TABLE 3.

Pathways to access pediatric behavioral or mental health care

Provider	Credential/degree	Care model	Services provided	Prescriptive therapy
Pediatric Nurse Practitioner Primary Care	PNP-PC Master's or doctoral degree in pediatric nursing with a state license and national certification	Primary care, some outpatient specialty settings	Health promotion, wellness, management of uncomplicated and common mental health concerns including anxiety, depression, attention deficit disorder	Yes, for simple conditions
Pediatrician	MD Doctoral degree with specialty training in pediatrics, board certification	Primary care, some outpatient or inpatient specialty settings	Health promotion, wellness, management of uncomplicated and common mental health concerns including anxiety, depression, attention deficit disorder	Yes, for simple conditions
Primary Care Mental Health Specialist (Pediatric Nurse Practitioner or Clinical Nurse Specialist)	PMHS Master's or doctoral degree in pediatric nursing with a state license and national certification	Can be co-located with primary care, or in outpatient specialty care services, or inpatient consultation and management	Experienced in early identification and intervention for developmental, behavioral, or mental health concerns for children. Therapeutic services include the use of screening tools, diagnosis, and psychotherapeutic interventions. Helps to collaborate with other health professionals and coordinate care	Yes, for simple and moderate-to-complex conditions
Psychiatric-Mental Health Nurse Practitioner	PMHNP-BC Master's or doctoral degree in nursing with a state license and national certification	Can be co-located with primary care, or in outpatient behavioral health centers, or inpatient consultation and management	This professional is trained to provide integrated care across the life span for comprehensive mental health, substance use, and other comorbid physical or mental health conditions. They also provide emergency psychiatric care and evaluate the effectiveness of prescribed therapy	Yes, for simple and moderate-to-complex conditions
Professional child counselor or therapist (Some state variation in title protection and license)	Varies (credentials) master's degree with a focus on child and adolescent development; national certification	Often work in schools, social-service offices, juvenile detention centers, domestic violence centers, child advocacy centers, homeless shelters, outpatient primary care, and specialty clinics	Help empower coping skills to foster emotional and mental health. They may care for children experiencing divorce, loss through death, serious illness, learning disabilities, emotional trauma, effects of abuse, familial conflict, bullying, peer pressure, disordered eating, or identity crises	No
Child Psychologist	Varies (credentials) Master's or doctoral degree in child psychology	Can work in schools, social-service offices, juvenile detention centers, domestic violence centers, child advocacy centers, homeless shelters, outpatient primary care, and specialty clinics; maybe in private or group practice; often works with governmental agencies	Provide a variety of services to children, sometimes adolescents and families, on a range of issues from developmental concerns, social skills, educational challenges, behavioral or emotional problems, substance misuse, or learning disabilities. Some are generalists, whereas others specialize in certain disorders. They may also conduct or oversee group or family therapy	No
Child Psychiatrist	MD Board-certified first in general psychiatry followed by training and board certification in child psychiatry	Usually works in a private or group outpatient practice, also works inpatient intensive therapy settings for long-term treatment of conditions like suicidality, substance abuse, and disordered eating	Most child psychiatrists are trained to see patients across the life span. Highly trained and qualified specialist equipped to deal with complex, severe behavioral and mental health concerns. Highly specialized and educated to provide complex pharmacotherapeutic training. May collaborate with psychologists, counselors, and/or therapists for adjunctive therapies	Yes, mild to highly specialized and complex