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Pediatric Primary Care Perspectives on Integrated Mental Health Care for Autism.

Authors
  • Stadnick, Nicole A1
  • Martinez, Kassandra2
  • Aarons, Gregory A3
  • Lee, David4
  • Van-Cleave, Jeanne5
  • Brookman-Frazee, Lauren6
  • 1 University of California, San Diego | Department of Psychiatry, Child and Adolescent Services Research Center, 9500 Gilman Drive, MC 8022, La Jolla, CA 92093. Electronic address: [email protected]
  • 2 San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, Child and Adolescent Services Research Center, 9500 Gilman Drive, MC 8022, La Jolla, CA 92093. Electronic address: [email protected]
  • 3 University of California, San Diego | Department of Psychiatry, Child and Adolescent Services Research Center, 9500 Gilman Drive, MC 8022, La Jolla, CA 92093. Electronic address: [email protected]
  • 4 University of California, San Diego | Department of Psychiatry, Child and Adolescent Services Research Center, 9500 Gilman Drive, MC 8022, La Jolla, CA 92093. Electronic address: [email protected]
  • 5 Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) University of Colorado | Anschutz Medical Campus, 13199 E Montview Blvd, Suite 300, Mail Stop F443, Aurora, CO 80045. Electronic address: [email protected]
  • 6 University of California, San Diego | Department of Psychiatry, Child and Adolescent Services Research Center, Rady Children's Hospital, San Diego, 9500 Gilman Drive, MC 8022, La Jolla, CA 92093. Electronic address: [email protected]
Type
Published Article
Journal
Academic pediatrics
Publication Date
Mar 20, 2020
Identifiers
DOI: 10.1016/j.acap.2020.03.006
PMID: 32205263
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Timely identification of mental health needs and linkage to services is critical to provide comprehensive care for children with autism spectrum disorder (ASD). Pediatric primary care is well-positioned to facilitate this process through integrated care approaches. As a first step towards mental health integration, this study applied the Exploration, Preparation, Implementation, and Sustainment framework to characterize determinants of implementing integrated care practices for ASD. Sixty pediatric primary care providers and leaders from three organizations completed focus groups and surveys about identification of mental health needs in children with ASD and access to mental health services. Findings were integrated to examine convergence (i.e., do the two methods confirm or find similar results) and expansion (i.e., do the two methods provide insights beyond either method alone). Results converged regarding three primary influences to integrated care practices for ASD: 1) limited specialized mental health referral options for ASD, 2) unique structural characteristics of the mental health system act as barriers to accessing care and 3) caregivers differ in the degree to which they understand co-occurring mental health conditions and pursue recommended services. Qualitative results provided expansion by highlighting unique implementation considerations (e.g., alignment with healthcare delivery priorities and values) based on primary care characteristics. Findings confirm need for a tailored approach for linking children with ASD to appropriate mental health treatment. Results yield insight into the needs for organizational capacity to support integrated care and provide direction towards adapting an integrated mental health care model for children with ASD. Copyright © 2020. Published by Elsevier Inc.

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