A newly published survey and research paper, Difficulty Obtaining Behavioral Health Services for Children: A National Survey of Multiphysician Practices, conducted before the pandemic indicates that 85 percent of group practices for children and youth have had difficulty in finding evidence-based psychotherapy; family-based treatment and medication advice from a child psychiatrist or psychiatric nurse practitioner.

The limitations found in the survey is similarly limited between system-owned and independent practices but was slightly less limited for Medicaid-funded providers.  Medication advice (81% vs 89%), evidence-based psychotherapy (81% vs 90%); and family-based treatment (85% vs 91%).

According to the authors the struggles of most multi-physician practices to obtain advice and services for child behavioral health needs, confirm a long-term problem.  The paper notes that the percentage of doctors experiencing overall difficulty increased to the 85 percent figure from the 67 percent of physicians responding in a 2004-2005.

Researchers noted that practices in rural locations had significantly greater difficulty obtaining pediatric behavioral health advice and related services relative to their non-rural providers. Rural practices were more likely to have difficulty obtaining all 3 types of behavioral health services.

As many news reports have indicated in the last two years, for children and youth, behavioral needs have grown during the pandemic. The authors note,

“the United States, behavioral health problems such as depression, anxiety, other mental illness, or substance use disorders are increasing among children, and this trend is expected to extend beyond the COVID-19 pandemic. When used appropriately, psychotropic drugs, evidence-based psychotherapy, and family-based treatments are cornerstones of effective treatment but are challenging to deliver broadly given the ongoing national shortage of child behavioral health professionals. Primary care practices are at the frontline of delivering pediatric behavioral health services because they provide a familiar, non-stigmatizing context in which behavioral health issues can gain attention.”