Clinicians' utilization of child mental health telephone consultation in primary care: findings from Massachusetts

Psychiatr Serv. 2014 Mar 1;65(3):391-4. doi: 10.1176/appi.ps.201200295.

Abstract

Objective: The authors examined utilization of the Massachusetts Child Psychiatry Access Project, a mental health telephone consultation service for primary care, hypothesizing that greater use would be related to severe psychiatric diagnoses and polypharmacy.

Methods: The authors examined the association between utilization, defined as the mean number of contacts per patient during the 180 days following the initial contact (July 2008-June 2009), and characteristics of the initial contact, including consultation question, the child's primary mental health problem, psychotropic medication regimen, insurance status, and time of year.

Results: Utilization (N=4,436 initial contacts, mean=3.83 contacts) was associated with initial contacts about medication management, polypharmacy, public and private health insurance, and time of year. The child's primary mental health problem did not predict utilization.

Conclusions: Telephone consultation services address treatment with psychotropic medications, particularly polypharmacy. Joint public-private funding should be considered for such public programs that serve privately insured children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child Health Services / methods*
  • Child Psychiatry / methods
  • Child, Preschool
  • Female
  • Hotlines / statistics & numerical data*
  • Humans
  • Insurance, Health
  • Male
  • Massachusetts
  • Mental Health Services / statistics & numerical data*
  • Pediatrics / methods
  • Polypharmacy
  • Primary Health Care / methods*
  • Psychotropic Drugs / therapeutic use
  • Referral and Consultation / statistics & numerical data
  • Retrospective Studies
  • Time Factors
  • Young Adult

Substances

  • Psychotropic Drugs