In 2021, the American Academy of Child and Adolescent Psychiatry (AACAP), the American Academy of Pediatrics (AAP), and the Children’s Hospital Association (CHA) joined together to declare a national state of emergency in children’s mental health. The emergency declaration was issued as pediatric providers noted higher rates of anxiety, depression, suicide, and other conditions. 

For years, behavioral health conditions in young children have been underdiagnosed and undertreated. The lack of child psychiatrists makes consultation with primary care providers (PCPs) a critical part of their health care. 

To understand the current state of mental health access among youth, members of the MC3 team reviewed 973 of their psychiatric consultations conducted from 2012 to 2023 for children 6 years and below.

Key points from their findings include: 

• Young children are disproportionately impacted by trauma, but many PCPs do not recognize trauma in young children, instead diagnosing ADHD and other disorders and sometimes medicating for these disorders. 
• Psychotherapy is the treatment of choice for young children with mental health concerns, but in many rural areas, it is underutilized and sometimes unavailable. 
• Pediatric Mental Health Care Access Programs (PMHCAs) such as MC3 can increase provider competence and support PCPs in delivering evidence-based interventions. 
• PMHCAs, which are developing nationwide, should have a team member available for expert consultation on preschool children and be mindful of the tenets of infant mental health.

Richard Dopp, M.D., Adjunct Clinical Associate Professor at Michigan Medicine Department of Psychiatry and Medical Director at MARI, was lead author on the publication. Co-authors include Elizabeth Tengelitsch, Ph.D., Paresh Patel, M.D., Ph.D., Sheila Marcus, M.D., and Joanna Quigley, M.D., FAAP.

Read the full publication below.