Integrated psychiatry training improves pediatric mental health care gap

Researchers from the University of Michigan have reported improvements in the pediatric mental health gap through implementing child psychiatry directly into pediatric resident training and the pediatric medical home, publishing their findings in Psychiatric Services.¹

Pediatricians have reported feeling underprepared to help children with mental health concerns, but parents continue to turn to these providers for assistance. This led University of Michigan Health to develop the Pediatric Psychiatry Colocalized Consult Clinic (P2C3) to improve access to care and help future pediatricians learn how to manage child mental health.

“Pediatricians are increasingly on the front lines of children’s mental health care, often without enough training or specialist support,” said Margeaux Naughton, MD, lead author and pediatrician at University of Michigan Health.

Pilot program and resident integration

P2C3 initially launched in 2013 through an 8-month pilot occurring within an academic pediatric primary care clinic. During this period, patients saw both pediatric residents and a child and adolescent psychiatrist in the same clinic space.

This allowed pediatric residents to gain direct, supervised experience in mental health care. Continued management of patients would be performed by their primary care physician following mental health consultation and management.

The pilot included 66 patients aged a mean 12.7 years, 30% of whom were covered by Medicaid. These patients received care significantly faster than standard psychiatric wait times, with most seen within 1 to 3 weeks of referral. Often, these patients presented with conditions seen by pediatricians every day, including the following:

• Attention-deficit/hyperactivity disorder in 45%
• Depression in 32%
• Anxiety in 29%

Knowledge before and after the rotation was assessed among pediatric residents through surveys. These surveys also asked residents about their comfort managing mental health conditions in children and were completed by 37 residents. Positive results were reported, leading P2C3 to become a permanent aspect of University of Michigan’s health system.

Long-term impact and clinical need

P2C3 has remained active in the past decade, during which it has completed more than 1500 visits with more than 400 patients. Additionally, hundreds of pediatric residents have received innovative mental health training from the intervention.

According to study authors, this helps children receive the psychiatric care needed to stabilize their mental health, which remains an urgent need as a severe shortage of child and adolescent psychiatrists remains prevalent in the United States. P2C3 also empowers pediatricians to manage care at a time when they are expected to manage complex health concerns.

“Families value knowing their child’s mental health care is connected to their primary care team,” said Naughton. “This model reduces fragmentation and provides both timely access for patients and lasting skill-building for physicians.”

Rising trends in youth self-injury

The need for improved mental health programs has been highlighted by the rising rate of self-injury among youths, which was reported in a recent JAMA Network Open study.² The data highlighted a rise in self-injury rates of 3.5% per year among youth aged under 24 years since 2000, during which the mean rate was 10.2 self-injury visits per 10,000 population.

Self-reported rates of self-injury also rose at this time, with a mean rate of 275 per 10,000 population and an annual relative rate increase of 2.5%. This highlighted a significant upward trend in self-injury among youth.

“Our findings emphasize the need for tailored, accessible support systems for youth, alongside a concerted effort to reduce stigma and improve prevention and early intervention strategies,” wrote investigators.

References

1. A new way to close the pediatric mental health gap. News release. Michigan Medicine. March 16, 2026. Accessed March 19, 2026. https://www.eurekalert.org/news-releases/1120101
2. Krewson C. Rising self-injury rates reported among youth. Contemporary Pediatrics. March 19, 2026. Accessed March 19, 2026. https://www.contemporarypediatrics.com/view/rising-self-injury-rates-reported-among-youth