Young children need better access to mental health care

Almost 10 percent of very young children struggle with significant mental health problems, yet few are getting help, according to a new American Academy of Pediatrics policy statement co-authored by a Tulane University child psychiatrist. 

“Young children have mental health problems, and we need to make sure they have access to treatments that work,” said Dr. Mary Margaret Gleason, associate professor of psychiatry and behavioral science at Tulane University School of Medicine

Gleason is lead author of “Addressing Early Childhood Emotional and Behavioral Problems,” which outlines effective evidence-based interventions in child care and recommends ways that pediatricians can advocate for better access to these services. The problems exhibited by young children include reactive attachment disorder; disruptive behavior disorders; attention-deficit/hyperactivity disorder (ADHD); anxiety and mood disorders; and difficulty in sleep and feeding.

Existing research shows that family-focused therapy can help reduce a very young child’s symptoms of emotional, behavioral and relationship problems and offer long-term positive effects. 

The paper cautions that more doctors are prescribing psychotropic medications to treat very young children even though psychotherapies have been proven to have substantially more lasting effects. The evidence base is limited to studies on medication for ADHD, and the clinical practice has far outpaced the evidence for safety or efficacy, especially for children in foster care, according to the report.

 “While there is little research on the use of medications with the youngest children, we know that many children can benefit from therapy that includes parents as partners or agents of change,” Gleason said.

Many families do not have access to effective mental health treatments because of where they live, a shortage of early childhood mental health workers or insurance barriers. The policy statement recommends that pediatricians advocate for increased funding of research on treatments and pediatric training; collaborate with community agencies to provide services and advocate for equal access to early childhood mental health services.