Challenges to Effective Primary Care-Specialty Communication and Coordination in the Mental Health Referral and Care Process for Publicly Insured Children

J Behav Health Serv Res. 2018 Oct;45(4):668-677. doi: 10.1007/s11414-018-9585-z.

Abstract

Publicly insured children needing referral to mental health (MH) services often do not access or receive services. The objective of this study was to identify gaps in communication and coordination between primary care providers (PCPs) and MH providers during the MH referral and care process for publicly insured children. Thirteen semi-structured interviews were conducted with 10 PCPs and staff from a federally qualified health center (FQHC) and 6 MH providers and staff from two local MH clinics. Interview participants identified multiple gaps in communication throughout the care process and different phases as priorities for improvement. PCPs described primary care-MH communication challenges during early phases, while MH providers described coordination challenges in transferring patients back to primary care for ongoing mental health management. Strategies are needed to improve primary care-specialty MH communication and coordination throughout all phases of the referral and care process, particularly at initial referral and transfer back to primary care.

Keywords: Collaboration; Coordination; Mental health care; Primary care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Attitude of Health Personnel*
  • Child
  • Child, Preschool
  • Community Mental Health Centers*
  • Cooperative Behavior
  • Female
  • Health Personnel / psychology*
  • Humans
  • Infant
  • Insurance, Health
  • Interprofessional Relations*
  • Interviews as Topic
  • Los Angeles
  • Male
  • Medicaid
  • Mental Disorders / psychology
  • Mental Disorders / therapy
  • Mental Health Services
  • Primary Health Care*
  • Public Sector
  • Referral and Consultation*
  • United States