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    Pediatrician and Child Adolescent Psychiatrist Perspectives of Coordinated Care for Emerging Adults

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    Authors
    Hugunin, Julie
    Khan, Sara
    McPhillips, Emily
    Davis, Maryann
    Larkin, Celine
    Skehan, Brian
    Lapane, Kate L
    UMass Chan Affiliations
    Emergency Medicine
    Pediatrics
    Population and Quantitative Health Sciences
    Psychiatry
    Document Type
    Journal Article
    Publication Date
    2023-01-03
    Keywords
    Coordinated care
    Mental health
    Transition to adult care
    UMCCTS funding
    
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    Link to Full Text
    https://doi.org/10.1016/j.jadohealth.2022.12.002
    Abstract
    Purpose: To explore pediatrician and child/adolescent psychiatrists' perspectives of the role of coordinated care for emerging adults with serious mental health conditions, particularly as they transition to adult care. Methods: Semi-structured individual interviews of a purposive sample of 10 pediatricians and 11 child/adolescent psychiatrists in Massachusetts were used to explore coordinated care for emerging adults. Following verbatim transcription and double coding, we conducted a thematic analysis to identify key themes. Care coordination concepts explored included a case discussion, teamwork, communication methods, medication management, transition to adult care, the healthcare home, and youth and family role. Organizational and societal barriers were also discussed. Results: Providers described key barriers to continuous, coordinated care for youth with serious mental health conditions, including poor communication systems between providers, no organized process for the transition from pediatric to adult care, state licensing laws (particularly impacting college-age youth), inadequate connection to community supports, and poor reimbursement rates for psychiatric care. Termination of primary care in young adults and inadequate medication side effect monitoring were described as key gaps in care. Discussion: The current system of coordinated care for emerging adults with serious mental health conditions is a perfect storm of challenges that creates a vicious cycle of interconnected barriers which lead to fragmented, discontinuous, and sub-par care for this population.
    Source
    Hugunin J, Khan S, McPhillips E, Davis M, Larkin C, Skehan B, Lapane KL. Pediatrician and Child Adolescent Psychiatrist Perspectives of Coordinated Care for Emerging Adults. J Adolesc Health. 2023 May;72(5):770-778. doi: 10.1016/j.jadohealth.2022.12.002. Epub 2023 Jan 3. PMID: 36604207; PMCID: PMC10121759.
    DOI
    10.1016/j.jadohealth.2022.12.002
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/52084
    PubMed ID
    36604207
    Rights
    Copyright © 2022 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jadohealth.2022.12.002
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