Bringing mental health care into pediatricians' offices works, finds five-year study []


By Children's Hospital Boston, Medical Xpress, June 11, 2019.

A five-year study at Boston Children's Hospital reports success with a program it started in 2013 to bring much-needed behavioral health services directly into primary care pediatricians' offices. As reported today in Pediatrics, the program improved children's access to behavioral health care, with only minor increases in cost, and got high marks from participating pediatric practices.

Based on the findings, Boston Children's Hospital is continuing to expand and evaluate the program, which currently reaches more than 70 of its affiliated pediatric practices in Massachusetts.

By late adolescence, up to 20 percent of children will have experienced functionally impairing anxiety, depression, and/or ADHD, the most common and treatable mental health conditions. But child behavioral health specialists are in chronic short supply with long wait lists, says Heather Walter, MD, MPH, a child/adolescent psychiatrist at Boston Children's Hospital and first author on the paper. Massachusetts, for example, has nearly 300,000 youths with at least one diagnosable psychiatric disorder—but only about 400 to 500 practicing pediatric psychiatrists.

"Nearly a decade can elapse between when a child first shows symptoms of a disorder and when it is diagnosed and treated, which has major consequences in their academic, social, and family lives," Walter says. "There aren't enough child psychiatrists to offer this care alone, and we realized we needed partners. The obvious physician partners are pediatricians—they see children for years, know them well, are tuned into , and are highly trusted by patients and families."

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How can a study that doesn’t survey patients and families be called a success? This shows that prescriptions and doctor appointments are higher and emergency room visits lower.

Are patients and families healthier, happier, and better off or are symptoms diagnosed and treated earlier and faster? What if medication side effects and how most insurance covered treatments aren’t even most effective for trauma-related suffering?

The most important feedback is from families. Here, and too often, it’s an afterthought.