Division of General and Community Pediatrics, Children's National Health System, Washington, District of Columbia;
Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia.
Pediatrics. 2019 Apr;143(4). doi: 10.1542/peds.2018-2418. Epub 2019 Mar 15.
Early engagement in mental health intervention is critical, yet the vast majority of children who are experiencing mental health concerns are not receiving needed services. Pediatric primary care clinics have been recognized as an ideal setting in which to identify and address mental health problems early, although engagement in mental health services within primary care and in community-based settings remains low. Navigators, or individuals with experience in navigating the mental health system, have been highlighted as promising partners in efforts to improve engagement in mental health services. Navigation has a growing body of research support among adults and in targeting medical concerns, but there has been limited research on integrating family navigators into pediatric primary care settings to address mental health concerns. Despite this gap in the evidence base, we believe there is significant promise for the use of this model in addressing children's mental health needs. In this report, we discuss factors contributing to high levels of unmet mental health needs and low levels of engagement in mental health services, the role that navigators can play in increasing engagement in mental health care, and implications and recommendations related to integrating mental health-focused family navigators into pediatric primary care settings.
早期介入心理健康干预至关重要，但绝大多数有心理健康问题的儿童并未获得所需的服务。儿科初级保健诊所已被认为是早期识别和解决心理健康问题的理想场所，尽管在初级保健和社区环境中参与心理健康服务的程度仍然较低。导航员，或有经验的人在导航心理健康系统，已被突出为改善心理健康服务参与度的有前途的合作伙伴。导航在成年人和针对医疗问题方面有越来越多的研究支持，但将家庭导航员纳入儿科初级保健环境以解决心理健康问题的研究有限。尽管证据基础存在这一差距，但我们相信，在解决儿童心理健康需求方面，使用这种模式具有很大的潜力。在本报告中，我们讨论了导致心理健康需求未得到满足和参与心理健康服务程度低的因素，导航员在增加心理健康护理参与度方面可以发挥的作用，以及将以心理健康为重点的家庭导航员纳入儿科初级保健环境的相关影响和建议。
