Barriers and facilitators to behavioral health follow-up in children screened and referred for Adverse Childhood Experiences (ACEs)

We conducted 20 semi-structured phone interviews with caregivers of children referred to behavioral health after positive ACEs screening. We analyzed the transcripts using inductive coding and thematic analysis. RESULTS: Three themes regarding barriers to completing behavioral health referrals after ACEs screening were identified: (1) difficulty communicating with behavioral health and navigating the healthcare system, (2) appointment availability and access, and (3) medication concerns. Additionally, four themes regarding facilitators were identified: (1) healthcare system support, (2) family and friend support, (3) previous positive experience with behavioral health, (4) child or caregiver requesting therapy. CONCLUSIONS: Most caregivers reported positive views of the referral process. However, the identified barriers indicate next steps to improve acceptability of the referral process from pediatric ACEs screening to behavioral health.