Assessing Barriers to Engagement in a Community Mental Health Center Using the Psychosocial Assessment Tool (PAT)

Barriers in access to care prevent many individuals from benefiting from mental health services. The purpose of the current project was to assess the effectiveness and utility of incorporating the Psychosocial Assessment Tool (PAT; Kazak et al., 2001) into standard evaluation procedures at a pediatric psychiatry clinic in a diverse urban setting. As a secondary objective, PAT results were used to develop case management interventions to address identified barriers with families during initial treatment sessions. Over 6 months, the PAT was administered to 87 families during their initial psychiatric evaluation appointment. Depending on their responses, families were stratified into three different risk levels and received case management intervention accordingly to address barriers. Treatment engagement (i.e., number of sessions attended in the first treatment quarter) was utilized as an outcome measure of the effectiveness of the intervention and was compared across an intervention group and a control sample. The majority of patients identified at least one barrier to engagement in mental health services, with the majority of families experiencing barriers related to caregiver mental health needs and a lack of resources (e.g., finances, unemployment, lack of child care). Initial outcome measures for families who completed the PAT and participated in intensive case management intervention indicate improved engagement in mental health services. The PAT is an easily implemented and evidence-based measure that facilitates assessment of potential barriers to treatment engagement. Impact Statement The impact of addressing initial engagement issues prior to the onset of treatment is the potential to improve outcomes throughout psychotherapy.