Policy statement - The future of pediatrics: Mental health competencies for pediatric primary care

William L. Coleman, Mary I. Dobbins, Andrew S. Garner, Benjamin S. Siegel, David L. Wood, Marian F. Earls, Ronald T. Brown, Mary Jo Kupst, D. Richard Martini, Mary Sheppard, George J. Cohen, Karen S. Smith, Jane Meschan Foy, Paula Duncan, Barbara Frankowski, Kelly Kelleher, Penelope K. Knapp, Danielle Laraque, Gary Peck, Michael RegaladoJack Swanson, Mark Wolraich, Margaret Dolan, Alain Joffe, Patricia O'Malley, James Perrin, Thomas K. McInerny, Lynn Wegner, Terry Carmichael, Darcy Gruttadaro, Garry Sigman, Myrtis Sullivan, L. Read Sulik, Linda Paul

Research output: Contribution to journalReview articlepeer-review

279 Scopus citations


Pediatric primary care clinicians have unique opportunities and a growing sense of responsibility to prevent and address mental health and substance abuse problems in the medical home. In this report, the American Academy of Pediatrics proposes competencies requisite for providing mental health and substance abuse services in pediatric primary care settings and recommends steps toward achieving them. Achievement of the competencies proposed in this statement is a goal, not a current expectation. It will require innovations in residency training and continuing medical education, as well as a commitment by the individual clinician to pursue, over time, educational strategies suited to his or her learning style and skill level. System enhancements, such as collaborative relationships with mental health specialists and changes in the financing of mental health care, must precede enhancements in clinical practice. For this reason, the proposed competencies begin with knowledge and skills for systems-based practice. The proposed competencies overlap those of mental health specialists in some areas; for example, they include the knowledge and skills to care for children with attention-deficit/hyperactivity disorder, anxiety, depression, and substance abuse and to recognize psychiatric and social emergencies. In other areas, the competencies reflect the uniqueness of the primary care clinician's role: building resilience in all children; promoting healthy lifestyles; preventing or mitigating mental health and substance abuse problems; identifying risk factors and emerging mental health problems in children and their families; and partnering with families, schools, agencies, and mental health specialists to plan assessment and care. Proposed interpersonal and communication skills reflect the primary care clinician's critical role in overcoming barriers (perceived and/or experienced by children and families) to seeking help for mental health and substance abuse concerns.

Original languageEnglish
Pages (from-to)410-421
Number of pages12
Issue number1
StatePublished - Jul 2009


  • Adolescents
  • Children
  • Competencies
  • Education
  • Medical home
  • Mental health
  • Primary care
  • Substance abuse
  • Training


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