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Call to action seeks to address 'crisis' in pediatric behavioral, mental health training
In a recent review, the American Board of Pediatrics identified a severe lack of pediatric residency training for behavioral and mental health problems and urged increased education in preventing, recognizing and managing these conditions.
The Board also plans to partner with other pediatric organizations, including the AAP, the American Academy of Child and Adolescent Psychiatry, and the Society for Adolescent Health and Medicine, to ensure that future graduates can better address these cognitive and behavioral aspects of child health.
“Twice within the past 40 years, comprehensive reports from task forces on the Future of Pediatric Education have emphasized the need to enhance residency training in behavioral, developmental and adolescent issues,” Julia A. McMillan, MD, FAAP, vice chair of pediatrics and the pediatric residency program at Johns Hopkins School of Medicine, and colleagues wrote. “Nevertheless, the challenges related to behavioral and mental health among the nation’s children have only grown [by 20.9%] since the second report was issued in 2000.”
An estimated 50% of Americans will experience a concern related to mental health at some point in their lives, and most of these concerns will have originated in childhood. Moreover, more than 15% of parents in the United States reported a clinician diagnosed their child with a mental, behavioral or developmental disorder between 2 and 8 years of age.
However, a recent survey conducted by the AAP showed that of 512 responding primary care and specialty pediatricians, 65% believed they lacked the necessary training in the treatment of children and adolescents with mental health problems, 40% responded they lacked the ability to diagnose mental health problems and more than 50% reported they lacked confidence in their ability to treat.
“Our goal should be to train pediatricians who can counsel parents to prevent behavioral and mental health problems and promote physical and emotional wellness, to identify those problems when they occur, to treat many common problems and to refer and coordinate care when additional expertise is needed,” McMillan and colleagues wrote.
Further barriers to care included inadequate preparation and confidence likely leading to disinterest among pediatricians treating or comanaging mental health problems in children.
McMillan and colleagues offered solutions for providing pediatricians-in-training the educational materials they need to deliver adequate behavioral and mental health care to children including:
- a robust behavioral and mental health curriculum that extends to all residency program directors, facility faculty, community practitioners, child and adolescent psychiatrists and psychologists, social workers, Pediatric Review Committee of the Accreditation Council for Graduate Medical Education and the American Board of Pediatrics;
- tools intended for assessing entrustment professional activity for unsupervised practice;
- immersion into appropriate training environments with clinicians experienced with behavioral and mental health issues in children;
- faculty development for pediatrician faculty; and
- collaboration of behavioral and mental health care within primary health care as proposed by the Patient Protection and Affordable Care Act.
“If the education of general pediatricians and subspecialists does not advance to meet this end, it will be difficult to assert, as the second Future of Pediatric Education Task Force did, that ‘the pediatrician is the best trained professional to provide quality health care services’ for the nation’s children,” the researchers wrote. – by Kate Sherrer
Disclosure: The researchers report no relevant financial disclosures.
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