P3.A012: Trends in Mental Health Concerns and Accessibility to Resources for the use of Pediatric Mental Health Care Access Program (PMHCA) in Puerto Rico

Background: Puerto Rico (PR) has gone through a myriad of stressors in the past years, including Hurricane Maria in 2017, earthquakes in 2020, COVID-19 pandemic in 2020, and Hurricane Fiona in 2022. Adapting to those stressors might have an impact on the mental health of our population, including children and adolescents. Our population faces many barriers to care, including limited access to mental health care services, which in turn may cause delays in treatment. PR has a need to implement strategies to expand access to pediatric mental health care due to the current mental health needs and the shortage of child and adolescent psychiatrists. A way to increase access to these services include implementing a Pediatric Mental Health Care Access Program (PMHCA) teleconsultation program for pediatricians and primary healthcare providers.

Project Description: The objectives of the PMHCA program in Puerto Rico include the following: (1) provide education and training to pediatricians and other primary care physicians in PR to effectively partner with our PMHCA program for teleconsultation and support, (2) empower pediatricians and PCPs by providing support for interventions, early identification, diagnosis and treatment of mental health conditions (3) deliver pediatricians and PCPs serving in geographically underserved areas access for the support needed and improved access to treatment and referrals for their patients.

Beginning our program, pediatricians and other PCPs were invited to a Virtual CME training course for participation in the pilot PMHCA PR program. During this activity held on February 27, 2024, an orientation was given on the protocol to participate in the PMHCA teleconsultation program. A survey was conducted to participants with the objective of evaluating their experiences with mental health conditions within the pediatric population in Puerto Rico.

Discussion: Data collected in this survey (n=90) demonstrated that most of the participating practitioners have observed an increase in patients with mental health concerns (92%) and express that their patients experience a lot of difficulty in accessing mental health resources (70%) (Figure 1). When addressing mental health diagnoses faced in the practitioners’ practices, the majority included anxiety (78%), depression (66%) and other disorders such as ADHD (13%), conduct disorder (8%) and substance abuse (2%) (Figure 2).

Conclusion: We are facing a mental health crisis in Puerto Rico, as evidenced by an increase in mental health problems reported by primary care practitioners. Implementing a PMHCA program is a tool that can contribute to bridging the gap for timely access to mental health care while providing support for providers to meet the needs of their pediatric patients. This will help increase access to support and quality care for many children, adolescents, and young adults locally.