Web-based child psychiatry access project (Web-CPAP): A feasibility study

Diagnosable mental health problems are seen in nearly 21% of youth. Primary care professionals (PCPs) are in a position to address these issues since children visit their PCP about 3 times yearly. However, lack of knowledge/skills and time, lack of supporting mental health providers, and reimbursement issues serve as significant barriers. Web-Based Child Psychiatry Access Project (Web-CPAP) aims to make child and adolescent psychiatric support more accessible to PCPs via a web-based consultation program. Several structured forms were devised to capture information on intake data, psychiatric consultant response and PCP follow-up. All data are captured in electronic form. Queries are de-identified, and security measures include a unique login for users, encryption of passwords, storage of login attempts to detect violations and hacker attempts, and a 128-bit Secure Socket Layer Certificate. PCPs provide only the date of birth and gender to comply with HIPAA standards. To date, the site has been found to be easy to use given comfort with computer use. Users have also indicated that the site helps in the process of thinking through a differential diagnosis, but time serves as a barrier to use. The range of problems posted, physician satisfaction, and experience with an estimation of cost and medico-legal aspects are all important to assess large scale feasibility. Web-CPAP, an innovative project, is expected to result in improved provision of quality mental health care to children in the primary care setting and an effective means of assisting in referrals to off-site services. The website may also serve as an important educational tool for clinicians.