By: Lewis First, MD, MS; Editor-in-Chief
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We
know that there is a critical shortage of mental health services for children
and teens in this country, such that primary care providers (PCPs) are called
upon to often diagnose and in turn treat and follow these patients because of
lack of access to psychiatrists and even psychologists and social workers.
So just how often are these children being
managed by a PCP? Anderson et al. (doi: 10.1542/peds.2015-0807), in a study being released this week, used a nationally representative data
set to determine if children and teens from 2 to 21 years are seen in the
outpatient setting for their mental health issues by PCPs, psychiatrists or
psychologists and social workers and who is prescribing psychotropic
medications for these patients. More
than a third of children in this database were being seen by PCPs only which
may or may not surprise you. What won’t
surprise you is that more than 40% of children with attention-deficit
hyperactivity disorder (ADHD) were only seen by a PCP. These numbers may be increasing rather than
decreasing as the mental health issues we uncover in our patients rise, and the
mental health work force stays about the same or even decreases in the years
ahead.
How does your
practice compare to the results shared in this provocative study? What do you suggest the AAP might do to help
remedy the situation? Should pediatricians be trained to prescribe psychotropic
medications that go beyond an ADHD regimen more than they are currently
learning how to do? We want to know how
you are dealing with the mental health problems in your practice through your
response to this blog, sending us an e-letter or posting your comments on our
Facebook or Twitter pages.
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