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J Adolesc Health. 2009 Dec;45(6):564-70. doi: 10.1016/j.jadohealth.2009.04.003. Epub 2009 May 27.

A trial of telephone services to increase adolescent utilization of health care for psychosocial problems.

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1
Ohio State University Department of Pediatrics and the Research Institute at Nationwide Children's Hospital, Columbus, Ohio 43205, USA. Jack.Stevens@nationwidechildrens.org

Abstract

PURPOSE:

Adolescents identified in primary care clinics as experiencing psychosocial problems frequently do not receive recommended referral mental health care services. The purpose of the present study was to test whether a Telephone Support Services (TSS) intervention would increase subsequent healthcare utilization. Our TSS intervention featured a combination of case management and motivational interviewing.

METHOD:

One hundred seventy-nine adolescents who screened positive for at least one of three psychosocial problems--depressive symptoms, suicidal ideation, or substance use--were randomly assigned to one of two study conditions. Eighty-nine participants were randomly assigned to TSS, and 90 participants were assigned to Enhanced Usual Care (UC+). Adolescents completed self-report interviews of medical and mental health utilization at 4 months. In addition, research staff queried our hospital's administrative data warehouse to obtain each participant's medical service and mental health service use at 6 months.

RESULTS:

TSS did not increase subsequent utilization of either medical or mental health services for adolescents screening positive for psychosocial problems in a primary care clinic. This finding held true whether service utilization was assessed through self-report or administrative data.

DISCUSSION:

The lack of experimental effect on healthcare utilization suggests that certain aspects of our TSS require modification in future work. On a positive note, given that each of the three TSS calls was completed by a strong majority of participants, TSS appears feasible and acceptable to adolescents with psychosocial problems.

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