To determine how the proportion of youth seen and/or prescribed medications for mental health conditions by PCPs compared with other mental health providers, researchers from MassGeneral Hospital for Children and Brigham and Women's Hospital in Boston examined data from the Medical Expenditure Panel Survey (MEPS). The analysis incorporated data collected from 2008 to 2011, which included 43,235 U.S. children and adolescents aged 2 to 21 years.
The researchers found that 1,778 children and adolescents aged 2 to 21 were reported to have had an office-based or outpatient visit for a mental health condition, with a mean of 5.4 visits per child with any mental health visits. Of those who had a visit for any mental health condition, 34.8% saw only a PCP, 26.2% saw only a psychiatrist, 15.2% saw only a psychologist or social worker, and 23.8% saw multiple providers. A greater proportion of youth with attention-deficit/hyperactivity disorder (ADHD) versus youth with anxiety/mood disorders saw a PCP only (41.8% vs 17.2%).
The study also revealed that youth who had a visit with a PCP were more likely to be prescribed a psychotropic medication than those who saw a psychiatrist: 70.2% versus 63.0% of children for any mental health condition, 73.7% versus 61.4% for ADHD, and 59.7% versus 45.9% for anxiety/mood disorders. Youth with ADHD seen by PCPs had 1.5 times the odds of receiving a medication than did those seen by psychiatrists.
“This study suggests PCPs alone care for a greater proportion of children receiving mental health care than do psychiatrists or psychologists/social workers, especially in the treatment of ADHD. However, fewer than half of children had any involvement from their PCP, and comanagement with other mental health specialists, especially psychiatrists, appears uncommon,” the study authors noted. “[I]n an effort to assist PCPs in their involvement in pediatric mental health care, further emphasis should be placed on collaborative care models with psychotherapy and programs that provide point-of-care advice to PCPs from mental health experts.”
For related information, see the Psychiatric News article “Pediatricians Urged to Adhere Better to ADHD Care Practices.”
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