Lessons Learned in a Physician Referral to Pediatric Telemental Health Services Program

Date

2019

Journal Title

Journal ISSN

Volume Title

Publisher

Journal of the Canadian Academy of Child and Adolescent Psychiatry

Abstract

This study explores the physician referral and engagement process of a pediatric telemental health program based in a large urban teaching children’s hospital, and identifies the processes, strengths and challenges from the perspectives of Primary Care Physicians (PCPs) and telepsychiatrist consultants. Methods A mixed methods approach was used. This included an online survey completed by 43 PCPs in Ontario rural communities who had referred patients to the telemental health program. Qualitative interviews were conducted with 11 child/adolescent telepsychiatrists who provide consultations via teleconferencing. Results The majority of PCPs (61%) reported somewhat to moderate satisfaction with referral experiences. Challenges identified by physicians were related to communication and administration issues including: lack of timely follow-up appointments and continuity of care; lengthy referral forms; and recommendations for mental health services not accessible in their communities. Similarly, psychiatrist consultants expressed frustration with the sparse information they received from referring physicians and most significantly, the absence of appropriate service providers/professionals during the consultation to provide collateral information and ensure uptake of recommendations. Conclusion Telemental health programs provide a valuable service to PCPs and their child and youth clients that could be significantly enhanced with a different consultation model. Such models of service delivery require protocols to educate PCPs, improve communication and information sharing and establish clear expectations between PCPs and telepsychiatry consultants.

Description

Keywords

International Resources, Canada, telemental health, telepsychiatry, primary care, trauma, treatment

Citation

Pignatiello, A., Stasiulis, E., Solimine, C., Ayad, O., & Boydell, K. M. (2019). Lessons learned in a physician referral to pediatric telemental health services program. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 28(3), 99.

DOI