Engagement interventions delivered in primary care to improve off-site pediatric mental health service initiation: A systematic review

Rachel A. Petts, Jeffrey D. Shahidullah

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Introduction: Although primary care clinicians often refer children and families to community-based mental health services, a sizable number of patients do not make it to their 1st appointment. Engagement interventions delivered in primary care that focus on reducing structural and perceptual barriers to accessing care hold promise to improve this referral-to-service gap. To date, no review to characterize and summarize the effectiveness of such engagement interventions has been completed. Method: We conducted a systematic review of pediatric mental health service engagement interventions delivered in primary care over the past 20 years using MEDLINE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO. We narratively summarized the literature and conducted quality and risk of bias analyses. Results: Out of 948 records, 10 studies met inclusion criteria and were reviewed. A variety of engagement interventions were evaluated and demonstrated varying levels of effectiveness in improving service initiation, with the most promising approach being primary care mental health integration. Quality and risk of biases analyses demonstrated several methodological weaknesses of the included studies. Discussion: Currently, there is limited evidence for engagement interventions to improve the referral-to-service gap for children and families. More research is needed to develop and evaluate effective mental health engagement interventions, particularly for disadvantaged youth and families.

Original languageEnglish (US)
Pages (from-to)310-322
Number of pages13
JournalFamilies, Systems and Health
Issue number3
StatePublished - Sep 2020
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Applied Psychology
  • Psychiatry and Mental health


  • Integrated behavioral health
  • Integrated care
  • Primary care
  • Treatment initiation
  • Youth


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