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Pediatric Behavioral Health Access - UW MHA

1.What is the name of your clinic?
2.In what county do you currently provide pediatric services?
3.If you are in clinical practice, either as a generalist or subspecialist, is your practice:
4.What resources for mental health services are available to your patients? Check all that apply:
5.I feel like my practice has the appropriate resources and support to refer a patient to behavioral health care.
6.Prior to the COVID-19 pandemic, what do you think was the proportion of your primary care appointments that include behavioral health issues? (Approximate)
7.During the COVID-19 pandemic, what do you think is the proportion of your primary care appointments that include behavioral health issues? (Approximate)
8.Does your clinic utilize telehealth for behavioral health appointments for families/children with PCPs or BH professionals?
Some examples of scenarios can include:

- A patient with a behavioral health disorder who would have benefitted from earlier care.
- A patient you were able to help in primary care.
- A patient who really needs care from a behavioral health professional but is facing a long wait or other barriers to establish care.
9.If you feel comfortable, please share a story about a patient’s experience accessing behavior health services? You may de-identify the patient/changing key information about the patient. For example, how has a patient benefited from such services? Where have there been shortcomings in behavioral health services? How has lack of access impacted a child or family?
10.In your experience, how has the COVID-19 pandemic impacted patient’s behavioral health needs? (Examples: New or exacerbated anxiety/depression; sleep difficulties; altered school performance; behavior difficulties)
11.If you have an integrated behavioral health provider on site, please skip to Question 15. If you do not have an integrated BH Provider available to you in your clinic, the wait period for an intake appointment with an outside behavioral health specialist is typically:
12.The percentage of your BH referrals that result in an intake is:
13.What are the most common barriers to completing the intake appointment? Check all that apply
14.When a patient is referred out of the clinic for BH care, what follow up communication do you typically receive? Check all that apply:
15.Answer questions 15 - 18 if your clinic has an integrated behavioral health provider on site.
For your patients who are referred to behavioral health services internally, the wait period for an intake appointment is typically:
16.The percentage of your BH referrals that result in an intake is:
17.What are the most common barriers to completing the intake appointment?
18.When your patient is seen by your integrated BH specialist what follow up communication do you typically receive?
19.Are you available for a brief (15 minute) phone interview to answer further questions?