Many pediatric patients receiving care in primary care settings have mental health concerns that are difficult for primary care providers to diagnose and manage. It’s estimated that one in seven youth in the United States suffer from a behavioral concern or mental illness and research shows half of all lifetime cases of mental illness will begin by the age of 14. Once a mental illness develops, it may become more difficult to treat.

Responding to a national need, experts from Duke University School of Nursing (DUSON) created a unique and robust Pediatric Behavioral and Mental Health Specialty to educate and prepare advanced practice nurses in the delivery of pediatric mental health care. The classes are taught by professionals who are actively practicing in the field. This new specialty is available to family and pediatric nurse practitioner students and to current practitioners who want specialized training to improve outcomes for pediatric patients with mental health conditions.

Pediatric behavioral and mental health issues include autism spectrum disorders, anxiety, problems at school, eating issues, sleeping issues, depression and social issues. Primary care pediatric healthcare providers typically are not prepared to diagnose and treat these mental health issues without specialized training.

“Currently, only about 20 percent of children living in the United States who experience a mental disorder in a given year receive treatment,” says Anne Derouin, DNP, APRN, CPNP, FAANP, lead faculty of the Pediatric Primary Care, Pediatric Behavioral and Mental Health Specialty and associate professor at Duke University School of Nursing. “The situation in North Carolina is dire with families waiting for hours, sometimes days, in the emergency room seeking help for children with severe symptoms because of a lack of resources and skilled mental health practitioners.”

Graduates of the new Pediatric Behavioral and Mental Health Specialty will have the knowledge and clinical skills to identify, diagnose and treat pediatric mental health issues in primary care settings, the same healthcare site most pediatric patients are familiar with for routine care. This integrated approach to healthcare leads to more comfortable, accessible and cost-effective mental health care. The sooner an issue is diagnosed, the faster a difference can be made in the lives of those pediatric patients living with behavioral and mental health disorders.

DUSON’s Pediatric Behavioral and Mental Health Specialty consists of three courses – two didactic courses and one clinical immersion course.  Upon completion of the specialty, students who are already advanced practice nurses will be prepared to sit for the Pediatric Primary care Mental Health Specialist (PMHS) exam. The PMHS exam is offered to validate the knowledge, skills and expertise of advanced practice registered nurses in the early identification, intervention and collaboration of care for pediatric patients with behavioral and mental health concerns.

The first didactic course, Pediatric Mental Health I, is completely distance-based with virtual group work focusing on the assessment methods of pediatric mental health care. The second course, Pediatric Mental Health II, prepares students for delivering healthcare in a variety of clinical settings, including sites with limited resources and in rural settings and offers an on-campus intensive where students can practice their skills in a simulation lab with standardized patients. Additionally students will learn about their professional roles and responsibilities. The third and final course in the specialty is a precepted clinical immersion in dedicated behavioral and mental health settings or primary care settings integrated with mental healthcare providers. This course allows students to apply the skills they have learned in their didactic courses in a clinical setting. Upon completion of the specialty, students will have earned a total of 168 hours between didactic and clinical courses.

“I witness a gap between need and treatment for mental illness daily and it’s sad to watch psychiatric illness go on, making it difficult for a child to succeed,” says Alyssa Hetfield, BSN, RN-BC, a student in the inaugural cohort of this specialty and a practicing RN in a pediatric cardiology outpatient setting. “There is a devastating shortage of mental health providers, which leads to an incredible need for pediatric primary care providers to identify and address mental health problems early in patients.” Hetfield says that she is taking the courses taught in this specialty so that she will feel well equipped to make a difference as a PNP-PC in pediatric mental health.

Graduates of this specialty will ideally work with other health care providers to provide an integrated approach to pediatric behavioral and mental health care. Graduates can serve in primary care settings where they can be integrated into practice, in specialty clinics where children with chronic conditions can benefit from the skills learned in this specialty and in schools and health centers.

“I’m excited to be a part of the inaugural cohort for this specialty and know its courses will prepare me to successfully diagnose and prescribe for a variety of mental health conditions,” says Brittany LeGarde, BA, RN, a practicing RN and student in the Pediatric Mental Health specialty. “The United States has a great need for well-equipped pediatric providers with a specialization in mental health management.”

The Duke University School of Nursing Pediatric Behavioral and Mental Health Specialty program is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant# T94HP30869, Advanced Nursing Education Workforce. The information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.

Learn more about the Pediatric Behavioral and Mental Health Specialty here. DUSON is proud to offer innovative programs that help fill nursing needs around the nation.