749 - “Please Don’t Make Decisions About Us Without Us”: Engaging the Patient Family Voice to Address Disparities in Mental Health Service Access

Publication Number: 749.3624

Ayanda Chakawa, Children's Mercy Hospitals and Clinics, Kansas City, MO, United States; Bertha A. Aldape, Children's Mercy Hospitals and Clinics, Independence, MO, United States; Emily Hamm, Children’s Mercy Hospital, Ottawa, KS, United States; Brenda V. Saenz, NA, Kansas city, MO, United States; Jamila Weaver, Children's Mercy Hospitals and Clinics, Leawood, KS, United States; Hung-Wen Yeh, Children's Mercy Hospitals and Clinics, Kansas City, MO, United States; Jessica K. Sun, Children's Mercy Hospitals and Clinics, Overland Park, KS, United States; Leslee T.. Belzer, Children's Mercy Kansas City & UMKC School of Medicine, Kansas City, MO, United States

Background: Mental health (MH) service seeking for youth is increasingly taking place in pediatric primary care, including within integrated primary care (IPC) services. Current IPC methods have helped increase service access but sociodemographic disparities in MH service access still exist, especially when referrals to MH specialty clinics outside of primary care are needed. These access disparities reveal significant gaps related to care navigation issues in the pediatric IPC service-seeking pathway that result in unmet MH needs.

Objective: Our study objective was to reduce MH service access disparities by addressing complexities of navigating from primary care to specialty MH care, and the resultant racial and ethnic disparities (including linguistic factors) that emerge.

Design/Methods: Our research team uniquely includes a parent advisory board including English and Spanish speaking families and families of color. The current study focuses on initial outcome data from a MH family navigation intervention called the Promoting Access To Healthy Well-Being Across Youth (PATHWAY) program. PATHWAY was developed for children 2-16 years old referred to MH services from within primary care. It includes a motivational interviewing approach where families are supported to set service access goals and overcome barriers (including addressing social determinants of health (SDOH)). Our single-arm pilot of PATHWAY includes racially and linguistically diverse (English and Spanish speaking) parent-child dyads (N=100) from a primary care clinic predominantly serving Medicaid-insured patients within a regional pediatric hospital system.

Results: Our preliminary data on current standard practice for MH service referrals showed that only ~32% of patients were scheduled for MH services within one year of referral. Additionally, racially and ethnically minoritized youth had significantly (p = .001) less odds of being scheduled for their referred MH service compared to White children. Comparatively, so far 64% of PATHWAY participants across sociodemographic groups have scheduled and attended MH services within one year of intervention – a 32% improvement from current standard practice. Also, 90% of participants endorsed program satisfaction and helpfulness.

Conclusion(s): Responsive MH care navigation is needed to address public health issues of sociodemographic disparities in MH service access. In conceptualizing our results and recommendations for pediatric health systems, we will elevate parent voices that guide our emphasis on the importance of MH psychoeducation, destigmatization, and addressing SDOH needs within MH care navigation.