Is it time to talk? Understanding specialty child mental healthcare providers' decisions to engage in interdisciplinary communication with pediatricians.

Communication between pediatric mental health and primary care providers is often inconsistent and frequently rated as unsatisfactory by providers of both disciplines. While numerous studies report pediatricians' desire for increased feedback from mental health providers, less is known about mental health providers' perspectives on collaborative communication with pediatricians. In the current qualitative study, 9 practitioners at 2 mental health practices participated in interviews about their experiences related to collaborating and communicating with pediatric providers. The interviews were analyzed inductively using thematic analysis procedures. Mental health providers consistently described the decision to communicate with pediatric primary care providers as occurring primarily when initiated by them, and on a "case by case" basis. Four determinants of the decision to initiate communication emerged from the interviews: severity of client concerns, mental health providers' own positive beliefs about collaborative/integrative mental health-pediatric care, perceptions of and past experiences with the primary care providers with whom they interact, and professional relationships with specific primary care providers. The findings of this study suggest that understanding and addressing the attitudes and beliefs that underlie both mental health and pediatric health care providers' decisions to engage in interprofessional communication is essential to establishing truly collaborative care.