Encouraging and sustaining integration of child mental health into primary care

Interviews with primary care providers participating in Project TEACH (CAPES and CAP PC) in NY

Anne M. Gadomski, Lawrence S Wissow, Lawrence Palinkas, Kimberly E. Hoagwood, Jeffrey M. Daly, David L. Kaye

Research output: Contribution to journalArticle

Abstract

Objective: Project Training and Education for the Advancement of Children's Health (TEACH) provides training, consultation and referral support to build child and adolescent mental health (MH) expertise among primary care providers (PCPs). This study describes how TEACH engages PCP, how program components lead to changes in practice and how contextual factors influence sustainability. Method: Thirty PCPs randomly selected from 139 trained PCPs and 10 PCPs from 143 registered with TEACH but not yet trained completed semistructured interviews. PCP selection utilized purposeful sampling for region, rurality and specialty. Interviews were recorded, transcribed and analyzed using grounded theory. Results: PCP participation was facilitated by perceived patient needs, lack of financial and logistic barriers and continuity of PCP-program relationships from training to ongoing consultation. Trained PCPs reported more confidence interacting with families about MH, assessing severity, prescribing medication and developing treatment plans. They were encouraged by satisfying interactions with MH specialists and positive feedback from families. Barriers included difficulties implementing screening, time constraints, competing demands, guarded expectations for patient outcomes and negative impressions of the MH system overall. Conclusions: Programs like TEACH can increase PCP confidence in MH care and promote increased MH treatment in primary care and through collaboration with specialists. Sustainability may depend on the PCP practice context and implementation support.

Original languageEnglish (US)
Pages (from-to)555-562
Number of pages8
JournalGeneral Hospital Psychiatry
Volume36
Issue number6
DOIs
StatePublished - Nov 1 2014

Fingerprint

Primary Health Care
Mental Health
Interviews
Education
Child Health
Referral and Consultation
Continuity of Patient Care
Delivery of Health Care
Therapeutics

Keywords

  • Child
  • Integration
  • Mental health care delivery
  • Primary care provider training

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Encouraging and sustaining integration of child mental health into primary care : Interviews with primary care providers participating in Project TEACH (CAPES and CAP PC) in NY. / Gadomski, Anne M.; Wissow, Lawrence S; Palinkas, Lawrence; Hoagwood, Kimberly E.; Daly, Jeffrey M.; Kaye, David L.

In: General Hospital Psychiatry, Vol. 36, No. 6, 01.11.2014, p. 555-562.

Research output: Contribution to journalArticle

Gadomski, Anne M. ; Wissow, Lawrence S ; Palinkas, Lawrence ; Hoagwood, Kimberly E. ; Daly, Jeffrey M. ; Kaye, David L. / Encouraging and sustaining integration of child mental health into primary care : Interviews with primary care providers participating in Project TEACH (CAPES and CAP PC) in NY. In: General Hospital Psychiatry. 2014 ; Vol. 36, No. 6. pp. 555-562.
@article{b61c5256d3794ad7ba8fe61dcecd14a2,
title = "Encouraging and sustaining integration of child mental health into primary care: Interviews with primary care providers participating in Project TEACH (CAPES and CAP PC) in NY",
abstract = "Objective: Project Training and Education for the Advancement of Children's Health (TEACH) provides training, consultation and referral support to build child and adolescent mental health (MH) expertise among primary care providers (PCPs). This study describes how TEACH engages PCP, how program components lead to changes in practice and how contextual factors influence sustainability. Method: Thirty PCPs randomly selected from 139 trained PCPs and 10 PCPs from 143 registered with TEACH but not yet trained completed semistructured interviews. PCP selection utilized purposeful sampling for region, rurality and specialty. Interviews were recorded, transcribed and analyzed using grounded theory. Results: PCP participation was facilitated by perceived patient needs, lack of financial and logistic barriers and continuity of PCP-program relationships from training to ongoing consultation. Trained PCPs reported more confidence interacting with families about MH, assessing severity, prescribing medication and developing treatment plans. They were encouraged by satisfying interactions with MH specialists and positive feedback from families. Barriers included difficulties implementing screening, time constraints, competing demands, guarded expectations for patient outcomes and negative impressions of the MH system overall. Conclusions: Programs like TEACH can increase PCP confidence in MH care and promote increased MH treatment in primary care and through collaboration with specialists. Sustainability may depend on the PCP practice context and implementation support.",
keywords = "Child, Integration, Mental health care delivery, Primary care provider training",
author = "Gadomski, {Anne M.} and Wissow, {Lawrence S} and Lawrence Palinkas and Hoagwood, {Kimberly E.} and Daly, {Jeffrey M.} and Kaye, {David L.}",
year = "2014",
month = "11",
day = "1",
doi = "10.1016/j.genhosppsych.2014.05.013",
language = "English (US)",
volume = "36",
pages = "555--562",
journal = "General Hospital Psychiatry",
issn = "0163-8343",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Encouraging and sustaining integration of child mental health into primary care

