The prevalence of mental health concerns in children has increased steadily over the last 30 years to approximately 1 in 5 children in the United States.1 Primary care providers (PCPs) often report time constraints to address mental health concerns and long waiting periods for mental health referrals as common barriers to identification and treatment of psychosocial concerns in children.2 Over half of general pediatricians who are recent graduates of pediatric residency programs indicated that they needed additional training in mental health.3
To address this growing concern, the US Department of Health and Human Services’ Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB) Division of Maternal and Child Health, provides funding for 10 programs nationwide to address the mental health-training gap and support the professional development of PCPs, known as collaborative office rounds (COR).4
All COR programs are structured as regularly scheduled discussion groups, co-led by developmental-behavioral pediatricians and child and adolescent psychiatrists, with the aim of increasing the comfort level and ability of PCPs to address routine psychosocial issues of children, adolescents, and their families.4 Participants include interdisciplinary community practitioners and trainees in fields such as medicine, psychology, dentistry, and social work. Most COR programs provide continuing education credits to participants.
There are 5 primary goals of the University of Minnesota COR program, as follows:5
GOAL 1: Enhance PCP understanding of psychosocial aspects of child development, disorders, and disability.
GOAL 2: Increase provider availability to help children and families address these issues.
GOAL 3: Expand the provider’s ability to distinguish between transient disturbances and more serious psychiatric disorders that may require referral.
GOAL 4: Promote collaboration among PCPs with developmental-behavioral pediatricians and child and adolescent psychiatrists.
GOAL 5: Facilitate a comprehensive approach to health supervision, such as outlined in Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents.6
1. Perou R, Bitsko RH, Blumberg SJ, et al. Centers for Disease Control and Prevention (CDC). Mental health surveillance among children—United States, 2005-2011. MMWR Suppl. 2013;62(2): 1-35.
2. Horwitz SM, Kelleher KJ, Stein RE, et al. Barriers to the identification and management of psychosocial issues in children and material depression. Pediatrics. 2007;119(1): e208-e218.
3. Freed GL, Durham KM, Switalski KE, Jones MD, McGuinness GA, Research Advisory Committee of the American Board of Pediatrics. Recently trained general pediatrics: perspectives on residency training and scope of practice. Pediatrics. 2009;123 suppl 1: S38-S43.
4. Health Resources and Services Administration (HRSA). Maternal and Child Health: MCH Practicing Professional Development Program Fact Sheet. Available at https://mchb.hrsa.gov/training/documents/fs/factsheet-PPD.pdf Last reviewed June 2019. Accessed October 2, 2019.
5. Health Resources and Services Administration. Maternal and Child Health: The Division of MCH Workforce Development: Funded Projects. Available at https://mchb.hrsa.gov/training/project_info.asp?id=746. Accessed October 2, 2019
6. Hagan JF, Shaw JS, Duncan PM, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics: 2017.
7. Roth A. ‘Mental health is health’: Docs who treat kids get trained to spot mental health problems. Minnesota Public Radio News. Available at: https:/www.mprnews.org/story/2019/05/29/mental-health-is-health-training-docs-who-treat-kids-to-spot-mental-health-programs. Published May 29, 2019. Accessed October 2, 2019.