Training helps pediatricians independently treat child anxiety and depression

Pediatricians who participated in the collaborative mental health program at Ann & Robert H. Lurie Children's Hospital of Chicago were more likely to diagnose and treat anxiety and depression in kids without reliance on additional support from specialists, according to a study published in Academic Pediatrics. Findings suggest that the program – called Mood, Anxiety, ADHD Collaborative Care (MAACC) – successfully prepares pediatricians to manage these conditions independently, so that more children can access care despite the ongoing shortage of pediatric mental health professionals.

Our study demonstrates that training pediatricians through collaborative care builds their capacity to manage mental health conditions on their own, which translates to exponentially greater access for children."

John Parkhurst, PhD, senior author, Psychology Director of Collaborative Care at Lurie Children's and Associate Professor of Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine

The MAACC program was launched in 2018 and currently serves 57 pediatric primary care practices with over 350 pediatricians participating. Pediatricians in MAACC completed training consisting of a 12-module curriculum and monthly virtual case presentations. Following training, they could refer patients for multidisciplinary evaluation and be equipped with a treatment plan. Pediatricians also had access to consultation with pediatric psychologists or psychiatrists at Lurie Children's as needed.

For the study, Dr. Parkhurst and colleagues used electronic health record data, excluding patients directly served by MAACC, in order to assess pediatrician-ascribed mental health diagnoses, medication prescriptions, and follow-up visit frequency across two groups: pediatricians participating in MAACC (four practices, 16 providers) and pediatricians providing usual care without access to the collaborative care program (three practices, 15 providers). Data were analyzed for a baseline year (July 1, 2017-June 30, 2018) and for the first four years of MAACC implementation (July 1, 2018 -June 30, 2022).

"We found that experience with MAACC had meaningful impact on pediatrician behavior. Even when accounting for year over year change, pediatricians exposed to MAACC had more than twice the odds of identifying patients with anxiety or depression and nearly three times the odds of seeing those patients for ongoing follow-up. Among diagnosed patients, antidepressant prescribing was approximately 20% higher in MAACC practices," said Dr. Parkhurst. "These findings affirm that our program is producing the intended results – shifting the necessary knowledge and skills to pediatricians so that common mental health conditions in kids can be managed in primary care."

This research was supplementally supported by the Pritzker Foundation.