# Assisted Identification and Navigation of Early Mental Health Symptoms in Children

> **NIH NIH R01** · KAISER FOUNDATION RESEARCH INSTITUTE · 2023 · $723,825

## Abstract

ABSTRACT
About 55% of children with significant mental health difficulties receive treatment and up to 80% of children
with sub-clinical symptoms receive no treatment. Treatments are often not initiated until issues are significantly
impacting the child and family. This study aims to conduct a pragmatic randomized trial in two non-academic
health care systems to test a mental health family navigator model to promote early access to, engagement in,
and coordination of needed mental health services for children. The first task of the study will focus on the
implementation of a predictive model to identify symptomatic children with no diagnosed mental health
disorder(s) or treatments initiated. The tool identifies patients with documentation of mental health symptoms
or complaints in the free text of a progress note from a recent primary care or urgent care visit. Using this
predictive algorithm, we will conduct a pragmatic randomized trial comparing intervention and usual care arm
patients enrolled from Kaiser Permanente (KP) Washington and KP Northern California. The trial will enroll 200
patients per arm (n=400). Children with (1) a new mental health diagnosis but no treatment initiated; (2) a new
mental health medication ordered with no mental health diagnosis; and (3) symptoms identified by the
predictive model with no new mental health diagnosis or treatment initiated will be recruited. The study
intervention will offer 6 months of support to the family by a mental health navigator (social worker). The
navigator will perform an initial needs and barriers assessment with the family around mental health services,
conduct ongoing motivational interviewing around mental health care, provide up to 4 psychotherapy sessions
(when appropriate) via clinic-to-home video visits, help the family find and schedule with appropriate mental
health providers in the community, and reach out ad hoc if mental health appointments or medication refills are
missed. The primary outcome is the percentage of youth initiating psychotherapy. The secondary outcome is
the percentage of youth with at least 4 mental health visits. We hypothesize that the intervention arm will have
higher rates of psychotherapy use compared to the control arm. We will also assess initiation of psychotropic
medications. All primary analyses will follow an intent-to-treat approach. A waiver of consent will be obtained to
include data for all individuals offered the intervention in the analysis, regardless of the amount of intervention
(“dose” of navigation) received.

## Key facts

- **NIH application ID:** 10528485
- **Project number:** 5R01MH124652-03
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Robert B. Penfold
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $723,825
- **Award type:** 5
- **Project period:** 2021-01-18 → 2024-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10528485

## Citation

> US National Institutes of Health, RePORTER application 10528485, Assisted Identification and Navigation of Early Mental Health Symptoms in Children (5R01MH124652-03). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10528485. Licensed CC0.

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