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Article Title

Provider Perspectives on Behavioral Health Navigation Program for Adolescents

Publication Date

8-10-2017

Keywords

child and adolescent health, survey research and methods, primary care, behavioral and mental health, evaluation research, qualitative research, quality improvement

Abstract

Background: This research evaluation is for an adolescent behavioral health (BH) quality improvement project within a multispecialty health care delivery system. Approximately 20% of U.S. adolescents have a mental health condition, thus underscoring the BH needs of this population. Best practices call for early detection of conditions by primary care providers (PCPs) and coordinated care aimed at managing conditions. Results from baseline PCP surveys and interviews showed that while confident about identifying adolescent BH needs, PCPs face challenges in providing necessary and appropriate treatment for their patients. In an effort to support PCPs and provide improved quality of BH care in primary care, a navigation program was developed to facilitate referrals from PCPs to BH specialists for adolescents. We asked PCPs about their experience with the program.

Methods: Pediatric and family medicine PCPs with access to the adolescent BH navigation program were surveyed and interviewed.

Results: Over 3,400 referrals have been made to the navigation program to date. Of 150 PCPs surveyed, 106 (70.7%) stated that they have used the navigation program. Their reasons for use include: for help with finding BH providers who accept patients’ insurance (96.2%), to ensure patients receive timely BH care (83.0%), and for help with determining appropriate type of BH provider or care for patients (42.6%). 87.7% of PCPs believed that navigation has enhanced their clinical care. Additionally, PCPs rated the program positively on: the referral process to navigation (90.6%), communication with navigators (87.7%), and overall experience with navigation (89.6%). However, PCPs commented through surveys and interviews that the navigation program could be improved. Some PCPs prefer having more feedback from navigators regarding patient referral status. Most noticeably, PCPs are concerned about delayed response time. They recognize that increasing demand for the program may be causing a slowdown; still, PCPs would like for navigators to process their referrals in a more timely manner.

Conclusion: Support needed by PCPs is evidenced by the demand of this BH navigation program. PCPs indicated that the program is a valuable service and offered suggestions for improvement. We will use their feedback to further refine our program to support PCPs and their adolescent patients.

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