title: Pediatricians may address barriers inadequately when referring low-income preschool-aged children to behavioral health services.
abstract: BACKGROUND
  Low-income parents often seek help from pediatricians for early childhood social-emotional problems but seldom follow through with referrals to behavioral health services.
  
  
  OBJECTIVE
  We sought to understand low-income parents' experiences seeking help from pediatricians for social-emotional problems and how those experiences influenced decisions about accessing behavioral health services.
  
  
  METHODS
  We conducted 20 semi-structured interviews with low-income parents with concerns about their children's behavior or emotions. Participants were asked about experiences seeking help from pediatricians and decision-making about accessing behavioral health services.
  
  
  RESULTS
  Three themes emerged: (1) Participants described reluctance to recognize social-emotional problems, which was often reinforced by doctors' reassurance. (2) Participants reported pediatricians did not meet their expectations about testing, providing explanations/advice, or addressing behavior on-site. (3) Participants had unclear expectations of behavioral health services.
  
  
  CONCLUSIONS
  Primary care mechanisms that reliably educate parents about behavioral trajectories and the role of behavioral health providers may improve follow-up rates.
authors: Courtney M
authors: CM
authors: Brown
authors: Erin L
authors: EL
authors: Girio-Herrera
authors: Susan N
authors: SN
authors: Sherman
authors: Robert S
authors: RS
authors: Kahn
authors: Kristen A
authors: KA
authors: Copeland
mesh_terms: D000328:Adult; D002652:Child Behavior; D002662:Child Health Services; D002675:Child, Preschool; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009820:Ohio; D010290:Parents; D010372:Pediatrics; D011203:Poverty; D011368:Professional-Family Relations; D012017:Referral and Consultation; D055815:Young Adult