**Background:** Pediatric inflammatory bowel diseases (IBD) are chronic, immune-mediated conditions where multidisciplinary care—including psychosocial providers such as psychologists, social workers, and child life specialists—is considered the standard of care. While psychosocial concerns (anxiety, depression, adherence, transition to adult care, body image) are known to impact pediatric IBD patients, empirical evidence about how pediatric GI health care professionals (HCPs) perceive and engage with psychosocial providers has been lacking. This study aimed to characterize HCPs' perceptions and experiences with psychosocial providers and describe IBD center-level data on access to psychosocial services.
**Methods:** A cross-sectional REDCap survey was disseminated electronically to pediatric GI HCPs (gastroenterologists, advanced practice nurses/nurse practitioners, physician assistants) across American hospitals through the ImproveCareNow (ICN) network, a Learning Health System focused on pediatric IBD. At the time of the study, there were 98 American ICN sites. Participants were recruited over a 4-month period beginning November 2021 via biweekly emails, intranet posts, and emails to ICN site contacts. The survey collected participant-level data (demographics, professional role, perceptions of and engagement with psychosocial providers) and ICN site-level data (types and settings of psychosocial providers available). If more than one participant per site completed the survey, responses were collapsed into a single site entry. ICN registry data on active patient populations were extracted as of November 1, 2021. Data were analyzed at participant and site levels through descriptive statistics, frequencies, an independent t test, and exploratory analyses of variance (ANOVAs) using SPSS.
**Key Results:** A total of 101 participants from 52% (n=51) of American ICN sites completed the survey. Participants were 88% (n=86) GI physicians, 10% (n=10) NP/APNs, and 2% (n=2) PAs; 49% (n=49) identified as female, 94% (n=95) as non-Hispanic, and 76% (n=75) as Caucasian. Two-thirds (66%, n=67) had worked in pediatric IBD for ≥10 years. At the participant level, 92% of HCPs reported psychosocial care was very important and 80% reported feeling very comfortable working with psychosocial providers. Two-thirds (64%) reported their clinical thresholds had shifted to engage psychosocial providers earlier in care. The top three referral reasons were coping with symptoms (78%), adjustment to diagnosis (77%), and current mental health concerns (76%). The most common barriers endorsed as somewhat to very difficult were lack of/limited psychosocial providers (92%), time/availability of psychosocial providers (87%), lack of openness of the IBD patient to psychosocial care (85%), lack of openness of the patients' family (84%), limited insurance coverage (78%), and geographical constraints (71%). Participants estimated that approximately 66% of outpatient pediatric IBD visits would benefit from psychosocial care, but only 26% currently had access to a psychosocial provider during visits. At the site level, 75% of ICN sites reported access to psychosocial providers for outpatient care and 94% for inpatient care. Participating ICN sites had significantly more patients than nonparticipating sites (M=371.8, SD=313.6 vs M=252.2, SD=164.5; t(88)=2.16, P=0.03). Exploratory one-way ANOVAs by HCP length of experience (<5 years, 5 to <15 years, ≥15 years) found no statistically significant differences on perceived understanding of psychosocial providers' role (F(2,27)=1.81, P=0.17) or perceived changes in clinical threshold over time (F(2,85)=1.2, P=0.33).
**Clinical Implications:** This study demonstrates that pediatric GI HCPs hold largely positive perceptions of psychosocial care, with most rating it as very important and feeling comfortable working with psychosocial providers. However, significant barriers—particularly limited availability of psychosocial providers—persist despite most ICN sites reporting some access. The finding that 64% of HCPs reported shifting their clinical thresholds to engage psychosocial care earlier suggests growing recognition of the value of integrated care, though this change was not statistically significant in exploratory analyses. The authors highlight the need for increased psychosocial provider positions with dedicated time to IBD, physician champions to advocate within departments, and systematic interprofessional education during fellowship training. Strategies to reduce patient and family stigma—such as integrated joint visits where psychosocial providers join HCP visits as standard practice with an opt-out rather than opt-in model—are proposed. Limitations include potential overrepresentation of larger ICN sites (participating sites had significantly more patients) and possible overrepresentation of sites with greater psychosocial integration, which may limit generalizability to non-ICN centers.