Clinical pediatrics
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Clinical pediatrics · Jun 2007
Behavioral health practices in the midst of black box warnings and mental health reform.
A standard guide was readministered to 42 primary care pediatricians after community interventions to assess changes in their behavioral health practices. Among the outcome findings: increased screening of young children (6 months to 5 years); attention deficit hyperactivity disorder continued to be the most frequent diagnosis, with a high level of diagnostic comfort and use of stimulants; decreased comfort in the diagnosis and treatment of depression, with a significant decline in use of selective serotonin reuptake inhibitors; nearly all continued to offer nonmedication, behavioral health treatment; and a significant increase in use of social workers for community referrals. ⋯ Black box warnings exerted a powerful effect on prescribing practices. Systemic changes involving financial incentives, increased access to mental health providers, practice guidelines, and technology for continuing education may offer possibilities for changing practice patterns.