Question Title * 1. First and Last Name (Required.) Question Title * 2. Credentials. Select all that apply. (Required.) MD DO NP PA RN LCSW LPC Psychologist Other or N/A (please specify) Question Title * 3. Health Organization/Clinic Name (Required.) Question Title * 4. Specialty (Required.) Pediatrics Family Medicine Behavioral Health Pediatric Specialty Other (please specify) Question Title * 5. Email Address (Required.) Question Title * 6. Mobile Phone Number (optional) Question Title * 7. Will you be bringing a guest? One guest allowed per member. (Required.) Yes No Question Title * 8. Guest First and Last Name (Required.) Question Title * 9. Guest Credentials (optional) Question Title * 10. Guest Health Organization/Clinic Name (optional) Question Title * 11. Which statement best describes your work during the past six months? Select one. (Required.) I have provided direct patient care. I have not provided direct patient care, but I am a clinical provider whose firsthand experience in consultation, clinical supervision, or clinical leadership allows me to answer questions about mental and behavioral health care. Neither statement describes my work. Question Title * 12. Which setting best describes the work you will draw on when answering this survey? Select one. (Required.) VUMC hospital-based department or service VUMC-owned community-based primary care clinic VUMC-owned community-based specialty clinic Non-VUMC-owned community-based pediatric primary care clinic Non-VUMC-owned community-based family medicine primary care clinic Non-VUMC-owned specialty or mental and behavioral health organization State or local public health department Other setting (please specify) Question Title * 13. During the past six months, how difficult has it been for children and adolescents served by your team or organization to obtain the following services when needed? (Required.) Not at all difficult Slightly difficult Moderately difficult Very difficult Extremely difficult Unable to assess Not applicable Outpatient counseling or psychotherapy Outpatient counseling or psychotherapy Not at all difficult Outpatient counseling or psychotherapy Slightly difficult Outpatient counseling or psychotherapy Moderately difficult Outpatient counseling or psychotherapy Very difficult Outpatient counseling or psychotherapy Extremely difficult Outpatient counseling or psychotherapy Unable to assess Outpatient counseling or psychotherapy Not applicable Psychiatric evaluation or medication-management services Psychiatric evaluation or medication-management services Not at all difficult Psychiatric evaluation or medication-management services Slightly difficult Psychiatric evaluation or medication-management services Moderately difficult Psychiatric evaluation or medication-management services Very difficult Psychiatric evaluation or medication-management services Extremely difficult Psychiatric evaluation or medication-management services Unable to assess Psychiatric evaluation or medication-management services Not applicable Urgent mental and behavioral health evaluation for concerns that cannot wait for a routine appointment Urgent mental and behavioral health evaluation for concerns that cannot wait for a routine appointment Not at all difficult Urgent mental and behavioral health evaluation for concerns that cannot wait for a routine appointment Slightly difficult Urgent mental and behavioral health evaluation for concerns that cannot wait for a routine appointment Moderately difficult Urgent mental and behavioral health evaluation for concerns that cannot wait for a routine appointment Very difficult Urgent mental and behavioral health evaluation for concerns that cannot wait for a routine appointment Extremely difficult Urgent mental and behavioral health evaluation for concerns that cannot wait for a routine appointment Unable to assess Urgent mental and behavioral health evaluation for concerns that cannot wait for a routine appointment Not applicable Question Title * 14. Which factors most limit children’s and adolescents’ ability to obtain mental and behavioral health care in the setting you know best? Select up to three. (Required.) Long waits for appointments Too few providers accepting new patients Difficulty finding an appropriate service for the patient’s needs Insurance coverage or authorization requirements Out-of-pocket costs Transportation or travel distance Appointment times that conflict with school, work, or caregiving Reluctance to seek care or concerns about stigma Language barriers or limited interpreter access Limited technology, internet access, or privacy for telehealth Difficulty navigating referrals or coordinating across organizations No significant barriers observed Unable to assess Other (please specify) Question Title * 15. How does your team currently address mental and behavioral health needs? Select all that apply. (Required.) Screening or assessment Brief counseling or behavioral intervention Medication management Behavioral health clinician employed by our practice or organization Behavioral health clinician from another organization located at our site Telehealth behavioral health services delivered by our team or through an established partner Clinician-to-clinician psychiatry or behavioral health consultation External referrals to mental and behavioral health providers Patient or caregiver education and support None of these Unable to assess Other (please specify) Question Title * 16. Which education topics would be most useful in your current role? Select up to three. (Required.) Anxiety and depression ADHD assessment and management Autism or developmental screening and referral Disruptive behavior and emotional regulation Trauma-related concerns Suicide risk assessment, safety planning, and follow-up Adolescent substance use Mental health assessment and diagnosis Treatment and medication management Brief behavioral interventions in medical settings Family engagement and communication Working across primary care and behavioral health teams Referral and community resource navigation Mental/behavioral health billing and reimbursement Team roles and workflows None at this time Unable to assess Other (please specify) Question Title * 17. Which supports would most help children and adolescents obtain