NC-PAL Rural Provider Consultation Program Expands as Need for Mental Health Care Increases

More than 70% of autistic children and 35–50% of autistic adults also have at least one mental health diagnosis, a rate much higher than that of the general population (8-20%). Ideally, patients find quality care from a licensed psychiatrist or psychologist trained to care for autistic patients and to assist their families in their support. In predominantly rural states, shortages of trained mental health providers mean access is limited and patients will rely more heavily on their primary care doctors or pediatricians.

In collaboration with the Duke University School of Medicine Department of Psychiatry & Behavioral Sciences and the North Carolina Department of Health and Human Services, Duke Autism Clinic clinicians helped launch the North Carolina Psychiatry Access Line (NC-PAL). The free provider-to-provider consultation service supports primary care providers and pediatricians who have questions about patient behavioral health or medication management. Since its inception, additional funding has helped expand NC-PAL, which now integrates a perinatal consultation program in partnership with The University of North Carolina at Chapel Hill. Nicole Heilbron, PhD, associate director of the Duke Center for Autism, and Gary Maslow, MD, MPH, associate professor of psychiatry and behavioral sciences and co-director of the Division of Child and Family Mental Health & Community Psychiatry, are co-program leaders for NC-PAL. As of fall 2021, NC-PAL had received more than 1,000 pediatric calls and 522 perinatal calls from 617 providers across 48 NC counties.

“In national surveys, primary care providers grade themselves as ‘fair’ or ‘poor’ in their expertise of autism, while 30 of North Carolina’s rural counties have no psychiatrist or psychologist to consult. With NC-PAL, we can make connections to bring that expertise to every corner of the state,” said Heilbron.