I do not know a single pediatrician who has not been overwhelmed in the past few years by the number of patients with mental and behavioral health concerns, not to mention the frustration that these patients and all of us who care for them experience with the long wait times to see a mental health professional if we need to refer them. There is a paucity of mental health professionals in many of our communities, and they are overwhelmed with referrals and unable to see patients as quickly as they (and we) would like. As a result, many of us have gotten additional training in mental and behavioral health, so that we can at least try to help the patients with more straightforward issues.
Often the length of the wait time to see a mental health professional is dependent upon the family’s resources – the type of insurance or the ability to pay out-of-pocket for mental health care.
I was therefore interested to see a State of the Art Review by Dr. Jennifer Hoffman from Lurie Children’s Hospital and colleagues from Boston Children’s Hospital entitled, “Disparities in Pediatric Mental and Behavioral Health Conditions,” which is being early released by Pediatrics (10.1542/peds.2022-058227).
The authors note that half of US children with a treatable mental health disorder do not receive treatment from a mental health professional. Children in minority groups (racial, ethnic, sexual, and/or gender) and who have fewer economic resources have disproportionately higher rates of mental health conditions, less access to mental health care, and poorer mental health outcomes.
This State of the Art Review is chock full of information, and everyone who provides care to children should read it. The review describes these disparities, discusses mechanisms underlying these disparities, and interventions and policy strategies that could mitigate these disparities. Some of these interventions and strategies are ones that you as an individual provider may be able to implement, and others, such as increasing access to school-based or telehealth behavioral health resources, are ones that you can advocate for in your community.