The healthcare industry is facing a wide variety of challenges—and solutions aren’t always straightforward. Each month, Modern Healthcare asks leaders in the field to weigh in on their approaches to the sector’s thorny issues.
This week, we hear from Dr. Sandy Chung, president of the American Academy of Pediatrics, and Dr. Kara Odom Walker, executive vice president and chief population health officer of Nemours Children’s Health, about the issues facing doctors treating young people.
How would you describe the pediatric population’s ongoing mental health challenges?
Chung: Our practices continue to see more and more children and adolescents with mental health issues. ... Of course, part of the challenge with their treatment has been the shortages in the behavioral health workforce. So pediatricians and family physicians have to fill in the gaps. In some areas, there are so few child and adolescent psychiatrists that [pediatricians] often have no one to refer their patients to.
Walker: We’re still seeing a huge increase in the need to address mental health for kids. I think we were, in some ways, hoping it was pandemic-related. What’s clear is that it isn’t going away. Unfortunately, 60% of children with behavioral health issues go untreated. And that leads to mental health issues for adults, where we often see a continuation of those same mental health conditions.
What factors play a role in equitable access to care?
Chung: One critical issue is when we look at how our national healthcare system pays for care, pediatrics continues to be undervalued, as does mental healthcare. So, for example, during the COVID-19 pandemic, some health systems closed pediatric care beds to take care of adults. That made a lot of sense at the time, but many community hospitals still have not reopened those pediatric beds.
Walker: We see a difference between racial and ethnic groups regarding mental health conditions, suicide ideation and, unfortunately, death due to suicide. So it’s clear that we all have more work to do. We also need to address the risk factors. Some of those are related to social media, to our economy and to other events happening around our country.
Do you have any specific policy proposals to improve pediatric care?
Chung: Let’s start with sustainability of the profession. Our government, our payers and our large employers must recognize that we need to value pediatrics differently. Children may represent about 25% of our population, but they are 100% of our future adults, so investing in them is key to the future of our economy and our country. We must realize that the return on investment is not short-term.
Walker: We’re always open to elevating any issue that would improve children’s health. But we’re certainly focused now on the Supplemental Nutrition Assistance Program and reauthorization of the U.S. Farm Bill. Data show that SNAP reduces food insecurity for millions of children, and that the long-lasting effects around food carry from childhood into adulthood, showing a range of improvements in health, education and economic outcomes.