Rural Primary Care Integration: Facilitating Identification and Management of Childhood Psychosocial Concerns

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Rural children have less access to mental health services and more health disparities than their urban counterparts. Additionally, pediatricians rank psychosocial problems as a top presenting concern in child care visits, making recognition and appropriate management of behavioral health problems an important aspect to primary care. Few studies, however, have examined the prevalence of childhood psychosocial concerns in rural Appalachia. This paper describes the results of a larger study that examined prevalence rates of parent-reported psychosocial concerns and parental help-seeking behavior. Research Assistants recruited parents of children (N= 2672) scheduled to see physicians from 8 regional primary care clinics, to fill out a demographic/help-seeking questionnaire and the Pediatric Symptom Checklist (PSC), a parent- report screening measure to help identify psychosocial problems. Consistent with national averages, the current study showed overall, 13.70% of children had clinically significant PSC scores. Furthermore, 62.4% of parents reported speaking to their child’s physician about psychosocial concerns. Given the high prevalence rate of psychosocial dysfunction, lack of services in rural areas and a majority of parents seeking help from their child’s physician for emotional and behavioral concerns, the results of this study seem to support integration of mental health professionals into primary care, as a way to help identify and treat psychosocial dysfunction.


Johnson City, TN

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