Abstract
Objective
Pediatricians report many barriers to caring for children with mental health (MH)
problems. The American Academy of Pediatrics (AAP) has focused attention on MH problems,
but the impact on perceived barriers is unknown. We examined whether perceived barriers
and their correlates changed from 2004 to 2013.
Methods
In 2004, 832 (52%) of 1600 and in 2013, 594 (36.7%) of 1617 of randomly selected AAP
members surveyed responded to periodic surveys, answering questions about sociodemographics,
practice characteristics, and 7 barriers to identifying, treating/managing, and referring
child/adolescent MH problems. To reduce nonresponse bias, weighted descriptive and
logistic regression analyses were conducted.
Results
Lack of training in treatment of child MH problems (∼66%) and lack of confidence treating
children with counseling (∼60%) did not differ across surveys. Five barriers (lack
of training in identifying MH problems, lack of confidence diagnosing, lack of confidence
treating with medications, inadequate reimbursement, and lack of time) were less frequently
endorsed in 2013 (all P < .01), although lack of time was still endorsed by 70% in 2013. In 2004, 34% of
pediatricians endorsed 6 or 7 barriers compared to 26% in 2013 (P < .005). Practicing general pediatrics exclusively was associated with endorsing
6 or 7 barriers in both years (P < .001).
Conclusions
Although fewer barriers were endorsed in 2013, most pediatricians believe that they
have inadequate training in treating child MH problems, a lack of confidence to counsel
children, and limited time for these problems. These findings suggest significant
barriers still exist, highlighting the need for improved developmental and behavioral
pediatrics training.
Keywords
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Article Info
Publication History
Published online: August 26, 2015
Accepted:
August 18,
2015
Received:
April 16,
2015
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
