Bridging the gap: associations of provider enrollment in OKCAPMAP with social deprivation, child abuse, and barriers to access in the state of Oklahoma, USA.

Abstract

Context: Oklahoma has one of the highest per capita rates of mental health needs in the United States; however, 72 of the 77 counties are designated as Health Professional Shortage Areas (HPSAs) in mental health services. In October 2022, after a year of planning, the Oklahoma Child and Adolescent Psychiatry and Mental Health Access Program (OKCAPMAP) was launched to deliver mental health and psychiatric consultation services to primary care providers across the state. Project planning incorporated a provider recruitment committee to target providers in rural communities and other areas with barriers to mental health services.

Objectives: This study's primary objective was to determine if, after 18 months of activity, provider enrollment aligned with this mission.

Methods: We conducted a cross-sectional analysis of data from OKCAPMAP. We report the number and type of enrolled providers and information extracted from consultation requests including generalized patient demographics and the mental health conditions for which the request was made. We then utilized the sum of providers pooled at the zip code tabulation area (ZCTA) level to measure correlations with the Social Deprivation Index (SDI), frequency of child abuse filings, and other barriers associated with access for individuals seeking treatment.

Results: As of April 30th, 2024, OKCAPMAP had enrolled 384 providers in 37 of the 77 counties of Oklahoma. Correlations of providers enrolled at the ZCTA showed significant (p<0.01) positive relationships with frequency of child abuse filings (R=0.39), percent of rented households (R=0.36), those with high housing cost burden (R=0.27), percent of households lacking a vehicle (R=0.19), single parent household (R=0.17), and the SDI (R=0.10).

Conclusions: OKCAPMAP data show successful recruitment of providers where there are high rates of pediatric trauma and in areas where household access to psychiatric services may be limited. By creating an accessible framework to provide free mental health consultations to pediatric-serving primary care providers in these areas, OKCAPMAP will likely have a significant impact on families and communities across Oklahoma.