Pediatric Psychiatry Patients Undertreated

Only 25% or so of the 15 million children in the US who are diagnosed with a mental disorder receive appropriate treatment based on scientific evidence, according to a new report from the American Psychological Association'€™s Presidential Task Force on Evidence-Based Practice. You read that right; according to the APA, about three-quarters of your pediatric patients aren’t appropriately treated. The seven-member task force said things are only going to get worse if the healthcare system doesn’t change the way that services are delivered. The task force recommended dissemination of evidence-based practice approaches to help ensure that the best available care is provided to children and adolescents with mental health conditions. “The care should include prevention, early intervention, targeted treatments for particular disorders, an understanding of developmental processes and continuity of care,” said task force chair Anne E. Kazak, PhD, ABPP. “Furthermore, treatments should be accessible regardless of age, gender, sexual orientation, disability, race, ethnicity and culture. Lastly, evidence-based practice should be cross-disciplinary and include collaborations with families, schools, practitioners and researchers from various health fields.”

Specific recommendations included in the task force’s report include:

Research

• Increase research funding to develop and deliver evidence-based practice to children in different settings

• Establish multidisciplinary coalitions to provide guidance on funding mechanisms for development and dissemination of evidence-based practice for children and adolescents

Education and Training

• Develop interdisciplinary Web-based training on core areas of evidence-based practice that include social work, education, pediatrics and psychiatry

• Develop accessible Web-based interactive system to allow stakeholders state psychological associations, state directors of children's mental health services, universities, mental health agencies, practitioners and families with youth needing treatment to share information about using evidence-based practice in different settings

• Increase evidence-based practice for children and adolescents in graduate and post-graduate training programs and develop means for evaluating EBP training

• Include evidence-based practice in continuing education to increase likelihood that frontline professionals have training opportunities

• Encourage cross-disciplinary, culturally diverse training in an international framework to encourage attention to evidence-based practice

Practice and Policy

• Identify appropriate funding levels so adequate coverage for evidence-based practice is secured for children and adolescents

• Develop policies that promote access to evidence-based practice for children and families, especially for underserved populations, such as ethnic minority children, pre-adolescents, children with multiple health and substance abuse problems and those with disabilities. Additionally, children who are in the child welfare and juvenile justice system and those in homeless shelters also need access to evidence-based interventions.

• Eliminate barriers to evidence-based practice for children and adolescents in the private sector and at the state and federal level as well as in regulatory and policy initiatives.

• Establish a cross-disciplinary, multi-agency task force to examine the barriers to evidence-based practice for children and adolescents

Why do so many pediatric patients with mental disorders receive treatment that does not conform to current evidence-based standards? Could the task force’s findings be skewed somehow? Is there something they don’t take into consideration? Or are they dead on and representative of a healthcare system in desperate need of a universal overhaul? Are the recommendations enough to make a significant change? If not, was else is needed? Government involvement? Patient education? Tell your colleagues what you think. Post a comment below!