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Article Title

Provider Perspectives on Behavioral Health Care for Adolescents: Barriers and Suggestions for Improvement

Publication Date

8-15-2016

Keywords

adolescent behavioral health, barriers to care

Abstract

Background/Aims: Onset of behavioral health needs commonly occurs at adolescence, and best practices call for early detection and coordinated care. Practices for assessing and treating these needs are not standardized and may vary widely. This research explores current provider practices and perspectives as a first step towards designing better strategies for adolescent behavioral health care.

Methods: Primary care providers (PCPs) within a multispecialty delivery system were surveyed and interviewed about assessment and treatment of adolescent behavioral health needs, barriers to appropriate care and suggestions for system improvement.

Results: Of 123 PCPs who completed the survey, 103 (83.7%) felt their teen patients were willing to discuss behavioral health, 94 (76.4%) felt their teen patients would want them to treat their behavioral health problems and 95 (76.9%) were confident in their ability to identify behavioral health needs. However, 61 (49.6%) PCPs were unaware of available resources, 63 (51.2%) lacked confidence in making effective referrals, 65 (52.8%) reported limited time was a barrier, and 72 (58.5%) found behavioral health evaluations overburdening. Analyses of interviews with 21 PCPs revealed a lack of confidence among PCPs in assessing and treating less commonly seen adolescent behavioral health needs such as bipolar disorder, schizophrenia, substance abuse and suicidality. Other barriers to adolescent behavioral health care included: lack of time during appointments, lack of standardized referral process, and difficulties in accessing specialty behavioral health providers. PCPs desired improved care coordination, accessible behavioral health specialists within the delivery system for better continuity and coordination of care in contrast to outside specialists, and additional resources to help teen patients and families navigate the system.

Conclusion: While confident about identifying behavioral health needs among their teen patients, many PCPs report multiple challenges to providing necessary and appropriate care to treat their patients. Further research and quality improvement efforts are needed to improve existing resources and provide adequate support for providers to ensure adolescent behavioral health needs are expertly addressed.

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