Treating kids with troubled minds: How to bridge the gap

Providing mental health care for children and teens in a primary care practice is possible, but there are hurdles to overcome.

By Susan J. Landers, AMNews staff. July 18, 2005.

Vermont pediatrician Thomas "Mike" Moseley III, MD, gained a window into a whole new side of his patients' lives when social worker Donna Laurin was hired as a member of the practice's treatment team more than five years ago.

While he thought referrals to mental health services would become simpler for his patients and their families, Dr. Moseley also found that the very nature of his practice changed. "I discovered that it has probably made us more aware of the problems that families face. It has made pediatric care more gratifying and, I hope, more useful for the kids."

The steps taken by this practice demonstrate one way of tackling head-on an issue that is surfacing throughout the nation: There are way too few child and adolescent psychiatrists available to meet the growing need for mental health services for young patients.

Only about 30 child and adolescent psychiatrists are in Vermont, said David Fassler, MD, who is counted among this group of specialists and is a clinical associate professor of psychiatry at the University of Vermont College of Medicine in Burlington. "If we had three times that number they would still be busy."

Additionally, the importance of mental health services for young people was recently underscored by the National Comorbidity Survey Replication, which found half of all lifetime cases of mental disorders begin by age 14.

The result: Primary care physicians are searching for and finding ways to bridge the gap.

"Our idea was to try to figure out a way to cope with a need we weren't trained for and weren't staffed for," said Dr. Moseley. "Being proactive about it gets you further than being run over."