Primary care providers (PCPs) in the United States saw more children with ADHD than did psychiatrists or psychologists/social workers for pediatric mental health care, as 35% of children with mental health conditions (and 42% of children with ADHD) saw only a PCP, according to research published online in Pediatrics.
L. Elizabeth Anderson of the University of Tennessee in Memphis and her associates used data from the Medical Expenditure Panel Survey from 2008-2011. The study sample comprised 1,778 children aged 2-21 years, all of whom had had outpatient mental health visits during the previous year. ADHD and anxiety/mood disorders combined to account for 87.9% of the conditions for which children received care.
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One-quarter (23.8%) of all patients were managed by more than one provider, 6.7% were managed by both a PCP and a psychiatrist, 34.8% saw only a PCP, 26.2% saw only a psychiatrist, and 15.2% saw only a psychologist or social worker.
Management by more than one type of provider occurred for 20.2% of children with ADHD and 27.7% of children with anxiety/mood disorders. Children seen by a PCP were at least as likely or more likely to be prescribed psychoactive medications than were those seen by psychiatrists (70.2% vs 63.0%). Less wealthy and non–English-speaking families were significantly more likely to be managed by a PCP than a psychiatrist, although both groups were less likely to be prescribed medication for ADHD.
“These data support the importance of enhancing PCPs’ capacity for mental health care through collaborative care models, which have been shown to improve mental health outcomes relative to community care, as well as other strategies, such as expanding reimbursements beyond face-to-face visits,” the authors wrote.
The authors had no disclosures. Read the article here.