T2 - Interviews with primary care providers participating in Project TEACH (CAPES and CAP PC) in NY

AU - Gadomski, Anne M.

AU - Wissow, Lawrence S

AU - Palinkas, Lawrence

AU - Hoagwood, Kimberly E.

AU - Daly, Jeffrey M.

AU - Kaye, David L.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Objective: Project Training and Education for the Advancement of Children's Health (TEACH) provides training, consultation and referral support to build child and adolescent mental health (MH) expertise among primary care providers (PCPs). This study describes how TEACH engages PCP, how program components lead to changes in practice and how contextual factors influence sustainability. Method: Thirty PCPs randomly selected from 139 trained PCPs and 10 PCPs from 143 registered with TEACH but not yet trained completed semistructured interviews. PCP selection utilized purposeful sampling for region, rurality and specialty. Interviews were recorded, transcribed and analyzed using grounded theory. Results: PCP participation was facilitated by perceived patient needs, lack of financial and logistic barriers and continuity of PCP-program relationships from training to ongoing consultation. Trained PCPs reported more confidence interacting with families about MH, assessing severity, prescribing medication and developing treatment plans. They were encouraged by satisfying interactions with MH specialists and positive feedback from families. Barriers included difficulties implementing screening, time constraints, competing demands, guarded expectations for patient outcomes and negative impressions of the MH system overall. Conclusions: Programs like TEACH can increase PCP confidence in MH care and promote increased MH treatment in primary care and through collaboration with specialists. Sustainability may depend on the PCP practice context and implementation support.

AB - Objective: Project Training and Education for the Advancement of Children's Health (TEACH) provides training, consultation and referral support to build child and adolescent mental health (MH) expertise among primary care providers (PCPs). This study describes how TEACH engages PCP, how program components lead to changes in practice and how contextual factors influence sustainability. Method: Thirty PCPs randomly selected from 139 trained PCPs and 10 PCPs from 143 registered with TEACH but not yet trained completed semistructured interviews. PCP selection utilized purposeful sampling for region, rurality and specialty. Interviews were recorded, transcribed and analyzed using grounded theory. Results: PCP participation was facilitated by perceived patient needs, lack of financial and logistic barriers and continuity of PCP-program relationships from training to ongoing consultation. Trained PCPs reported more confidence interacting with families about MH, assessing severity, prescribing medication and developing treatment plans. They were encouraged by satisfying interactions with MH specialists and positive feedback from families. Barriers included difficulties implementing screening, time constraints, competing demands, guarded expectations for patient outcomes and negative impressions of the MH system overall. Conclusions: Programs like TEACH can increase PCP confidence in MH care and promote increased MH treatment in primary care and through collaboration with specialists. Sustainability may depend on the PCP practice context and implementation support.

KW - Child

KW - Integration

KW - Mental health care delivery

KW - Primary care provider training

UR - http://www.scopus.com/inward/record.url?scp=84919415094&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84919415094&partnerID=8YFLogxK

U2 - 10.1016/j.genhosppsych.2014.05.013

DO - 10.1016/j.genhosppsych.2014.05.013

M3 - Article

VL - 36

SP - 555

EP - 562

JO - General Hospital Psychiatry

JF - General Hospital Psychiatry

SN - 0163-8343

IS - 6

ER -