What Do Adolescents and Their Parents Need From Mental Health Integration in Primary Care? A Qualitative Exploration of Design Insights

Abstract

Introduction: The design of integrated adolescent mental health care should address needs and preferences of patients and parents/guardians.

Method: We conducted interviews and focus groups with adolescents aged 13-17 years who received care at Kaiser Permanente Washington in 2020 and interviews with parents of such adolescents. We sought to (1) understand the challenges of primary care-based mental health and substance use screening and care for adolescents and (2) identify program design solutions. Sessions were audio-recorded, transcribed, and coded. Thematic analysis was applied to identify key challenges and design solutions.

Results: Emerging themes from interviews (n = 41) and focus groups (n = 10) were summarized in five overarching design principles: Engagement, Privacy, Communication, Choice, and Ease. Each design principle was expanded for operationalization within a new health system program.

Discussion: Health systems serving adolescents in primary care may consider application of these design principles to the development of mental health integration programs.

Keywords: Adolescent mental health; adolescent substance use; primary health care; qualitative; quality improvement.