Examining Patient- and Community-Level Factors Associated with Pediatric Mental Healthcare Access Within a Patient Navigation Program

Caitlin Koob; Mackenzie Stuenkel; Ryan J Gagnon; Sarah F Griffin; Kerry Sease

doi:10.1007/s10597-024-01258-7

Examining Patient- and Community-Level Factors Associated with Pediatric Mental Healthcare Access Within a Patient Navigation Program

Community Ment Health J. 2024 Mar 20. doi: 10.1007/s10597-024-01258-7. Online ahead of print.

Authors

Caitlin Koob^{1

2}, Mackenzie Stuenkel³, Ryan J Gagnon⁴, Sarah F Griffin⁵, Kerry Sease^{3

6}

Affiliations

¹ Department of Public Health Sciences, Clemson University, 501 Edwards Hall, Clemson, SC, 29634, USA. ckoob@clemson.edu.
² Prisma Health Children's Hospital-Upstate, Greenville, SC, USA. ckoob@clemson.edu.
³ Prisma Health Children's Hospital-Upstate, Greenville, SC, USA.
⁴ Department of Parks, Recreation, Tourism, and Management, Clemson University, Clemson, SC, USA.
⁵ Department of Public Health Sciences, Clemson University, 501 Edwards Hall, Clemson, SC, 29634, USA.
⁶ University of South Carolina School of Medicine Greenville, Greenville, SC, USA.

PMID: 38507129
DOI: 10.1007/s10597-024-01258-7

Abstract

In 2021, national leaders in the United States declared a "national youth mental health crisis." Still, only 1-in-4 children receive adequate mental healthcare access. Patient Navigator Programs (PNPs) can improve children's referral-to-connection to mental health services. We examined patient- and community-level factors associated with pediatric mental healthcare access. Pediatric Support Services (PSS) is a PNP that triages mental and behavioral health referrals within a large health system in a southeastern state. This study analyzes PSS data from September 2017-March 2023 and Child Opportunity Index 2.0 state-normed zip-code level data to assess social drivers of health estimates. Structural equation modeling was conducted between patient- and community-level factors and connection to mental health services. Overall, 62.7% of children connected to mental health services since PSS' inception. Regardless of SDOH, as children get older, they are more likely to connect with mental health services (β = .053, SE = .010, p < .001). Children with greater number of referral needs are more likely to connect with mental health services (β = .034, SE = .011, p = .002). Further, children who live in communities with higher opportunity levels are more likely to connect with mental health services (β = .016, SE = .008, p = .040), suggesting that children who live in low-income communities experience more barriers to mental healthcare. Social drivers may inform referral practices and tiered navigation support for optimal mental healthcare access among children. Further research should demonstrate the effectiveness of PNPs integrated within healthcare and community-based settings.

Keywords: Community health; Health equity; Pediatric mental health; Social drivers of health; Systems navigation.