SIIReN - System Integration & Innovation Research Network

Primary Health Care System


Caring for Children and Youth with Ongoing Mental Health Problems: Perspectives of Providers in Primary Health Care
Principal investigator/co-investigators:
Graham J. Reid, Judith B. Brown & Christian M. Hahn

This qualitative study gathered the perspectives of 12 primary health care providers on the care of children and youth with ongoing and complex mental health problems. Problems with access to care, both within primary health care and in other sectors, was a consistent theme. Providers’ reflections on the terms ongoing and complex when applied to children or youth with mental health problems were diverse; many providers felt that almost all mental health issues with children were complex. Difficulties in collaborating with providers in other sectors were almost universal across the providers interviewed. A comprehensive approach to the care of children and youth with mental problems that incorporates primary health care along with specialized mental health services within health and other sectors is needed. Defining one individual/agency that would take the lead on coordinating care would be a clear step toward improving collaboration.

Key Messages:

Access is an ongoing issue within the systems that provide care for children and youth with mental health problems. The creation of primary health care teams which include specialized mental health providers, such as social workers and psychologists, is an important step in improving access to mental health care. However, lack of training and/or confidence to address mental health problems for children and youth limits access within primary health care. This leads to variation in care available across primary health care teams, which may lead to frustration for both families of children with mental health issues and individuals in other sectors (e.g., specialized mental health, child welfare) that help care for these children and their families.

Primary care providers have a general sense that mental health issues in general for children and youth were complex. However, there was a wide range of perspectives expressed. Variation in providers’ views on what constitutes a complex mental health problem may contribute to difficulties in collaborating with individuals in other sectors.

Collaboration with other sectors involved with children and youth with mental health problems was highly problematic and typically a source of frustration for providers. Most primary health care providers felt receiving written feedback on the care being provided in other sectors would balance the need and desire for information on their patients, and the difficulties with organizing direct communication with multiple providers in other sectors.

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