Facilitators of and Barriers to Mental Health Treatment among Adolescents in an Integrated HealthCare Setting

Background: The high incidence of mental health disorders among adolescents, accompanied by low treatment utilization, is a major public health problem. Including mental health treatment in primary care medical settings through an integrated health care model offers an opportunity for early intervention and easier treatment uptake for adolescents with mental health diagnoses. Methods: This thesis examined the barriers to and facilitators of implementing a mental health referral system with the support of a quality improvement project within a single clinic. Results: Qualitative analysis revealed key facilitators to be provider education; communication among team members; a shared EHR and electronic referral orderset; ongoing monitoring, evaluation, and improvement of the system; and social workers. Barriers included workflow challenges; lack of protocols; and fewer available services. Quantitative data analyses showed significant improvement in mental health utilization rates since the implementation of the project. Conclusion: The findings from this thesis can be used to inform future integrated models for adolescent mental health care in primary care settings. Expanding integrated models has public health implications for increasing treatment utilization among adolescents in need of mental health services, ultimately leading to improved quality of life throughout adulthood. \ud \u