TY - JOUR
AU - A. Chakawa
AU - T. P. Crawford
AU - L. T. Belzer
AU - H. W. Yeh
A1 - 
AB - OBJECTIVE: Youth unmet behavioral health needs are at public health crisis status and have worsened since the onset of the coronavirus disease 2019 pandemic (Covid-19). Integrating behavioral health services into pediatric primary care has shown efficacy in addressing youth behavioral health needs. However, there is limited guidance on facilitating equitable access to care in this setting, including in triaging access to co-located services (i.e., onsite outpatient behavioral health services with only the behavioral health provider) or to specialty behavioral health services in other clinics within larger health systems. METHODS: A retrospective, comparative study was conducted to examine variability in access to co-located and specialty behavioral health (SBH) services for a pre-Covid-19 cohort (April 2019 to March 2020; n = 367) and a mid-Covid-19 cohort (April 2020 to March 2021; n = 328), while accounting for integrated primary care consultation services. The sample included children 1-18 years old served through a large, inner-city primary care clinic. Logistic regression models were used to examine the association between scheduled and attended co-located and SBH visits, pre- and mid-Covid-19 effects, and sociodemographic factors of race and ethnicity, language, health insurance (SES proxy), age, and sex. RESULTS: The majority of youth were not directly scheduled for a co-located or SBH visit but the majority of those scheduled attended their visit(s). The odds of not being directly scheduled for a co-located or SBH visit were greater for the mid-Covid-19 cohort, Black youth, and older youth. Accounting for integrated primary care consultation visits addressed these disparities, with the exception of persisting significant differences in scheduled and attended co-located and SBH visits for Black youth even while accounting for IPC consultation. IMPLICATION: Findings from the current study highlight the effective role of integrated primary care consultation services as facilitating access to initial behavioral health services, especially given that referrals to integrated primary care co-located and SBH services within the larger health system often involve barriers to care such as longer wait-times and increased lack of referral follow through. Ongoing research and equitable program development are needed to further this work.
AD - Division of Developmental and Behavioral Health, Section of Pediatric Psychology, Children's Mercy Hospitals and Clinics, Kansas City, MO, United States.; University of Missouri Kansas City School of Medicine, Kansas City, MO, United States.; Emory Pediatric Institute, Emory School of Medicine, Atlanta, GA, United States.; Children's Healthcare of Atlanta, Center of Behavioral and Mental Health, Atlanta, GA, United States.; The Beacon Program, Children's Mercy Hospitals and Clinics, Kansas City, MO, United States.; Division of Health Services and Outcomes Research, Children's Mercy Hospitals and Clinics, Kansas City, MO, United States.
AN - 38800067
BT - Front Psychiatry
C5 - Healthcare Disparities
DO - 10.3389/fpsyt.2024.1356979
DP - NLM
ET - 20240510
JF - Front Psychiatry
LA - eng
N2 - OBJECTIVE: Youth unmet behavioral health needs are at public health crisis status and have worsened since the onset of the coronavirus disease 2019 pandemic (Covid-19). Integrating behavioral health services into pediatric primary care has shown efficacy in addressing youth behavioral health needs. However, there is limited guidance on facilitating equitable access to care in this setting, including in triaging access to co-located services (i.e., onsite outpatient behavioral health services with only the behavioral health provider) or to specialty behavioral health services in other clinics within larger health systems. METHODS: A retrospective, comparative study was conducted to examine variability in access to co-located and specialty behavioral health (SBH) services for a pre-Covid-19 cohort (April 2019 to March 2020; n = 367) and a mid-Covid-19 cohort (April 2020 to March 2021; n = 328), while accounting for integrated primary care consultation services. The sample included children 1-18 years old served through a large, inner-city primary care clinic. Logistic regression models were used to examine the association between scheduled and attended co-located and SBH visits, pre- and mid-Covid-19 effects, and sociodemographic factors of race and ethnicity, language, health insurance (SES proxy), age, and sex. RESULTS: The majority of youth were not directly scheduled for a co-located or SBH visit but the majority of those scheduled attended their visit(s). The odds of not being directly scheduled for a co-located or SBH visit were greater for the mid-Covid-19 cohort, Black youth, and older youth. Accounting for integrated primary care consultation visits addressed these disparities, with the exception of persisting significant differences in scheduled and attended co-located and SBH visits for Black youth even while accounting for IPC consultation. IMPLICATION: Findings from the current study highlight the effective role of integrated primary care consultation services as facilitating access to initial behavioral health services, especially given that referrals to integrated primary care co-located and SBH services within the larger health system often involve barriers to care such as longer wait-times and increased lack of referral follow through. Ongoing research and equitable program development are needed to further this work.
PY - 2024
SN - 1664-0640 (Print); 1664-0640
SP - 1356979
ST - Disparities in accessing specialty behavioral health services during the COVID-19 pandemic and why we need pediatric integrated primary care
T1 - Disparities in accessing specialty behavioral health services during the COVID-19 pandemic and why we need pediatric integrated primary care
T2 - Front Psychiatry
TI - Disparities in accessing specialty behavioral health services during the COVID-19 pandemic and why we need pediatric integrated primary care
U1 - Healthcare Disparities
U3 - 10.3389/fpsyt.2024.1356979
VL - 15
VO - 1664-0640 (Print); 1664-0640
Y1 - 2024
ER -