As demand for youth psychiatry rose, promise in 'pediatric mental health care access programs' emerged

Referrals from primary care providers (PCPs) to Pediatric Mental Health Care Access (PMHCA) programs increased and involved more complex mental health concerns, particularly regarding mood and anxiety, during the pandemic, according to a new study published online today in Psychiatric Services. These trends underscore the importance of these programs to supporting the growing need for children's mental health care.

PMHCA programs provide training, consultation, and resource-referral support to primary care providers (PCPs), thereby increasing children's access to mental health care. The U.S. Health Resources and Services Administration began providing support for PMHCAs in 2018 and expanded the effort in 2021. PMHCA programs now reach 40 states, the District of Columbia, the U.S. Virgin Islands, and the Republic of Palau, the Chickasaw Nations, and the Red Lake Band of Chippewa Indians. The program is part of an effort to build workforce capacity and to make early identification, diagnosis, treatment, and referral of behavioral disorders a routine part of children's health care services.

The study, led by Amie F. Bettencourt, Ph.D. with the Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine in Baltimore, compared trends in services provided by two PMHCA programs during the COVID-19 pandemic. The researchers looked at more than 2,840 contacts between PCPs and PMHCAs in Maryland and Mississippi from January 2019 to March 2021.

Both programs saw significant increases in calls during the COVID-19 pandemic compared with before COVID-19. Specifically, increases were seen in calls for patients with multiple diagnoses (Maryland, 20% to 37%; Mississippi, 0% to 11%) and patients with mood and anxiety symptoms. The authors note that "the somewhat mixed findings of changes in the features of mental health problems highlight regional variability in the impact of COVID-19 on population mental health," and highlight the importance of local responses to mental health needs provided by PMHCA programs.

This study "provides evidence supporting the role of PMHCA programs in bolstering PCPs' identification and management of pediatric mental health needs and in connecting children with mental health services," the authors conclude. "As an innovative workforce development and mental health care model capable of bridging the mental health care gap, PMHCA programs are poised to respond to the ongoing and likely increasing mental health care needs of children associated with the global pandemic."