113. MENTAL HEALTH IN THE PEDIATRIC SUBSPECIALTIES: PHYSICIANS’ BELIEFS AND CONFIDENCE PROVIDING CARE

Abstract

Background Mental and behavioral health (MBH) issues are prevalent in children with chronic medical conditions and negatively impact health outcomes. However, rates of screening and referral for MBH issues are low among subspecialists. The American Board of Pediatrics has recommended that curricula be instituted to improve subspecialists’ MBH care. However, the goals of such curricula are unclear as barriers to subspecialists and trainees providing MBH care have not been defined. Objective As part of a needs assessment to develop a curriculum for fellows, we sought to define subspecialists’ barriers to providing MBH care. Methods Yale School of Medicine pediatric faculty and fellows were surveyed on training, confidence addressing (5-point Likert scale), and screening of MBH issues. Respondents completed a modified Physician Belief Scale (PBS), divided into two subscales (beliefs and burden), with a higher score indicating more negative MBH attitudes. Results were analyzed with descriptive and inferential statistics. Results Surveys were completed by 71 pediatric faculty and 26 fellows (87 subspecialists, response rate 53%). General pediatricians screened more often for MBH issues than subspecialists (OR=3.3, p Conclusion A curriculum to increase MBH care in the subspecialties should highlight the importance of addressing MBH issues in children with chronic medical conditions, teach communication skills and screening strategies, and address perceived burdens on time.