OBJECTIVE: To determine availability of and test whether on-site mental health providers (MHP) is associated with greater odds of reported mental health consultation and referral among primary care pediatricians. METHODS: Pediatricians were identified from the American Medical Association's 2004 physician directory and stratified by region. Six hundred were randomly selected to receive a mail survey. The main independent variable was on-site MHP. The dependent variable was reported frequency (4-point rating) of mental health consultation and referral. Estimates were weighted to account for survey design and nonresponse. RESULTS: Overall response rate was 51%. The majority of respondents were male (56%), age > or =46 years old (59%), white (68%), and practicing in suburban locations (52%). Approximately half reported consultation with (44%) or referral to (51%) MHP always or often, but a few (17%) reported on-site MHP. After adjustment for demographic and practice characteristics, pediatricians with on-site MHP were more likely to consult (odds ratio [OR] 6.58, 95% confidence interval [95% CI] 3.55- 12.18) or refer (OR 4.25, 95% CI 2.19-8.22) than those without on-site MHP. Among those without on-site MHP, pediatricians with greater practice burden were less likely to consult (OR 0.69, 95% CI 0.48-0.99) or refer (OR 0.75, 95% CI 0.54-1.04) than those with lesser burden. CONCLUSIONS: Most pediatricians in the United States experienced practice-related burdens that limit mental health collaboration, but those with co-located services reported a greater likelihood of consultation and referral. Policy changes that encourage co-location of mental health services and limit practice burden may facilitate mental health consultation and referral.
OBJECTIVE: To determine availability of and test whether on-site mental health providers (MHP) is associated with greater odds of reported mental health consultation and referral among primary care pediatricians. METHODS: Pediatricians were identified from the American Medical Association's 2004 physician directory and stratified by region. Six hundred were randomly selected to receive a mail survey. The main independent variable was on-site MHP. The dependent variable was reported frequency (4-point rating) of mental health consultation and referral. Estimates were weighted to account for survey design and nonresponse. RESULTS: Overall response rate was 51%. The majority of respondents were male (56%), age > or =46 years old (59%), white (68%), and practicing in suburban locations (52%). Approximately half reported consultation with (44%) or referral to (51%) MHP always or often, but a few (17%) reported on-site MHP. After adjustment for demographic and practice characteristics, pediatricians with on-site MHP were more likely to consult (odds ratio [OR] 6.58, 95% confidence interval [95% CI] 3.55- 12.18) or refer (OR 4.25, 95% CI 2.19-8.22) than those without on-site MHP. Among those without on-site MHP, pediatricians with greater practice burden were less likely to consult (OR 0.69, 95% CI 0.48-0.99) or refer (OR 0.75, 95% CI 0.54-1.04) than those with lesser burden. CONCLUSIONS: Most pediatricians in the United States experienced practice-related burdens that limit mental health collaboration, but those with co-located services reported a greater likelihood of consultation and referral. Policy changes that encourage co-location of mental health services and limit practice burden may facilitate mental health consultation and referral.
Authors: P Wu; C W Hoven; H R Bird; R E Moore; P Cohen; M Alegria; M K Dulcan; S H Goodman; S M Horwitz; J H Lichtman; W E Narrow; D S Rae; D A Regier; M T Roper Journal: J Am Acad Child Adolesc Psychiatry Date: 1999-09 Impact factor: 8.829
Authors: P J Leaf; M Alegria; P Cohen; S H Goodman; S M Horwitz; C W Hoven; W E Narrow; M Vaden-Kiernan; D A Regier Journal: J Am Acad Child Adolesc Psychiatry Date: 1996-07 Impact factor: 8.829
Authors: Cori Green; Amy Storfer-Isser; Ruth E K Stein; Andrew S Garner; Bonnie D Kerker; Moira Szilagyi; Karen G O'Connor; Kimberly E Hoagwood; Sarah M Horwitz Journal: Acad Pediatr Date: 2017-03-06 Impact factor: 3.107
Authors: Elizabeth H Connors; Prerna Arora; Angela M Blizzard; Kelly Bower; Kelly Coble; Joyce Harrison; David Pruitt; Janna Steinberg; Lawrence Wissow Journal: J Behav Health Serv Res Date: 2018-07 Impact factor: 1.505
Authors: Sarah McCue Horwitz; Amy Storfer-Isser; Bonnie D Kerker; Moira Szilagyi; Andrew S Garner; Karen G O'Connor; Kimberly E Hoagwood; Cori M Green; Jane M Foy; Ruth E K Stein Journal: Acad Pediatr Date: 2016-04-06 Impact factor: 3.107