Stakeholder views on behavioral health care in the pediatric primary care setting: A qualitative approach towards integration of care

Abstract

STAKEHOLDER VIEWS ON BEHAVIORAL HEALTH CARE IN THE PEDIATRIC PRIMARY CARE SETTING: A QUALITATIVE APPROACH TOWARDS INTEGRATION OF CARE By: Alexis Michelle Quinoy, M.S. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Psychology at Virginia Commonwealth University. Virginia Commonwealth University, 2015 Major Director: Michael A. Southam-Gerow, Ph.D. Professor Department of Psychology and Pediatrics The pediatric primary care setting has been discussed as playing a central role for the identification and treatment of behavioral and mental health disorders in youth. Although this setting is in a unique position to provide these services, there are many barriers to the integration of mental health care and pediatric primary care. The aim of this study is to examine perspectives of multiple stakeholders (i.e., patient, parent, nurse, resident, faculty, clinic director) in a pediatric primary care setting to explore barriers, behavioral and mental health needs, and facilitators to the integration and provision of mental health care for children and families in pediatric primary care. The study involved both focus group and individual interviews with a total of 36 stakeholders (patient n = 2; parent n = 7; nurse n = 4; resident n = 16; faculty n = 5; clinic director n = 2). A grounded theory approach was used to analyze the focus group and interview data. Barriers to integration and consequences of these barriers are presented, as well as facilitators identified by stakeholders to overcome these obstacles. Identified behavioral and mental health needs will also be presented. Limitations of the study and future directions are discussed.