One in three American children with anxiety, attention deficit hyperactivity disorder (ADHD) and other mental health conditions is treated only by pediatricians or primary care physicians (PCPs), according to recent research findings.
Published in the journal Pediatrics, the study discovered that 34.8 percent of kids seeking outpatient mental health care are treated only by a primary care physician. About 26 percent went to psychiatrists while 15.2 percent saw psychologists or social workers.
The research team led by L. Elizabeth Anderson of the University of Tennessee College of Medicine looked at the Medical Expenditure Panel Survey's nationally representative data on about 43,000 children and youth 2 to 21 years old. The subjects had been checked by medical professionals for mental health care in an outpatient basis from 2008 to 2011.
Of the group that saw only pediatricians, there is a higher proportion of children with ADHD (41.8 percent) than those with anxiety-mood disorders (17.2 percent).
The authors – who came from University of Tennessee, MassGeneral Hospital for Children in Boston and Harvard Medical School – said that efforts toward mental health support in the primary care segment “will reach a substantial portion of children receiving mental health services.”
They also called for collaborative care between PCPs and mental health specialists.
The study saw that pediatricians prescribed more medication than psychiatrists, with kids with ADHD, for instance, more likely to be prescribed stimulants when they see the former than the latter.
Last year, a study in the Journal of Clinical Psychiatry found that these primary care doctors increased prescribed doses of antidepressants, antipsychotics and similar drugs much faster than psychiatrists did.
Other recent research warned against commonly provided prescriptions for children who didn’t have psychosis, such as those with ADHD or depression.
According to pediatrician Dr. Wendy Sue Swanson, the Seattle Children’s Hospital's executive director of digital health, a “multifaceted plan” should underlie strategies for addressing children’s mental health issues, including support at home, school and the healthcare system.
"It can get complicated with multiple providers. We need to empower families to partner with their pediatricians,” Swanson said, encouraging the use of other resources including suicide hotlines and telehealth services.
She also urged parents to communicate any discomfort they have with the care being given to their children.
