University of Michigan Model Improves Pediatric Mental Healthcare Access

For years, pediatricians have faced a growing dilemma: families increasingly turn to primary care for help with mental health concerns, yet many pediatricians feel underprepared, and child psychiatrists remain in short supply. A program at University of Michigan Health is offering a potential solution.

Bridging the Gap in Pediatric Mental Health

University of Michigan Health implemented the Pediatric Psychiatry Colocalized Consult Clinic (P2C3) to improve access to care and train future pediatricians in managing common mental health conditions. The model embeds psychiatric expertise directly within primary care settings.

“Pediatricians are increasingly on the front lines of children’s mental health care, often without enough training or specialist support,” said lead author Margeaux Naughton, M.D., pediatrician at U-M Health C.S. Mott Children’s Hospital. “This clinic was built around the conditions pediatricians see every day. By embedding psychiatric expertise within primary care, we’re able to respond more quickly to mental health concerns, keep more patients within their medical home, and foster collaboration between pediatricians and psychiatrists for the best possible outcomes.”

How the P2C3 Model Works

Launched in 2013 as an eight-month pilot within an academic pediatric primary care clinic, P2C3 involved pediatric residents seeing patients alongside a child and adolescent psychiatrist in the same clinic space. This allowed for direct, supervised practice in mental health care.

After consultation and management within the clinic, appropriate patients were transitioned back to their primary care physician for continued care. During the pilot, the clinic served 66 patients with a mean age of 12.7 years, with 30% covered by Medicaid. New patients were typically seen within one to three weeks of referral, significantly faster than typical psychiatric wait times.

Common Conditions Addressed

The most common conditions seen at the clinic reflected those frequently encountered by pediatricians:

• Attention-deficit hyperactivity disorder (ADHD) – diagnosed in 45% of patients
• Depression – diagnosed in 32% of patients
• Anxiety – diagnosed in 29% of patients

Training the Next Generation

Beyond patient care, P2C3 was designed as a teaching model. Pediatric residents reported greater confidence in diagnosing and treating common conditions like depression and anxiety, and improved comfort with initial treatment strategies.

“Residents weren’t just observing psychiatry,” said Joanna Quigley, M.D., U-M Health child and adolescent psychiatrist. “They were actively participating in care with support, which makes a difference when they carry these skills into independent practice.”

Long-Term Impact and Scalability

Following the successful pilot, the clinic became a permanent part of the health system. Over the last decade, P2C3 has completed more than 1,500 visits and cared for over 400 patients, from early childhood through young adulthood. Hundreds of pediatric residents have benefited from the innovative mental health training.

The United States continues to face a shortage of child and adolescent psychiatrists, even as pediatricians are increasingly asked to manage complex mental health concerns.

“Families value knowing their child’s mental health care is connected to their primary care team,” Naughton said. “This model reduces fragmentation and provides both timely access for patients and lasting skill-building for physicians. With primary care and psychiatry working hand-in-hand, we’re bringing mental health care access for our patients and preparing the next generation of pediatricians to meet these challenges head-on.”