Comparing First Contact Methods Within a Pediatric Behavioral Health Integrated Care Program

BACKGROUND AND OBJECTIVES Transforming Mental Health Initiative, a primary care behavioral health integration program at several clinics throughout San Diego, aims to increase access to timely behavioral health treatment. The program uses warm handoffs in which referring clinicians share information with mental health therapists during primary care visits to help facilitate referrals. When warm handoffs were not feasible, the centralized access and triage team (CAT) was developed to reach out to patients by phone and explain the services provided by the program. This study evaluated the association between types of first contact methods and initial appointment scheduling outcomes. METHODS Patients in this study received a referral for mental health services at integrated primary care locations. Data were collected through electronic health record abstraction and analyzed using Chi2, Wilcoxon rank-sum, and logistic regression. RESULTS There were 317 patients with warm handoffs and 86 CAT-contacted patients instructed to schedule an initial assessment. Of those who scheduled an initial assessment, 82.6% were warm handoff and 89.5% were CAT patients, and 85.9% and 83.1% completed their initial assessment, respectively. Median days from referral to initial appointment were 14 (6,27) for warm handoff and 15 (8,22) for CAT patients. None of these differences was statistically significant. CONCLUSIONS We found outreach by care coordinators was as effective as warm handoffs for patient scheduling and completing initial appointments. Further research is needed to better understand the clinical benefits of the warm handoff, particularly in pediatric patients, to determine if there are other benefits besides patient scheduling and initial appointment adherence.