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

• Published in: Community mental health journal Vol. 60; no. 6; pp. 1055 - 1067
• Main Authors: Koob, Caitlin, Stuenkel, Mackenzie, Gagnon, Ryan J., Griffin, Sarah F., Sease, Kerry
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.08.2024; Springer Nature B.V
• Subjects: Adolescent; Child; Child poverty; Child, Preschool; Children; Community; Community and Environmental Psychology; Female; Health behavior; Health care access; Health services; Health Services Accessibility; Humans; Low income areas; Low income groups; Male; Medical referrals; Medicine; Medicine & Public Health; Mental Disorders - therapy; Mental health care; Mental health services; Mental Health Services - organization & administration; Mental Health Services - statistics & numerical data; Navigation; Older children; Original Paper; Patient Navigation; Patients; Pediatrics; Psychiatry; Referral and Consultation - statistics & numerical data; Referrals; Structural equation modeling; Support services; Community health; Health equity; Social drivers of health; Pediatric mental health; Systems navigation
• DOI: 10.1007/s10597-024-01258-7
• ISSN: 0010-3853; 1573-2789

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.