July 15, 2019
Telephone hotlines that allow primary care doctors to immediately consult with a child psychiatrist about urgent patient problems appear to increase the number of children who receive aid, offering one strategy to help more children receive mental health services, according to a new study from the nonprofit RAND Corporation.
Examining the growth of such services from 2009 to 2015, researchers found that parents of children who lived in states with child psychiatric telephone access programs were significantly more likely to say their children received mental health services than parents of children in states without such programs.
The study is the first to examine the influence of child psychiatric telephone access programs on a national level. The findings are published online by the Journal of the American Academy of Child & Adolescent Psychiatry.
“These findings suggest that telephone access programs may be one strategy to improve the proportion of children who receive help for their mental health needs,” said Dr. Bradley D. Stein, the study's lead author and a physician scientist at RAND, a nonprofit research organization.
Studies estimate that half of the children in the U.S. with mental health problems do not receive needed treatment, often because there are too few child mental health specialists to provide the services needed.
In response, many states have established child psychiatric telephone consultant programs in the hope that access to psychiatric specialists will encourage more primary care physicians to provide mental health services to their patients.
Most of the programs are modeled after the first such effort that was created in Massachusetts in 2004. Since then a majority of states have established such programs, although some states have partial programs that serve only select counties.
RAND researchers used information from the National Survey of Children's Health to examine how mental health treatment patterns have changed since the establishment of child psychiatric telephone consultant programs. The information included details about more than 245,000 children ages 5 to 17 who took part in surveys done in 2003, 2007, 2011 and 2016.
Because states adopted child psychiatric telephone access programs in different years, examining treatment trends over time allowed researchers to account for the influence of other efforts to improve access to child mental health services.
Researchers found that nationally the percentage of children receiving mental health treatment rose from 8.4% in 2003 to 9.5% in 2007, 11.1% in 2011 and 11.4% in 2016.
By 2016, the percentage of children receiving mental health services in states with statewide child psychiatric telephone access programs was 12.3 percent, in contrast to states where there were partial programs (10.9%) or no such programs (9.5%).
Even after considering factors such as family income that could influence access to treatment, children from states with statewide child psychiatry telephone access programs were significantly more likely to receive mental health services than children residing in states without such programs.
Researchers say the study suggests that recent federal investment to substantially expand child psychiatric telephone consultation programs could bolster the number of children who receive needed mental health services.
“These programs likely complement other efforts such as telepsychiatry programs for children and families who have no nearby provider, and student loan forgiveness programs intended to increase the number of child-focused mental health providers,” Stein said. “Helping families to find mental health care for their children is likely to require the full range of efforts.”
Funding for the study was provided by the National Institute of Mental Health. Other authors of the study are Aaron Kofner and Hao Yu of RAND and William B. Vogt of the University of Georgia.
RAND Health Care promotes healthier societies by improving health care systems in the United States and other countries.