Correlation of Warm Handoffs Versus Electronic Referrals and Engagement With Mental Health Services Co-located in a Pediatric Primary Care Clinic
Open accessAbstract
Objective To analyze the correlation of referral mechanism-warm handoff or electronic referral and attendance at behavioral health appointments in an outpatient pediatric primary care setting.Methods A retrospective cohort study was conducted in an inner-city pediatric primary care clinic from January 2019 to December 2019. Adolescent patients who screened positive for depression or anxiety were referred to a Licensed Master Social Worker (LMSW) either via a warm handoff (WH group, n = 148) or an electronic referral (EF group, n = 180). The EF group was contacted by the LMSW via telephone to schedule an appointment. Multiple logistic regression was used to analyze the correlation of type of referral, age, gender, race/ethnicity, primary language, and time between referral and first contact with attendance at three appointments.Results The WH group was more likely to engage with mental health services compared to the EF group (odds ratio = 3.301, 95% confidence interval = 1.850-5.902, p = .002) while age, gender, race/ethnicity, and primary language had no correlation. Within the EF group, those who were contacted by the LMSW within 3 days (1-3 days group) were more likely to attend appointments (odds ratio = 2.680, 95% confidence interval = 0.414-8.219, p = .040). There was no difference in attendance in the WH group and the 1-3 days group (p = .913) DISCUSSION: A warm handoff between primary care providers and behavioral health clinicians is significantly correlated with engagement with behavioral health services for adolescents who screen positive for depression or anxiety. Contact with the family within 3 days of referral is significantly correlated with engagement compared to a longer duration between referral and family contact.
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Warm handoffs help reduce fragmentation, clarify roles, and prevent caregivers from being left to coordinate alone.
“Warm handoffs, direct, relational transitions where responsibility is transferred with the caregiver rather than to them, help reduce fragmentation, clarify roles, and prevent caregivers from being left to coordinate alone [33,34,35,36].”
From Home care comparison (2026) · cites this paper as [33]
The Abstract (page unavailable) describes warm handoffs as direct communication between providers in a transition that might otherwise disrupt care. The Discussion (page unavailable) says they may transfer trust from the primary care provider to the receiving clinician and reports an association with therapy attendance. Neither section establishes that warm handoffs clarify roles or prevent caregivers from having to coordinate care alone. (LLM, conf=0.84)
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- Authors
- Anand, P., & Desai, N.
- Affiliations
- New York City Health and Hospitals Corporation (US)
- Kings County Hospital Center (US)
- Corresponding author
- Anand, Paridhi
- Venue
- Journal of Adolescent Health
- Publisher
- Elsevier BV
- Published
- 2023-08
- Volume
- 73
- Issue
- 2
- Pages
- 325-330
- ISSN
- 1054-139X (ISSN-L)
- OpenAlex
- W4365813242
- Cited by
- 17
- References
- 25
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 2 · 2023: 3
- FWCI
- 5.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Adolescent Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Keywords
- warm handoff, electronic referral, mental health service engagement, behavioral health referral, pediatric primary care, adolescent depression, adolescent anxiety, appointment attendance
- MeSH terms
- Adolescent, Child, Humans, Mental Health Services, Primary Health Care, Referral and Consultation, Retrospective Studies, Patient Handoff
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