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Interactions Between Parents and Pediatric Primary Care Physicians About Children's Mental Health
William T. Garrison; Edward N. Bailey; Jane Garb; Bruce Ecker; Peter Spencer; David Sigelman
Psychiatric Services 1992; doi:
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This work was supported by a grant to Dr. Garrison from the Massachusetts Hospital Foundation's Fund for Cooperative Innovation.

Children's National Medical Center, 111 Michigan Avenue, N.W., Washington, D.C. 20010

Baystate Medical Center in Springfield, Massachusetts

1992 by the American Psychiatric Association

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Abstract

Interaction patterns between parents and pediatricians were examined during 1,378 well-child visits to four public and private podiatric dinics. During 327 visits, parents listed at least one psychosocial concern related to their child's mental health. At 37 percent of these visits, parents saidthey did not wish to discuss the concern with the physician. Physicians failed to address concerns during approximately 35 percent of visits at which parents were willing to discuss them. Successful parent-physician interactions were three times more frequent in private practices than in a public clinic; they were more likely when fewer concerns were stated and less likely when behavior problems were the concern. Parents concerned about the parent infant relationship were four times more likely to be referred to outside mental health services, although these cases were relatively rare. Older children and families receiving Medicaid were also more likely to be referred to such services.

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