Pediatricians Don’t Routinely Ask About Mental Health

Don't count on your child's doctor to ask whether you're worried about mental health issues such as ADHD or bad behavior. Fifty-six percent of parents say their pediatrician or family-practice doctor never asks about mental health concerns, according to a new survey out of C.S. Mott Children's Hospital at the University of Michigan. Another 22 percent say they get asked sometimes, with 22 percent more saying their doc is always on the ball.

This is no small issue, seeing as 1 in 10 children suffers a serious emotional or mental disorder, according to the surgeon general. Twenty percent of the 2,245 parents polled said that one or more of their children had been diagnosed with a mental health problem, the most common being attention deficit hyperactivity disorder, a behavior problem, or depression.

So here's a health issue that affects lots of kids in serious ways, and the docs more often than not aren't bringing it up. What gives? One reason often cited is that physicians get less training in mental health and aren't comfortable discussing it. But given the large numbers of kids being treated for ADHD alone and the fact that most of that treatment is provided by pediatricians or family doctors, it's hard to believe that the doctors are still that squeamish.

The real reason may well be that doctors know that when they refer families for mental healthcare, parents often can't find it or can't afford to pay for it. Last year, I wrote about college freshman Meghann Eckerdt and her family, who paid more than $30,000 out of pocket for treatment for the obsessive-compulsive disorder that threatened to destroy Meghann's life. More recently, I talked with Jim Hackett, who struggled to find treatment for his 15-year-old daughter after she had been sexually assaulted. Jim's the CEO of Anadarko Petroleum; paying wasn't the problem. His family had to look out of state to find a psychiatrist who helped his daughter work through her fears, confront her attacker, and "unlock the secret to being able to control her future," Hackett says. "It's a minor miracle." What parent wouldn't want to be able to provide that kind of lifesaving help to a child when she or he needed it?

The new federal mental health parity law, which goes into effect in 2010, should expand insurance coverage for many families. But that doesn't do much good if there's no mental healthcare for kids available. Seven percent of the parents in the Mott survey said they had trouble finding mental healthcare for their children. Here's the next big battle in parity; giving kids the help they need to grow up to be healthy, productive adults.