appropriate mental and behavioral health care in the setting you know best? Select up to three. (Required.) Clinician or staff education and training Timely consultation with psychiatry or behavioral health clinicians Behavioral health services located within medical practices Telehealth behavioral health services Established partnerships with outside behavioral health organizations Accurate service directories and referral instructions Staff support for referral navigation and follow-up Screening or assessment tools Practical clinical workflows and referral protocols Patient and caregiver education materials Billing or reimbursement assistance Other (please specify) Question Title * 18. Which perspective best matches your work? Select one. (Required.) Providing primary care Providing specialty or mental and behavioral health care Coordinating referrals, appointments, or transitions between care settings Managing a practice, department, or clinical organization Working in public health or coordinating programs across organizations None of these describes my work Question Title * 19. Which mental or behavioral health concerns do you most commonly encounter among children and adolescents in your work? Select up to three. (Required.) Anxiety Depression ADHD or attention concerns Autism or developmental concerns affecting behavioral health care Disruptive behavior or emotional regulation concerns Trauma-related concerns Substance use, including vaping or alcohol Suicidal thoughts or other mental health crises Family or parenting concerns Unable to assess Other (please specify) Question Title * 20. When your team refers a child or adolescent to another mental and behavioral health team or provider, how often is each of the following true? (Required.) Never Rarely Sometimes Often Always Unable to assess Not applicable We can determine whether the initial appointment was completed We can determine whether the initial appointment was completed Never We can determine whether the initial appointment was completed Rarely We can determine whether the initial appointment was completed Sometimes We can determine whether the initial appointment was completed Often We can determine whether the initial appointment was completed Always We can determine whether the initial appointment was completed Unable to assess We can determine whether the initial appointment was completed Not applicable We receive recommendations sufficient to guide our next steps in care We receive recommendations sufficient to guide our next steps in care Never We receive recommendations sufficient to guide our next steps in care Rarely We receive recommendations sufficient to guide our next steps in care Sometimes We receive recommendations sufficient to guide our next steps in care Often We receive recommendations sufficient to guide our next steps in care Always We receive recommendations sufficient to guide our next steps in care Unable to assess We receive recommendations sufficient to guide our next steps in care Not applicable Question Title * 21. Which mental or behavioral health concerns do you most commonly encounter among children and adolescents in your work? Select up to three. (Required.) Anxiety Depression ADHD or attention concerns Autism or developmental concerns affecting behavioral health care Disruptive behavior or emotional regulation concerns Trauma-related concerns Substance use, including vaping or alcohol Suicidal thoughts or other mental health crises Family or parenting concerns Unable to assess Other (please specify) Question Title * 22. When your team receives a referral for a child or adolescent with a mental and behavioral health concern, how often does it include each of the following? Select one answer per row. (Required.) Never Rarely Sometimes Often Always Unable to assess Not applicable A clear reason for referral or consultation question A clear reason for referral or consultation question Never A clear reason for referral or consultation question Rarely A clear reason for referral or consultation question Sometimes A clear reason for referral or consultation question Often A clear reason for referral or consultation question Always A clear reason for referral or consultation question Unable to assess A clear reason for referral or consultation question Not applicable Enough clinical information to determine the next step Enough clinical information to determine the next step Never Enough clinical information to determine the next step Rarely Enough clinical information to determine the next step Sometimes Enough clinical information to determine the next step Often Enough clinical information to determine the next step Always Enough clinical information to determine the next step Unable to assess Enough clinical information to determine the next step Not applicable Enough information to assess urgency Enough information to assess urgency Never Enough information to assess urgency Rarely Enough information to assess urgency Sometimes Enough information to assess urgency Often Enough information to assess urgency Always Enough information to assess urgency Unable to assess Enough information to assess urgency Not applicable Question Title * 23. For mental and behavioral health referrals or transitions your team helps coordinate, how often can you determine each of the following? (Required.) Never Rarely Sometimes Often Always Unable to assess Not applicable Whether the receiving service accepted the referral Whether the receiving service accepted the referral Never Whether the receiving service accepted the referral Rarely Whether the receiving service accepted the referral Sometimes Whether the receiving service accepted the referral Often Whether the receiving service accepted the referral Always Whether the receiving service accepted the referral Unable to assess Whether the receiving service accepted the referral Not applicable Whether the patient completed the initial appointment Whether the patient completed the initial appointment Never Whether the patient completed the initial appointment Rarely Whether the patient completed the initial appointment Sometimes Whether the patient completed the initial appointment Often Whether the patient completed the initial appointment Always Whether the patient completed the initial