The extent and quality of the relationships that mental health therapists have with pediatric care providers in non-integrated settings is unclear. It is necessary to discover how mental health therapists can collaborate effectively with medical providers given the needs and contexts of children with mental health needs. It is important to investigate some of the current barriers to involvement and what patterns of referral and collaboration are being used. The purpose of this study was to discover if mental health therapists are collaborating with medical providers, and if they are, how can they collaborate effectively given the needs and contexts of children with mental health needs. In-depth interviews were conducted with two groups of professionals who work with children: medical providers and mental health therapists in Kent County, Michigan. Professionals were interviewed and grounded theory methodology was used to analyze the data and develop collaboration and referral models between mental health therapists and medical providers.Navigating the maze of the plethora of health insurance companies and plans seems to be a significant factor in the collaboration and referral processes for both mental health and medical providers. Each patient, with a different health insurance plan, requires professionals to approach referral and collaboration from separate directions. Some companies require referrals to specific professionals or agencies, and some provide lists of acceptable professionals, while some provide no directions at all. It is impossible for professionals to remember how each plan functions. Thus, referral processes are often taken out of the control of the professionals and placed in the control of health insurance companies. This is frustrating and confusing for professionals. Professionals agree that collaboration is an essential part of effective patient care. However, there appears to be confusion about how and what needs to be communicated between mental health and medical professionals. Both professionals report that it seems easier at times to rely on parents of children to communicate essential information. Professionals need to negotiate and implement more effective methods to sending pertinent information to each other. Finally, collaboration and referrals are related. It is obvious that professional relationships are built with communication over time and professionals with relationships tend to refer more to each other. Both medical and mental health professionals should work to get to know each other and develop positive relationships.
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