The U.S.1999 Surgeon General's Report on Mental Health documented almost 21% of U.S. children and adolescents ages 9 to 17 had a psychiatric disorder with at least minimal impairment. From this prevalence statistic, one in five children age 9-17 experienced some degree of emotional or behavioral dysregulation. While there are over 60,000 board-certified U.S. pediatricians, current competencies for specialty certification cover minimal mental and behavioral health care. According to statistics from the American Academy of Child and Adolescent Psychiatry, there are less than 6700 sub-board qualified child and adolescent psychiatrists practicing in the U.S. Moreover, due to established third-party payment and reimbursement venues, many children are not eligible for the care of these professionals. Many U.S. children, therefore, do not have adequate access to mental and behavioral health care.

To address this serious need, in 2004, the American Academy of Pediatrics (AAP) Board of Directors (BOD) appointed the Task Force on Mental Health (TFMH), charging it to develop evaluation algorithms, tools and models of third-party payment to assist primary care pediatricians in enhancing the mental health care they provide as they provide care for children and adolescents in the primary pediatric health care setting: the “medical home.” The TFMH, which included representatives from the American Academy of Child and Adolescent Psychiatry, as well as many other related professional and consumer organizations, concludes in 2008 with comprehensive recommendations for improving primary clinical care for U.S. children and adolescents with mental and behavioral health care needs. This presentation summarizes those results.