Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI; Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, MI.
University of Michigan Medical School, Ann Arbor, MI.
Psychosomatics. 2019 Mar-Apr;60(2):179-189. doi: 10.1016/j.psym.2018.06.005. Epub 2018 Jun 21.
Pediatric mental healthcare is a growing component of primary care practice. However, there is a lack of access to mental health services, particularly those provided by Child and Adolescent Psychiatrists. The Michigan Child Collaborative Care (MC3) Program is a telepsychiatry service that offers embedded behavioral health consultants within primary care practices, telephonic consultation, video consultation and embedded care. Primary care provider (PCP) utilization of telepsychiatry services is predicated on perceiving the consultation service as user-friendly, helpful, and feasible in their practice.
A survey of PCPs was conducted over a 5-year period to assess PCP attitudes and perceptions regarding MC3 consultation, including measures of efficiency, user-friendliness, and confidence in providing mental healthcare. The survey contained 4 items, (2 quantitative and 2 qualitative), and took less than 2 minutes to complete.
649 responses were received out of 1475 possible responses (44% response rate). Common themes elicited from the qualitative items included perception of improved patient care for youth with mental illness (45.3%), improved comfort and confidence in caring for youth with mental illness (30.9%), greater comfort with the prescribing and monitoring of psychotropics (25.9%) and improved access to mental healthcare for youth (23.1%). PCPs strongly agreed that MC3 was user-friendly, efficient, and enhanced their confidence in managing pediatric mental health concerns.
This study demonstrates that the MC3 Telepsychiatry Program is well accepted by PCPs with self-reported improvements in providing mental healthcare to patients. Future research should explore how PCP perception impacts PCP practice, knowledge, as well as outcomes for patients and families longitudinally.
儿科心理健康保健是初级保健实践中日益重要的组成部分。然而,获得心理健康服务,尤其是儿童和青少年精神病学家提供的服务的机会有限。密歇根儿童协作护理(MC3)计划是一项远程精神病学服务,它在初级保健实践中提供嵌入式行为健康顾问、电话咨询、视频咨询和嵌入式护理。初级保健提供者(PCP)使用远程精神病学服务的前提是认为咨询服务易于使用、有帮助且在其实践中可行。
在五年期间对 PCP 进行了一项调查,以评估 PCP 对 MC3 咨询的态度和看法,包括对效率、易用性和提供心理健康保健的信心的衡量。该调查包含 4 个项目(2 个定量和 2 个定性),完成时间不到 2 分钟。
在可能的 1475 个回复中,收到了 649 个回复(44%的回复率)。从定性项目中得出的常见主题包括改善对患有精神疾病的青年患者的护理的看法(45.3%)、改善对照顾患有精神疾病的青年的舒适度和信心(30.9%)、对精神药物的处方和监测更有信心(25.9%)以及改善对青年心理健康的获得(23.1%)。PCP 强烈认为 MC3 易于使用、高效,并增强了他们管理儿科心理健康问题的信心。
这项研究表明,MC3 远程精神病学计划得到了 PCP 的广泛接受,他们报告在为患者提供心理健康护理方面有所改善。未来的研究应该探讨 PCP 的看法如何影响 PCP 的实践、知识以及患者和家庭的长期结果。