With behavioral health problems on the rise among children in the United States, primary care practices are often the first stop for families seeking care needed to treat conditions like depression, anxiety and substance abuse disorders. In order to treat these patients, primary care practices must navigate a patchwork of rapidly changing standards of care, siloed human resources and shifting payment models. A new study attempts to quantify how difficult it is for practices to obtain pediatric medication advice, evidence-based psychotherapy and family-based therapy in this context. Researchers determined that more than 85% of the practices included in the study found it difficult to obtain help with evidence-based elements of pediatric behavioral health care. The percent experiencing difficulty was similar between system-owned and independent practices, but was lower for Medicaid Accountable Care Organization practices for medication advice (80% versus 89%) and evidence-based psychotherapy (81% versus 90%). Differences were not significant for family-based treatment (85% versus 91%). The study illustrates that significant barriers exist to pediatric behavioral health treatment across the primary care landscape, regardless of institution size, clinic ownership or payor mix. Policy changes may be necessary to address these barriers.
Difficulty Obtaining Behavioral Health Services for Children: A National Survey of Multiphysician Practices
Alyna T. Chien, MD, MS, et al
Division of General Pediatrics, Department of General Pediatrics, Boston Children’s Hospital and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
The Annals of Family Medicine