Primary Care Doctors Spearhead Youth Mental Health Treatment

Mental health problems in children predominantly treated by primary care physicians

/ Author:  / Reviewed by: Jennifer Gershman, PharmD, CPh

(RxWiki News) Children's mental health treatment can be a delicate process — and one in which pediatricians and other primary care physicians may play an important role.

A new study found that primary care physicians (PCPs) are often the only source of mental health care for children.

"This study uses nationally representative US data of children receiving care for mental health conditions, with a focus on ADHD and anxiety/mood disorders," wrote study co-author Jeanne Van Cleave, MD, FAAP, of MassGeneral Hospital for Children and Harvard Medical School, and colleagues.

According to Dr. Van Cleave and colleagues, less than half of all US children with mental health conditions are estimated to receive proper care. As a result, the American Academy of Pediatrics has encouraged PCPs to monitor for untreated mental health conditions in children.

"We examined the involvement of PCPs and other providers in pediatric mental health care among US children and youth," Dr. Van Cleave and colleagues wrote. "This study suggests PCPs alone care for a greater proportion of children receiving mental health care than do psychiatrists or psychologists/social workers, especially in the treatment of ADHD."

For this study, Dr. Van Cleave and team used medical records from the Medical Expenditure Panel Survey to look at current treatment trends. They focused on data from 2008 to 2011 from patients ages 2 to 21.

The largest group (34.8 percent) of patients who received outpatient care for a mental health condition only saw a PCP. Another 26.2 percent only saw a psychiatrist, while 15.2 percent only saw a psychologist or social worker. Some children (23.8 percent) saw multiple providers.

The likelihood of only seeing a PCP varied with the type of mental health condition. For instance, more children (41.8 percent) with attention deficit hyperactivity disorder (ADHD) only saw a PCP than did children with anxiety or mood disorders (17.2 percent).

Children who only saw PCPs were also more likely to be prescribed medication than children who saw psychiatrists.

According to Dr. Van Cleave and team, this study emphasizes the important role of PCPs in mental health treatment.

"In an effort to assist PCPs in their involvement in pediatric mental health care, further emphasis should be placed on collaborative care models with psychotherapy and programs that provide point-of-care advice to PCPs from mental health experts," Dr. Van Cleave and colleagues wrote.

This study was published Oct. 12 in the journal Pediatrics.

The National Institutes of Health and the American Pediatric Society/Society for Pediatric Research Student Research Program funded this research. No conflicts of interest were disclosed.

Review Date: 
October 9, 2015
Last Updated:
October 12, 2015