Integrated Primary Care for Children in Rural Communities: An Examination of Patient Attendance at Collaborative Behavioral Health Services

Many barriers have been proposed to explain why rural residents do not receive adequate behavioral health services even though the need for such services is great. One solution proposed to address the need in rural settings is to offer these services within primary care. This study was designed to examine child attendance rates at integrated behavioral health clinics (BHCs) in rural primary care offices. Referral forms for all children recommended to attend three BHCs were reviewed by research assistants. Attendance at appointment, length of time on waiting list, severity of the problem, referral reasons, and parent stress were coded. Across the three BHCs, nearly 88% of children referred were scheduled for an initial appointment, and 81% of children referred for behavioral health services attended the initial appointment. Follow through for children referred by their primary care physician to a colocated behavioral health specialist in rural settings was much higher than found in other studies. These data suggest that in rural settings integrated care may increase access to and continuity of care for a population that is often neglected.