title: Parent Burden in Accessing Outpatient Psychiatric Services for Adolescent Depression in a Large State System.
abstract: OBJECTIVE
  This study examined barriers facing parents who seek outpatient psychiatric care in a large state system for adolescents with depression.
  
  
  METHODS
  A total of 264 outpatient facilities licensed to treat youths in New York were contacted by using a mystery shopper methodology. Callers tracked the number of call attempts, in-person appointments, and other steps required prior to seeing a psychiatrist.
  
  
  RESULTS
  Fewer than two-thirds of parents made a psychiatry, therapy, or intake appointment. Of those who did not make an appointment, 19% received no referrals. Most callers made at least two calls and spoke with at least two people before initiating scheduling. Virtually all clinics required at least one intake or therapy appointment before receipt of a psychiatry appointment. Parental burden did not differ by region, urbanicity, clinic type, seasonality (spring or summer), or insurance status.
  
  
  CONCLUSIONS
  Families of youths with mental health needs face considerable burden in accessing timely treatment.
authors.affiliation: Dr. Gallo is with McLean Hospital, Belmont, Massachusetts, and with the Department of Psychiatry, Harvard Medical School, Boston (e-mail: kgallo@post.harvard.edu ). Dr. Olin, Dr. Hoagwood, and Dr. Horwitz are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Storfer-Isser is with Statistical Research Consultants, L.L.C., Schaumburg, Illinois. Dr. O'Connor is with Coordinated Care Services, Inc., Rochester, New York. Ms. Whitmyre is with the Department of Psychology, George Mason University, Fairfax, Virginia.
authors.forename: Kaitlin P
authors.initials: KP
authors.lastname: Gallo
authors.affiliation: Dr. Gallo is with McLean Hospital, Belmont, Massachusetts, and with the Department of Psychiatry, Harvard Medical School, Boston (e-mail: kgallo@post.harvard.edu ). Dr. Olin, Dr. Hoagwood, and Dr. Horwitz are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Storfer-Isser is with Statistical Research Consultants, L.L.C., Schaumburg, Illinois. Dr. O'Connor is with Coordinated Care Services, Inc., Rochester, New York. Ms. Whitmyre is with the Department of Psychology, George Mason University, Fairfax, Virginia.
authors.forename: S Serene
authors.initials: SS
authors.lastname: Olin
authors.affiliation: Dr. Gallo is with McLean Hospital, Belmont, Massachusetts, and with the Department of Psychiatry, Harvard Medical School, Boston (e-mail: kgallo@post.harvard.edu ). Dr. Olin, Dr. Hoagwood, and Dr. Horwitz are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Storfer-Isser is with Statistical Research Consultants, L.L.C., Schaumburg, Illinois. Dr. O'Connor is with Coordinated Care Services, Inc., Rochester, New York. Ms. Whitmyre is with the Department of Psychology, George Mason University, Fairfax, Virginia.
authors.forename: Amy
authors.initials: A
authors.lastname: Storfer-Isser
authors.affiliation: Dr. Gallo is with McLean Hospital, Belmont, Massachusetts, and with the Department of Psychiatry, Harvard Medical School, Boston (e-mail: kgallo@post.harvard.edu ). Dr. Olin, Dr. Hoagwood, and Dr. Horwitz are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Storfer-Isser is with Statistical Research Consultants, L.L.C., Schaumburg, Illinois. Dr. O'Connor is with Coordinated Care Services, Inc., Rochester, New York. Ms. Whitmyre is with the Department of Psychology, George Mason University, Fairfax, Virginia.
authors.forename: Briannon C
authors.initials: BC
authors.lastname: O'Connor
authors.affiliation: Dr. Gallo is with McLean Hospital, Belmont, Massachusetts, and with the Department of Psychiatry, Harvard Medical School, Boston (e-mail: kgallo@post.harvard.edu ). Dr. Olin, Dr. Hoagwood, and Dr. Horwitz are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Storfer-Isser is with Statistical Research Consultants, L.L.C., Schaumburg, Illinois. Dr. O'Connor is with Coordinated Care Services, Inc., Rochester, New York. Ms. Whitmyre is with the Department of Psychology, George Mason University, Fairfax, Virginia.
authors.forename: Emma D
authors.initials: ED
authors.lastname: Whitmyre
authors.affiliation: Dr. Gallo is with McLean Hospital, Belmont, Massachusetts, and with the Department of Psychiatry, Harvard Medical School, Boston (e-mail: kgallo@post.harvard.edu ). Dr. Olin, Dr. Hoagwood, and Dr. Horwitz are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Storfer-Isser is with Statistical Research Consultants, L.L.C., Schaumburg, Illinois. Dr. O'Connor is with Coordinated Care Services, Inc., Rochester, New York. Ms. Whitmyre is with the Department of Psychology, George Mason University, Fairfax, Virginia.
authors.forename: Kimberly E
authors.initials: KE
authors.lastname: Hoagwood
authors.affiliation: Dr. Gallo is with McLean Hospital, Belmont, Massachusetts, and with the Department of Psychiatry, Harvard Medical School, Boston (e-mail: kgallo@post.harvard.edu ). Dr. Olin, Dr. Hoagwood, and Dr. Horwitz are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Storfer-Isser is with Statistical Research Consultants, L.L.C., Schaumburg, Illinois. Dr. O'Connor is with Coordinated Care Services, Inc., Rochester, New York. Ms. Whitmyre is with the Department of Psychology, George Mason University, Fairfax, Virginia.
authors.forename: Sarah McCue
authors.initials: SM
authors.lastname: Horwitz
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001071:Appointments and Schedules; D017281:Cost of Illness; D003866:Depressive Disorder / Q000628:therapy*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009518:New York; D010290:Parents; D012017:Referral and Consultation / Q000706:statistics & numerical data*
keywords: Adolescents/adolescence; Community mental health services; Depression; Mental health systems/hospitals; Psychiatry/general