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TOPLINE:

Primary care visits that resulted in diagnoses of mental health conditions among children increased from 2014 to 2023, with those related to anxiety showing the greatest increase.

METHODOLOGY:

• Researchers analyzed data from the 2014 to 2023 Massachusetts All-Payer Claims Database, including 1.8 million children and teens younger than 18 years (mean age, 9.5 years; 50.7% male).
• The primary outcome was the number of all primary care practitioner (PCP) visits with any mental health diagnosis per 100 insured children per quarter.
• Secondary outcomes were the number of all-cause primary care office visits per 100 children, the percentage of primary care visits with diagnoses of attention-deficit/hyperactivity disorder (ADHD), depression, anxiety, autism spectrum disorder, and trauma or stressor-related disorders.

TAKEAWAY:

• PCP visits with any diagnosis of a mental health condition increased from 5.9 visits per 100 children and teens in 2014 to 9.7 visits per 100 in 2023.
• PCP visits related to anxiety showed the greatest absolute change, increasing from 1.7% visits to 6.1% visits from 2014 to 2023.
• PCP visits related to ADHD increased from 5.0% to 6.7%, while visits related to depression rose from 1.2% to 1.6% over the same period.
• Visits related to autism and trauma or stressor-related disorders also increased.

IN PRACTICE:

“[R]esults suggest the need for additional MH [mental health] training and clinical service capacity to screen, diagnose, and treat MH conditions within pediatric primary care settings — such as through integrated MH models — especially for anxiety and ADHD,” the authors of the study wrote.

SOURCE:

The study was led by Kerrin M. Gallagher, PhD, MPH, of the Department of Health Law, Policy & Management at the Boston University School of Public Health in Boston. It was published online on May 18, 2026, as a research letter in JAMA Network Open.

LIMITATIONS:

The claims data were used for billing and might not have complete information about diagnoses.

DISCLOSURES:

The Richard and Susan Smith Family Foundation and the Klarman Family Foundation provided funding for this study. No conflicts of interest were reported by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.