23.3 ADDRESSING RACIAL AND ETHNIC DISPARITIES IN ACCESS TO MENTAL HEALTH CARE FOR CHILDREN AND ADOLESCENTS: THE ROLE OF CHILD PSYCHIATRY ACCESS PROGRAMS

Abstract

Child psychiatry access programs (CPAPs) are regional clinical services designed to improve access to care by supporting and enhancing the ability of pediatric primary care teams to address mental health needs of children and adolescents in the primary care setting. Although racial and ethnic disparities in access to mental health care have been well-described for decades, the attention of CPAPs to understanding and addressing them is recent and long overdue. The Massachusetts CPAP (MCPAP), the first and longest continually operating CPAP, has identified the issue of health equity as integral to its mission and operation, and has engaged in planning efforts both internally and in collaboration with stakeholders and peer programs across the United States. Components of planning include identification of unique access barriers for Black, Indigenous, and People of Color (BIPOC) and Latinx populations and exploring administrative and clinical strategies for mitigating them. Training modules are aimed at MCPAP clinical and administrative staff as well as our network of affiliated primary care providers for the purpose of raising awareness of individual, systemic, historical, and structural factors contributing to access barriers for BIPOC/Latinx children and their families. Other key components of the MCPAP strategy are: 1) applying continuous performance improvement methodology including quantitative measures for assessing progress in health equity in relation to baseline; 2) developing processes to include consumer voices in the planning and oversight of our efforts; 3) engaging community mental health providers in mitigating access barriers; and 4) collaborating with similar programs across the United States to identify best practices and compare data. In the context of their mission to improve access to mental health care for children and their families, CPAPs have a unique opportunity and responsibility to address issues of health equity for BIPOC and Latinx populations.