71(1), 81–90.
Perrin, E. C. (1999). Commentary: Collaboration in pediatric primary care: A pediatrician’s view. Journal of Pediatric Psychology, 24(5), 453–458.
Pidano, A. E., Honigfeld, L., Bar-Halpern, M., & Vivian, J. E. (2014). Pediatric primary care providers’ relationships with mental health care providers: Survey results. Child & Youth Care Forum, 43(1), 135–150.
Pidano, A. E., Kimmelblatt, C. A., & Neace, W. P. (2011a). Behavioral health in the pediatric primary care setting: Needs, barriers, and implications for psychologists. Psychological Services, 8(3), 151.
Pidano, A. E., Marcaly, K. H., Ihde, K. M., Kurowski, E. C., & Whitcomb, J. M. (2011b). Connecticut's enhanced care clinic initiative: Early returns from pediatric-behavioral health partnerships. Families, Systems, & Health, 29(2), 138–143. doi:10.1037/a0023474.
Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The modified checklist for autism in toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31(2), 131–144.
Rosie, D. (2008). Reforming the mental health system in Massachusetts. Center for Public Representation. www.rosied.org/Default.aspx.
Ross, W. J., Chan, E., Harris, S. K., Goldman, S. J., & Rappaport, L. A. (2011). Pediatrician–psychiatrist collaboration to care for children with attention deficit hyperactivity disorder, depression, and anxiety. Clinical Pediatrics, 50(1), 37–43. doi:10.1177/0009922810379499.
Sarvet, B., Gold, J., Bostic, J. Q., Masek, B. J., Prince, J. B., Jeffers-Terry, M., et al. (2010). Improving access to mental health care for children: The Massachusetts Child Psychiatry Access Project. Pediatrics, 126(6), 1191–1200.
Sarvet, B., Gold, J., & Straus, J. H. (2011). Bridging the divide between child psychiatry and primary care: The use of telephone consultation within a population-based collaborative system. Child and Adolescent Psychiatric Clinics of North America, 20(1), 41–53.
Sheldrick, R. C., Mattern, K., & Perrin, E. C. (2012). Pediatricians’ perceptions of an off-site collaboration with child psychiatry. Clinical Pediatrics, 51(6), 546–550.
Spitzer, R. L., Kroenke, K., Williams, J. B., & Patient Health Questionnaire Primary Care Study Group. (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. Journal of the American Medical Association, 282(18), 1737–1744.
Stancin, T., & Perrin, E. C. (2014). Psychologists and pediatricians: Opportunities for collaboration in primary care. American Psychologist, 69(4), 332.
Steele, M. M., Lochrie, A. S., & Roberts, M. C. (2010). Physician identification and management of psychosocial problems in primary care. Journal of Clinical Psychology in Medical Settings, 17(2), 103–115.
Stein, R. E., Horwitz, S. M., Storfer-Isser, A., Heneghan, A., Olson, L., & Hoagwood, K. E. (2008). Do pediatricians think they are responsible for identification and management of child mental health problems? Results of the AAP periodic survey. Ambulatory Pediatrics, 8(1), 11–17.
Trude, S., & Stoddard, J. J. (2003). Referral gridlock. Journal of General Internal Medicine, 18(6), 442–449.
Tynan W. D., Woods K., & Carpenter J. (2013). Integrating child psychology services in primary care. American Psychological Association. Retrieved from http://www.apa.org/pi/families/resources/primary-care/integrating-services.aspx?item=1.
United States Census Bureau. (2014). QuickFacts Beta United States. Retrieved from http://www.census.gov/quickfacts/table/PST045214/00.
Van Cleave, J., Le, T. T., & Perrin, J. M. (2015). Point-of-care child psychiatry expertise: The Massachusetts Child Psychiatry Access Project. Pediatrics, 135(5), 834–841.
Ward-Zimmerman, B., & Cannata, E. (2012). Partnering with pediatric primary care: Lessons learned through collaborative colocation. Professional Psychology: Research and Practice, 43(6), 596.
Williams, J., Klinepeter, K., Palmes, G., Pulley, A., & Foy, J. M. (2004). Diagnosis and treatment of behavioral health disorders in pediatric practice. Pediatrics, 114(3), 601–606.
Williams, J., Palmes, G., Klinepeter, K., Pulley, A., & Foy, J. M. (2005). Referral by pediatricians of children with behavioral health disorders. Clinical Pediatrics, 44(4), 343–349.
Wolraich, M. L., Feurer, I. D., Hannah, J. N., & Baumgaertel, A. (2003). Vanderbilt ADHD teacher rating scale (VADTRS) and the Vanderbilt ADHD parent rating scale (VADPRS). Oklahoma City, OK: University of Oklahoma Health Sciences Center.
Acknowledgments
The authors would like to thank Jon S. Reichelt for his suggestions regarding methodology, Michael J. Dean, Jr. for assistance with data collection, and, especially, all of the primary care pediatric providers who took time from their busy schedules to complete the survey.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pidano, A.E., Slater, C.M., Dale, L.P. et al. Availability of Telephone-Based Child Psychiatry Consultation: Implications from a Survey of Pediatric Providers in Two States. J Child Fam Stud 25, 2607–2615 (2016). https://doi.org/10.1007/s10826-016-0423-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10826-016-0423-8