Closing the gap in access to child mental health care: provider feedback from the Wisconsin Child Psychiatry Consultation Program. BMC Prim Care 2024 Aug 14;25(1):300
Date
08/15/2024Pubmed ID
39143470Pubmed Central ID
PMC11323596DOI
10.1186/s12875-024-02538-7Scopus ID
2-s2.0-85201319499 (requires institutional sign-in at Scopus site)Abstract
BACKGROUND: Mental illnesses are common among children and negatively impact wellbeing during childhood as well as later in life. However, many children with these conditions are not able to access needed mental health care. The Wisconsin Child Psychiatry Consultation Program (WI CPCP) was created to reduce gaps in access to care by providing primary care providers with referral resources, access to behavioral health consultations, and training on mental health topics.
OBJECTIVES: The purpose of this study was 1) to assess the effectiveness of the WI CPCP in Milwaukee County, providing specific insights into provider's ability to care for child mental health, and 2) identify challenges Milwaukee PCPs faced in providing mental health care to child patients and contextualize these challenges in a conceptual framework of access to health care.
METHODS: A cross-sectional mixed-methods secondary data analysis was conducted using data collected from online baseline and nine-month follow-up surveys completed by providers participating in the program practicing in Milwaukee County from 2014 to 2022. Provider confidence and skill in providing mental health care was analyzed quantitatively using Two-sample Wilcoxon rank-sum (Mann-Whitney) tests (baseline vs. follow-up survey responses) and descriptive statistics (follow-up survey only). Provider challenges to providing mental health care were analyzed qualitatively using a thematic analysis research approach.
RESULTS: Results from quantitative analyses showed that provider confidence and skill in treating childhood anxiety and depression improved from baseline to follow-up. Results from qualitative analyses were categorized by factors within and beyond the scope of WI CPCP. Within the scope of WI CPCP, providers reported a lack of knowledge of referral options and a lack of training in mental health care as well as a lack of knowledge in assessing and treating mental disorders. Still, many barriers to mental healthcare access persist that are beyond the scope of WI CPCP, such as long wait times and a lack of insurance coverage.
CONCLUSIONS: This study supports the effectiveness of the program to improve access to care for children. However, there is a need for additional solutions such as better reimbursement for mental health professionals and expanded insurance coverage.
Author List
Daskalska L, Broaddus M, Young SAuthor
Staci A. Young PhD Sr Associate Dean, Associate Director, Professor in the Family Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
ChildChild Psychiatry
Clinical Competence
Cross-Sectional Studies
Female
Health Services Accessibility
Humans
Male
Mental Disorders
Mental Health Services
Primary Health Care
Referral and Consultation
Wisconsin
