Collaborative care program increases pediatricians’ confidence in managing pediatric mental health

Pediatricians who participated in a collaborative mental health program were significantly more likely to diagnose and treat children with anxiety and depression in primary care than peers without access to the program, according to a study published in Academic Pediatrics. The findings suggest that collaborative care models centered on clinician education may help expand access to pediatric mental health services amid persistent shortages of child mental health specialists.^1,2

Investigators evaluated the Mood, Anxiety, ADHD Collaborative Care (MAACC) program at Ann & Robert H. Lurie Children's Hospital of Chicago, which was established in 2018 to strengthen pediatricians' ability to manage common mental health conditions. The program combines a 12-module educational curriculum, monthly virtual case presentations, multidisciplinary evaluations when needed, and access to consultation with pediatric psychologists and psychiatrists.

Researchers analyzed electronic health record data from patients who were not directly enrolled in MAACC, allowing them to assess whether pediatricians applied the knowledge and skills gained through the program in routine clinical practice. The retrospective cohort study compared pediatricians participating in MAACC (16 providers across 4 practices) with pediatricians providing usual care without the collaborative care program (15 providers across 3 practices). Data from a baseline year (July 2017 through June 2018) were compared with the program's first 4 years of implementation (July 2018 through June 2022).

What changes did researchers observe?

After accounting for year-to-year changes, pediatricians participating in MAACC had more than twice the odds of diagnosing anxiety or depression and nearly three times the odds of providing at least 3 follow-up visits annually for these patients compared with pediatricians not participating in the program. Among children with diagnosed anxiety or depression, antidepressant prescribing was approximately 20% higher in MAACC practices.

Senior author John Parkhurst, PhD, said the study was designed to determine whether improvements in pediatricians' confidence translated into measurable changes in clinical practice.

"Our work has focused on outcomes, you know, historically as far as within the collaborative care model, and what we really wanted to do, we we've always kind of had signals that confident that we were improving confidence in independent practice of our primary care clinicians that were participating in our collaborative care model, but we wanted to see if that behavior aligned with their confidence."

Rather than attempting to replace specialty mental health care, the program was developed to help pediatricians manage mild to moderate mental health conditions while maintaining access to specialist consultation when needed.

"So I think it was really two things: it's how do we how do we have the how do we you know have the education, but also have a supported model that has the specialists and the people that you know who to call and when to call."

Parkhurst emphasized that the goal is not to transform pediatricians into child psychiatrists but to provide the education and support necessary to increase confidence in treating common conditions such as attention-deficit/hyperactivity disorder, anxiety, and depression.

Why do these findings matter for pediatric practice?

The study suggests that collaborative care programs may strengthen pediatricians' ability to deliver evidence-based mental health care beyond patients formally enrolled in the program. Investigators intentionally excluded children who received direct MAACC services to evaluate whether pediatricians incorporated these skills into routine practice.

"What we wanted to see, and we're glad that we found an indicator of this, is that our clinicians were doing the work with the patients that we weren't providing consultation on or supporting with diagnostic support."

Parkhurst noted that the findings support collaborative care as a workforce development strategy that can increase access to quality mental health care while preserving specialty resources for children with more complex needs.

"I would love that to kind of be the the big finding from this is that these models can really enhance independence in providing care, good and quality care to children."

He encouraged pediatricians seeking to build confidence in pediatric mental health management to pursue available educational resources and consultation services.

"And so I think it's building comfort and confidence for these clinicians, primary care clinicians, to jump into some of the education around it."

As demand for pediatric mental health services continues to outpace the available specialist workforce, the investigators suggest that collaborative care models emphasizing education, ongoing consultation, and shared expertise may help primary care practices expand access to evidence-based mental health treatment.

References

1. Ann & Robert H. Lurie Children's Hospital of Chicago. Lurie Children’s Program helps pediatricians gain independent expertise to treat more kids with depression and anxiety, study finds. Eurekalert. July 17, 2026. Accessed August 6, 2026. https://www.eurekalert.org/news-releases/1136627

2. Ballard R, Terry N, Friedland SJ, Parkhurst JT. Building independent mental health practice through collaborative care. Acad Pediatr. Published online June 24, 2026. doi:10.1016/j.acap.2026.103361.