Campbell Duncan G, Downs Andrew, Meyer William J, McKittrick Megan M, Simard Nicole M, O'Brien Patricia
Department of Psychology.
Department of Psychological Sciences, University of Portland.
Fam Syst Health. 2018 Sep;36(3):404-409. doi: 10.1037/fsh0000309. Epub 2017 Dec 4.
Pediatricians are more likely than mental health (MH) specialists to manage children's MH concerns, and multiple factors complicate their abilities to do so adequately. Integrated care initiatives mitigate systems-related shortcomings that hamstring MH management in primary care. These initiatives, which improve outcomes for adults, are not widespread for youth. Integrated health care for children with MH concerns requires regular collaborative communication among pediatricians and MH specialists. The nature and quality of this communication in typical practice are not fully clear.
We conducted an anonymous pilot survey of 123 pediatric primary care providers from 41 states. We examined respondents' experiences with and attitudes about collaborative communication barriers and strategies.
Respondents estimated that 28% of their patients had MH concerns. Nearly 30% reported discomfort treating these concerns, 54% described MH care resources in their communities as inadequate, and 24% of pediatricians reported no communication at all with MH specialists about shared patients. Actual contact among communicators was less frequent than desired. Satisfaction with communication was low. Barriers to satisfactory communication included systems factors, inconsistent/nontimely responses from specialists, and the perception that MH specialists are unwilling to communicate.
Many pediatricians appear to view communication with MH specialists as less systematic than it ought to be. Efforts to address communication barriers may advance integrated care aims and mitigate pediatricians' perceptions of MH treatment resource inadequacy. As an important step toward integration, MH specialists should consider prioritizing systematic ongoing collaborative communication about shared patients. (PsycINFO Database Record
与心理健康（MH）专家相比，儿科医生更有可能处理儿童的心理健康问题，而多种因素使他们难以充分胜任此项工作。综合护理举措可缓解阻碍初级保健中MH管理的系统相关缺陷。这些对成年人有效的举措在青少年中并不普遍。为有心理健康问题的儿童提供综合医疗保健需要儿科医生和MH专家之间定期进行协作沟通。在日常实践中，这种沟通的性质和质量尚不完全清楚。
我们对来自41个州的123名儿科初级保健提供者进行了一项匿名试点调查。我们研究了受访者在协作沟通障碍和策略方面的经历与态度。
受访者估计，他们28%的患者存在心理健康问题。近30%的人表示在处理这些问题时感到不适，54%的人认为他们所在社区的MH护理资源不足，24%的儿科医生表示与MH专家根本没有就共同的患者进行沟通。沟通者之间的实际接触比预期的要少。对沟通的满意度较低。令人满意的沟通障碍包括系统因素、专家回复不一致/不及时，以及认为MH专家不愿意沟通。
许多儿科医生似乎认为与MH专家的沟通不如应有的那样系统。解决沟通障碍的努力可能会推进综合护理目标，并减轻儿科医生对MH治疗资源不足的看法。作为整合的重要一步，MH专家应考虑优先就共同的患者进行系统的持续协作沟通。（PsycINFO数据库记录）