appointment Unable to assess Whether the patient completed the initial appointment Not applicable Which team is responsible for the patient’s next follow-up Which team is responsible for the patient’s next follow-up Never Which team is responsible for the patient’s next follow-up Rarely Which team is responsible for the patient’s next follow-up Sometimes Which team is responsible for the patient’s next follow-up Often Which team is responsible for the patient’s next follow-up Always Which team is responsible for the patient’s next follow-up Unable to assess Which team is responsible for the patient’s next follow-up Not applicable Question Title * 24. Which factors most limit your ability to help families complete referrals or transitions? Select up to two. (Required.) Outdated or incomplete information about available services Difficulty reaching receiving organizations Unclear referral requirements Limited time for repeated follow-up Lack of a shared referral-tracking process Difficulty reaching patients or caregivers Insurance or authorization processes Unclear responsibility for follow-up between teams No significant limitations Unable to assess Other (please specify) Question Title * 25. How much does each factor limit your organization’s ability to improve mental and behavioral health care processes? (Required.) Not at all A little Somewhat A lot A great deal Unable to assess Not applicable Staff time available to implement changes Staff time available to implement changes Not at all Staff time available to implement changes A little Staff time available to implement changes Somewhat Staff time available to implement changes A lot Staff time available to implement changes A great deal Staff time available to implement changes Unable to assess Staff time available to implement changes Not applicable Financial resources to sustain changes Financial resources to sustain changes Not at all Financial resources to sustain changes A little Financial resources to sustain changes Somewhat Financial resources to sustain changes A lot Financial resources to sustain changes A great deal Financial resources to sustain changes Unable to assess Financial resources to sustain changes Not applicable Ability to obtain usable data on access, referrals, or follow-up Ability to obtain usable data on access, referrals, or follow-up Not at all Ability to obtain usable data on access, referrals, or follow-up A little Ability to obtain usable data on access, referrals, or follow-up Somewhat Ability to obtain usable data on access, referrals, or follow-up A lot Ability to obtain usable data on access, referrals, or follow-up A great deal Ability to obtain usable data on access, referrals, or follow-up Unable to assess Ability to obtain usable data on access, referrals, or follow-up Not applicable Question Title * 26. Which types of assistance would make improvement most practical for your organization? Select up to two. (Required.) Help selecting a manageable improvement priority Help mapping workflows and assigning responsibilities Ready-to-use policies, templates, or tools Staff training linked to a specific workflow change Help measuring whether changes are working Billing or financial planning assistance Help establishing agreements with partner organizations No assistance needed at this time Unable to assess Other (please specify) Question Title * 27. Based on your work, how much does each factor limit coordination of children’s mental and behavioral health care across organizations? Select one answer per row. (Required.) Not at all A little Somewhat A lot A great deal Unable to assess Not applicable Limited awareness of available services and eligibility requirements Limited awareness of available services and eligibility requirements Not at all Limited awareness of available services and eligibility requirements A little Limited awareness of available services and eligibility requirements Somewhat Limited awareness of available services and eligibility requirements A lot Limited awareness of available services and eligibility requirements A great deal Limited awareness of available services and eligibility requirements Unable to assess Limited awareness of available services and eligibility requirements Not applicable Unclear responsibility for connecting families with services Unclear responsibility for connecting families with services Not at all Unclear responsibility for connecting families with services A little Unclear responsibility for connecting families with services Somewhat Unclear responsibility for connecting families with services A lot Unclear responsibility for connecting families with services A great deal Unclear responsibility for connecting families with services Unable to assess Unclear responsibility for connecting families with services Not applicable Limited information on whether families successfully obtain services Limited information on whether families successfully obtain services Not at all Limited information on whether families successfully obtain services A little Limited information on whether families successfully obtain services Somewhat Limited information on whether families successfully obtain services A lot Limited information on whether families successfully obtain services A great deal Limited information on whether families successfully obtain services Unable to assess Limited information on whether families successfully obtain services Not applicable Question Title * 28. Which cross-organization activities would be most useful? Select up to two. (Required.) Maintaining accurate service and eligibility information Establishing referral and follow-up agreements Clarifying roles among medical, behavioral health, school, and community partners Developing shared measures of access and referral completion Identifying populations or communities with unmet service needs Coordinating education and resources across organizations Addressing payment or policy barriers through appropriate partners None at this time Unable to assess Other (please specify) Question Title * 29. What one change or resource would most improve children’s mental and behavioral health care in the setting you know best? (optional) Please do not include patient-identifying information. (Required.) Submit Registration