Pediatric primary care providers (PCPs) made more calls to two state programs seeking advice on how to treat youth with mental illness, especially those with comorbid conditions, during the COVID-19 pandemic than before the pandemic. These findings were published today in Psychiatric Services in Advance.
The research is based on data from Pediatric Mental Health Care Access (PMHCA) programs in Maryland and Mississippi, which provide PCPs with free services to help bolster their knowledge and skills in managing common mental health problems in children and adolescents. Services include mental health care education, consultation, and referrals; some PMHCA programs also provide direct-to-patient consultation and treatment services.
“These programs, now operating in >30 states, have shown positive effects on mental health outcomes; these benefits include decreases in antipsychotic prescriptions, increased provider capacity for addressing mental health concerns, and increased identification and connection to mental health supports,” wrote Amie Bettencourt, Ph.D., of the Johns Hopkins School of Medicine and colleagues.
Bettencourt and colleagues examined the trends in the types of calls received by the PMHCAs that support PCPs in Maryland and Mississippi between January (Maryland) or September (Mississippi) 2019 and March 2021. They found that both programs experienced an uptick in call volume starting in April 2020, when the pandemic took hold in the United States, especially calls involving depression and anxiety.
The proportion of calls involving patients with comorbid diagnoses also increased sharply in both states. In Maryland, 37% of all PMHCA calls were for patients with multiple diagnoses during the pandemic, compared with 20% before the pandemic; in Mississippi, 11% of PMHCA calls were related to patients with multiple diagnoses during the pandemic compared with 0% before the pandemic. In contrast, the proportion of calls involving patients with severe mental health concerns (a patient with a score of >4 on the seven-point Clinical Global Impressions scale) dropped in both states during the pandemic, going from 11% pre-COVID-19 to 7% during COVID-19 in Maryland, and from 29% to 9% in Mississippi.
“[T]his highly similar pattern was observed in two PMHCA programs in operation for different durations; moreover, these programs had very different racial-ethnic and geographic features, health systems, and state responses to COVID-19,” the authors wrote. “Taken together, the increased utilization of PMHCA programs in these two states underscores the growing mental health needs during COVID-19 and how PMHCA programs are well situated to respond to this increased demand.”
For related information, see the Psychiatric News article “Long-Term Impact of COVID-19 on Children, Adolescents Constitutes Public Health Emergency.”
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