WINSTON-SALEM, N.C. Continuing medical education, newsletters and resource guides were only partially successful in changing the way that pediatricians handled behavioral health problems, according to a follow-up study at Wake Forest University School of Medicine.
But external factors, especially "black box warnings" from the U.S. Food and Drug Administration "exerted a powerful effect on prescribing practices," said Jane Williams, Ph.D., and colleagues, writing in the June issue of Clinical Pediatrics. So did the changes in the public mental health system brought about by North Carolina's mental health reform.
In 2004, the same group reported in Pediatrics that pediatricians were diagnosing and treating growing numbers of children with behavioral health problems about 15 percent of the children they see but did not always feel sufficiently trained to fill this new role.
This year, Williams and her colleagues went back to 42 primary care pediatricians they had originally interviewed in 2002-03 to find out which of a series of what they called "structured interventions" worked.
The structured interventions "focused on recognition, treatment and referral of children with behavioral health problems," Williams said. They included a quarterly newsletter, Pediatric Mental Health Connections, a Mental Health Resource Guide consisting of information about community mental health providers, quarterly collaborative behavioral health "rounds," and three continuing education workshops covering screening children for developmental and behavioral problems and diagnosing and treating depression.
Williams noted that the structured interventions "focused on increased education in areas requested by the pediatricians, especially recognition of anxiety and depression, increased awareness of community mental health providers, increased communication between pediatricians and mental health providers, and use of a community protoco
Contact: Karen Richardson
Wake Forest University Baptist Medical Center