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Most pediatricians do not use mental health clinicians to co-manage patients

BALTIMORE — The majority of general pediatricians did not use mental health professionals in the co-management of most of their patients with anxiety and depression, according to study data presented at the Pediatric Academic Societies Meeting.

“There aren’t enough mental health providers to go around,” Ruth E.K. Stein, MD, attending physician at Children’s Hospital at Montefiore, told Infectious Diseases in Children. “And in some locations, pediatricians are practicing in areas where there are few, if any, mental health providers.”

Ruth E.K. Stein

National mental health competencies have stated that pediatricians should manage their patients with ADHD, anxiety and depression either alone or by co-managing them with mental health professionals, the researchers wrote. Previous data have shown that outside of ADHD, however, most pediatricians do not co-manage these disorders.

Stein and colleagues analyzed data from a sample of 305 general pediatricians who had completed a 2013 AAP survey by performing a weighted logistic regression. The survey asked about physician traits, practice characteristics and training experiences in treating and co-managing patients with mental health issues.

The researchers observed that only one-third of pediatricians co-managed at least 50% of their patients with mental health problems. Pediatricians who completed at least 4 weeks of developmental-behavioral pediatrics rotations were twice as likely to co-manage these patients (P = .02). Further, pediatricians who reported being very interested in further education on managing pediatric mental health concerns were 2.8 times more likely to co-manage (P < .001). Among pediatricians working in multispecialty practices, those trained in medication dosing were twice as likely to co-manage for each training session (P < .001).

No association was observed between pediatricians working in primary care settings and co-managing. In addition, there was no association between physician or practice characteristics, including co-location, and co-managing.

“Mental health has not been given as much attention as physical health care in many primary care practices,” Stein said “That’s something that the American Academy of Pediatrics and others are working very hard to change.” – by Will Offit

Reference:

Green C, et al. Abstract 1495.378. Presented at: Pediatric Academic Societies Meeting; April 30-May 3, 2016; Baltimore.

Disclosure: Stein reports no relevant financial disclosures.