Improved pediatric behavioral health appointment scheduling in an integrated primary care program

To better understand appointment scheduling for pediatric behavioral health (BH) referrals, we examined appointment scheduling behavior among patients with and without access to primary care mental health integration (PCMHI).

A prospective cohort study compared PCMHI and non-PCMHI pediatric patients with BH referrals from January 17, 2022, to June 10, 2022. Six pediatric primary care clinics affiliated with a southern California Children's Hospital were studied: two PCMHI and four non-PCMHI clinics with similar patient demographic characteristics. BH referrals at PCMHI clinics are directly referred to the embedded integrated health therapists. Non-PCMHI clinics referred patients to community BH services. Data were collected from electronic health record abstraction and telephone interviews.

PCMHI (n = 471) and non-PCMHI (n = 97) groups did not differ significantly in patient characteristics. About 87.3% (n = 172) of PCMHI patients eligible for an integrated health therapist initial BH appointment scheduled their appointment within 14 days compared to 9.2% (n = 7) of the non-PCMHI patients (χ² = 148.2, p < .001). There was no difference in median days to initial BH appointment between the cohorts, PCMHI: 21 (interquartile range = 15, 27.5) and non-PCMHI: 23 (interquartile range = 13, 35), p = .71. Primary reasons for not scheduling initial BH appointments were similar for both groups and included confusion about the referral and patient/parent busy schedules.

Patients in the PCMHI cohort were more likely to schedule their initial BH appointment compared to the non-PCMHI cohort. (PsycInfo Database Record (c) 2026 APA, all rights reserved).