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Intervention Models for Increasing Access to Behavioral Health Services Among Youth

A Systematic Review

Choi, Kristen R. PhD, RN*; Easterlin, Molly C. MD

Journal of Developmental & Behavioral Pediatrics: December 2018 - Volume 39 - Issue 9 - p 754–762
doi: 10.1097/DBP.0000000000000623
Review Article

Objective: The purpose of this systematic literature review is to examine interventions designed to improve access to behavioral health services among youth in the United States and to identify how the concept of access to health care has been measured and conceptualized in these studies.

Method: The review used a systematic search strategy to identify articles published in medical, nursing, and psychological literature. The search yielded 579 initial articles, of which 69 appeared to be candidates for inclusion in the review. In the end, 19 studies qualified for synthesis in the review. Studies were required to use an experimental or quasi-experimental design and include a comparison group.

Results: Results indicated that access to behavioral health services can be improved by providing services in schools, using telehealth models, or delivering multicomponent interventions in clinical settings. Models that incorporated parental support, peer support from other parents, or other ways of engaging parents in the utilization process, as well as multicomponent and policy interventions, helped improve access to care. In the studies reviewed, access was operationalized primarily in terms of child behavioral health service utilization.

Conclusion: Interventions delivered in schools, engaging parents, or utilizing telehealth technology show promise for increasing access for youth affected by behavioral health disorders.

This article has supplementary material on the web site:

*National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, Los Angeles, CA;

National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, Department of Pediatrics, Cedars-Sinai Medical Center, University of California, Los Angeles, Los Angeles, CA.

Address for reprints: Kristen R. Choi, PhD, University of California Los Angeles, 10940 Wilshire Boulevard, Suite 710, Los Angeles, CA 90024; e-mail:

Disclosure: The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Received June 26, 2018

Accepted August 30, 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.