Jandrisevits Matthew D, Broaddus Michelle, Kim Rosa, DiFranceisco Wayne, Manak Colleen
Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 W. Watertown Plank Rd., Milwaukee, WI, 53226, USA.
J Behav Health Serv Res. 2025 Jun 16. doi: 10.1007/s11414-025-09954-2.
Child psychiatry access programs address the shortage of child and adolescent psychiatrists and other mental health professionals nationwide. The Wisconsin Child Psychiatry Consultation Program (WI CPCP) provides telephone or email guidance to pediatric primary care providers treating mild to moderate psychiatric symptoms in patients. Statewide programs like the WI CPCP offer direct outreach meetings to primary care clinics, which, though resource-intensive, are hypothesized to increase program utilization. This study examined whether direct outreach meetings to primary care corresponded with subsequent increased primary care consultations with the WI CPCP. The authors hypothesized that direct outreach meetings would increase primary care consultations with the WI CPCP. WI CPCP consultations among 492 primary care providers were compared in the period 3 and 12 months before and after receiving a direct outreach meeting. These were also compared to 492 matched control providers who did not receive a direct outreach meeting. Results of generalized estimating equation analyses suggested that direct outreach meetings significantly increased primary care utilization of the WI CPCP (p < .01). Consultation numbers more than doubled when including consultations generated during direct outreach meetings themselves. Consultation numbers nearly doubled when examining consultations after direct outreach meetings. Results held for both the 3- and 12-month periods following a direct outreach meeting. Although direct outreach meetings may require additional time and resources for pediatric psychiatry access programs, they add value via increased primary care engagement for at least 1 year.
儿童精神病学接入项目旨在解决全国范围内儿童及青少年精神科医生和其他心理健康专业人员短缺的问题。威斯康星州儿童精神病学咨询项目（WI CPCP）为治疗患者轻度至中度精神症状的儿科初级保健提供者提供电话或电子邮件指导。像WI CPCP这样的全州性项目会为初级保健诊所提供直接的外联会议，尽管这需要大量资源，但据推测这会提高项目的利用率。本研究调查了与初级保健的直接外联会议是否与随后WI CPCP的初级保健咨询增加相关。作者假设直接外联会议会增加与WI CPCP的初级保健咨询。在492名初级保健提供者接受直接外联会议前后的3个月和12个月期间，比较了他们的WI CPCP咨询情况。还将这些情况与492名未接受直接外联会议的匹配对照提供者进行了比较。广义估计方程分析结果表明，直接外联会议显著提高了WI CPCP的初级保健利用率（p < 0.01）。若将直接外联会议期间产生的咨询纳入计算，咨询数量增加了一倍多。在考察直接外联会议后的咨询时，咨询数量几乎翻了一番。在直接外联会议后的3个月和12个月期间，结果均成立。尽管直接外联会议可能需要儿科精神病学接入项目投入额外的时间和资源，但它们通过提高至少1年的初级保健参与度增加了价值。
