Pediatric Primary Care Perspectives on Integrated Mental Health Care for Autism

Area of Science:

• Pediatric primary care
• Autism Spectrum Disorder (ASD)
• Mental Health Integration

Background:

• Effective care for children with ASD necessitates prompt identification of mental health needs and seamless connection to services.
• Pediatric primary care settings are pivotal for facilitating integrated care models for children with ASD.
• The Exploration, Preparation, Implementation, and Sustainment (EPIS) framework was used to understand barriers and facilitators to integrated care.

Purpose of the Study:

• To characterize the determinants influencing the implementation of integrated care practices for ASD within pediatric primary care.
• To identify challenges and opportunities for improving mental health service access for children with ASD.
• To inform the development of effective integrated mental health care models.

Main Methods:

• Focus groups and surveys were conducted with 60 pediatric primary care providers and leaders from 3 organizations.
• Data were analyzed to examine convergence and expansion between qualitative and quantitative findings.
• The EPIS framework guided the assessment of implementation determinants.

Main Results:

• Limited specialized mental health referral options for ASD were identified as a key barrier.
• Structural characteristics of the mental health system impede access to care.
• Variations in caregiver understanding of co-occurring conditions and service navigation were observed.
• Primary care-specific implementation considerations, such as alignment with organizational priorities, emerged.

Conclusions:

• A tailored strategy is essential for connecting children with ASD to appropriate mental health treatments.
• Findings highlight the need for enhanced organizational capacity to support integrated care.
• The study provides direction for adapting integrated mental health care models for children with ASD.