The AAP Chapter 1 Mental Health Committee began performed a survey of pediatricians in our Chapter in 2018 to determine perceived barriers to access to mental health services for children in their practice.  The study results showed that 38% of the pediatricians responding to the survey felt that their patients “seldom” have appropriate access to mental health services and another 49% felt that access was appropriate “some of the time.”  The most critical access barriers noted were in the provision of counseling and support for severe mental health conditions. The top 3 barriers to access identified in the survey were:

  • The lack of an adequate number of mental health providers with training in children’s mental health services
  • Inadequate reimbursement for mental health services
  • The difficulties experienced by patients and families in navigating the referral process for mental health services


Action Steps

After receiving the results of the survey, the Committee developed an action plan to improve access and quality of mental health services in Northern and Central California.  AAP California has subsequently adopted improvement in mental health services as a major goal of our outreach and advocacy activities. In partnership with the Medical Education committee, we have offered two in-person CME courses on the provision of mental health care in the primary care office which have trained over 200 pediatricians.  We have also partnered with the AAP State Governmental Affairs committee and other partners to submit comment letters to the Department of Health Care Services regarding: 

  • The credentialing of mental health providers serving children and teens
  • The use of EPSDT criteria to permit children to receive mental health services without a mental health diagnosis
  • Compliance of Medi-Cal plans with timely access to care regulations for children and teens seeking mental health services.
  • Compliance of Medi-Cal plans with CMS Parity requirements that mental health services should have equal access as medical services.
  • Funding for trauma and developmental screenings.

Many of these communications have resulted in changes in the regulations governing care for children and teens seeking behavioral/mental health services.


Get Involved!

Chapter members are encouraged to join our committee and get involved in future advocacy and educational activities.  Our priorities for action at this time are:

  • Increasing access to school mental health counseling and supports
  • Increasing access to therapists by assuring adequate payment and health plan/health insurance accountability for services

Please contact Diane Dooley, MD, FAAP at or contact AAP Chapter 1 for more information on joining our committee. 


Explore other sections:

Improve Your Practice – Mental Health Skills and Practice Management

Connect with Your Community

or go back to Mental Health Issue Page