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. 2017 Jul;17(5):479-486.
doi: 10.1016/j.acap.2016.10.014. Epub 2017 Mar 6.

Which Pediatricians Comanage Mental Health Conditions?

Cori Green  1 , Amy Storfer-Isser  2 , Ruth E K Stein  3 , Andrew S Garner  4 , Bonnie D Kerker  5 , Moira Szilagyi  6 , Karen G O'Connor  7 , Kimberly E Hoagwood  8 , Sarah M Horwitz  8
Affiliations

Which Pediatricians Comanage Mental Health Conditions?

Cori Green et al. Acad Pediatr. 2017 Jul.

Abstract

Objective: Given the prevalence of mental health (MH) conditions (MHC) in children, pediatricians should initiate treatment alone or in collaboration with a specialist for children with MHC. However, the majority of pediatricians do not manage or comanage common MHC even with an on-site MH provider. We examined which physician, practice, and training characteristics are associated with pediatricians' comanaging at least half of their patients with MHC.

Methods: We analyzed responses of general pediatricians (n = 305) from the American Academy of Pediatrics 2013 Periodic Survey. Practice characteristics include presence of an on-site MH provider and perceived access to services. Independent variables included sociodemographics, training experiences, and interest in further training. The outcome was comanagement of ≥50% of patients with MHC. Weighted univariate, bivariate, and multivariable analyses were performed.

Results: Of the pediatricians who reported comanaging ≥50% of their patients with MHC, logistic regression analysis showed that pediatricians who completed ≥4 weeks of developmental behavioral pediatrics training had 1.8 increased odds (95% confidence interval 1.06, 3.08, P = .03) of comanagement, those very interested in further education in managing/treating MHC had 2.75 increased odds (95% confidence interval 1.63, 3.08, P < .001), and those with more training in MH treatment with medications had 1.4 increased odds (95% confidence interval 1.12, 1.75, P = .004) of comanaging children with MHC.

Conclusions: Specific educational experiences and interest in further education in managing or treating MHC were significantly associated with comanaging ≥50% of patients, suggesting that enhanced MH training among pediatricians could increase the comanagement of children with MHC.

Keywords: behavior problems; comanagement mental health; developmental behavioral pediatrics; pediatric education learning problems.

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Conflict of interest statement

Conflict of Interest: None

References

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