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Brief Reports   |    
Clinicians’ Utilization of Child Mental Health Telephone Consultation in Primary Care: Findings From Massachusetts
Katherine Hobbs Knutson, M.D.; Bruce Masek, Ph.D.; Jeffrey Q. Bostic, M.D.; John H. Straus, M.D.; Bradley D. Stein, M.D., Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201200295
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Dr. Hobbs Knutson, Dr. Masek, and Dr. Bostic are with the Department of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston (e-mail: kknutson@partners.org). Dr. Straus is with the Massachusetts Behavioral Health Partnership, Boston. Dr. Stein is with the RAND Corporation and the Department of Psychiatry, University of Pittsburgh, both in Pittsburgh, Pennsylvania.

Copyright © 2014 by the American Psychiatric Association


Objective  The authors examined utilization of the Massachusetts Child Psychiatry Access Project, a mental health telephone consultation service for primary care, hypothesizing that greater use would be related to severe psychiatric diagnoses and polypharmacy.

Methods  The authors examined the association between utilization, defined as the mean number of contacts per patient during the 180 days following the initial contact (July 2008–June 2009), and characteristics of the initial contact, including consultation question, the child’s primary mental health problem, psychotropic medication regimen, insurance status, and time of year.

Results  Utilization (N=4,436 initial contacts, mean=3.83 contacts) was associated with initial contacts about medication management, polypharmacy, public and private health insurance, and time of year. The child’s primary mental health problem did not predict utilization.

Conclusions  Telephone consultation services address treatment with psychotropic medications, particularly polypharmacy. Joint public-private funding should be considered for such public programs that serve privately insured children.

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Table 1Characteristics of initial contacts with the Massachusetts Child Psychiatry Access Project
Table Footer Note

a Mean number of contacts during the 180 days following the initial contact

Table Footer Note

b Total percentages may not equal 100% because of rounding error.



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