- A report from the American Academy of Pediatrics urges pediatricians to get more training in mental health.
Data show that children are more likely to have mental health disorders than physical ailments, yet most children never receive the care they need because of stigma, cost and a shortage of mental health specialists, according to a report from the American Academy of Pediatrics (AAP). And although pediatricians are often the first providers to spot mental health issues in children, many say they feel ill-prepared to address these concerns.
In response, the AAP is urging pediatricians to pursue integrated and collaborative care models that incorporate psychologists into medical practices and to start including psychologists as training faculty in pediatric residency training programs.
“Psychologists are uniquely suited to teach pediatricians how to communicate with families and utilize brief interventions to help patients who are dealing with mild to moderate mental health conditions,” says Cori Meredith Green, MD, MS, “This type of training could potentially prevent untreated symptoms from becoming more serious disorders in the future.”
Although most pediatric residencies typically include a four-week developmental-behavioral pediatrics rotation, data suggest that this training is not equipping physicians to address common concerns such as attention-deficit hyperactivity disorder (ADHD), disruptive behaviors, sleep problems, anxiety, depression and suicidality. One national study showed that more than 62% of pediatric residency program directors described the quality of behavioral health training in their program as suboptimal or below ( Journal of Developmental & Behavioral Pediatrics , Vol. 39, No. 4, 2018).
“The current training tends to focus on autism and lacks hands-on experience,” says study co-author Jeffrey Shahidullah, PhD. “Residents want to work alongside psychologists and other mental health specialists and have more than four weeks with patients.”
Geisinger Health System in Pennsylvania is one organization that has successfully integrated hands-on mental health training into its pediatric residency program. Psychologists work alongside primary-care pediatricians in many clinics, so residents can invite a psychologist into the exam room immediately if they encounter a child with a mental health concern.
Paul Kettlewell, PhD, director of pediatric psychology at Geisinger, who is among the psychologists training residents how to assess conditions like ADHD, depression and anxiety. He teaches residents how to use elements of cognitive-behavioral therapy and exposure treatment to help anxious kids face their fears and reduce excessive worry.
Start building partnerships
Creating opportunities for psychology and physician trainees to learn side-by-side not only helps future pediatricians learn how to address mental health issues, but also benefits the psychologists who watch physicians in action.
Stringer, H. (2020). “A new opportunity to improve children’s mental health care”
American Psychological Association.