TY - JOUR
AU - R. Ballard
AU - N. Terry
AU - S. J. Friedland
AU - J. T. Parkhurst
A1 - 
AB - OBJECTIVE: Pediatricians provide the majority of mental health treatment in the United States yet often feel unprepared to diagnose and manage anxiety and depression. Integrated care models such as collaborative care support provider competence and ability to treat youth mental health problems. These models may result in increased independent management of patients by pediatricians. METHODS: We conducted a 4-year retrospective cohort study comparing the trajectory of pediatricians' behaviors (ie, mental health diagnosis, treatment, visit frequency) across 2 practice groups. Group 1 (N=16, 3 practices) participated in an off-site collaborative care program, and Group 2 (N=16, 3 practices) did not participate in the program. Outcomes included proportions of patients with pediatrician-assigned diagnoses, frequency of visits, and pharmacologic prescribing. RESULTS: Pediatrician participation in the collaborative care program was associated with higher odds of seeing patients at least once per year for anxiety and/or depression (OR = 2.35, 95% CI: 1.34-4.15, adjusted P=.015), seeing patients at least 3 times per year for anxiety and/or depression (OR = 2.98, 95% CI: 1.30-6.84, adjusted P=.039), patients receiving an antidepressant prescription (OR = 6.33, 95% CI: 3.58-11.18, adjusted P<.001), and patients receiving an ADHD medication prescription (OR = 1.31, 95% CI: 1.06-1.61, adjusted P=.04). CONCLUSIONS: Participation in a collaborative care program was associated with increased independent pediatrician diagnosis and management of anxiety and depression beyond the formal consultation pathway.
AD - Ann & Robert H. Lurie Children's Hospital (R Ballard, SJ Friedland, and JT Parkhurst), Chicago, Ill.; Northwestern University Feinberg School of Medicine Psychiatry and Behavioral Science (N Terry, SJ Friedland, and JT Parkhurst), Chicago, Ill.; Ann & Robert H. Lurie Children's Hospital (R Ballard, SJ Friedland, and JT Parkhurst), Chicago, Ill; Northwestern University Feinberg School of Medicine Psychiatry and Behavioral Science (N Terry, SJ Friedland, and JT Parkhurst), Chicago, Ill.; Ann & Robert H. Lurie Children's Hospital (R Ballard, SJ Friedland, and JT Parkhurst), Chicago, Ill; Northwestern University Feinberg School of Medicine Psychiatry and Behavioral Science (N Terry, SJ Friedland, and JT Parkhurst), Chicago, Ill. Electronic address: jtparkhurst@luriechildrens.org.
AN - 42341867
BT - Acad Pediatr
C5 - Healthcare Disparities; Education & Workforce
CP - 6
DA - 06/2026
DO - 10.1016/j.acap.2026.103361
DP - NLM
ET - 20260624
IS - 6
JF - Acad Pediatr
LA - eng
N2 - OBJECTIVE: Pediatricians provide the majority of mental health treatment in the United States yet often feel unprepared to diagnose and manage anxiety and depression. Integrated care models such as collaborative care support provider competence and ability to treat youth mental health problems. These models may result in increased independent management of patients by pediatricians. METHODS: We conducted a 4-year retrospective cohort study comparing the trajectory of pediatricians' behaviors (ie, mental health diagnosis, treatment, visit frequency) across 2 practice groups. Group 1 (N=16, 3 practices) participated in an off-site collaborative care program, and Group 2 (N=16, 3 practices) did not participate in the program. Outcomes included proportions of patients with pediatrician-assigned diagnoses, frequency of visits, and pharmacologic prescribing. RESULTS: Pediatrician participation in the collaborative care program was associated with higher odds of seeing patients at least once per year for anxiety and/or depression (OR = 2.35, 95% CI: 1.34-4.15, adjusted P=.015), seeing patients at least 3 times per year for anxiety and/or depression (OR = 2.98, 95% CI: 1.30-6.84, adjusted P=.039), patients receiving an antidepressant prescription (OR = 6.33, 95% CI: 3.58-11.18, adjusted P<.001), and patients receiving an ADHD medication prescription (OR = 1.31, 95% CI: 1.06-1.61, adjusted P=.04). CONCLUSIONS: Participation in a collaborative care program was associated with increased independent pediatrician diagnosis and management of anxiety and depression beyond the formal consultation pathway.
PY - 2026
SN - 1876-2859
SP - 103361
ST - Building Independent Mental Health Practice Through Collaborative Care
T1 - Building Independent Mental Health Practice Through Collaborative Care
T2 - Acad Pediatr
TI - Building Independent Mental Health Practice Through Collaborative Care
U1 - Healthcare Disparities; Education & Workforce
U3 - 10.1016/j.acap.2026.103361
VL - 26
VO - 1876-2859
Y1 - 2026
ER -