Across Massachusetts, kids are bringing more than sore throats and sports injuries to their checkups. A new statewide analysis shows pediatricians are fielding a sharp rise in anxiety and other mental-health concerns during routine primary-care visits, adding strain to schools, emergency rooms and outpatient clinics. Families are increasingly turning to their child’s doctor as the first place to talk about behavioral-health worries, yet access to follow-up care remains spotty. With school-based mental-health grants set to expire and pediatric psychiatric beds still scarce, parents and clinicians say timely help is often out of reach.
Study: Primary Care Visits With Mental Health Diagnoses Rose
The cohort study, published May 18, 2026, found that the share of primary-care visits that included a mental-health diagnosis climbed from 5.9% in the first quarter of 2014 to 9.7% in the first quarter of 2023, according to JAMA Network Open. Over the same period, visits specifically involving anxiety diagnoses jumped from 1.7% to 6.1%. Using the Massachusetts All-Payer Claims Database, researchers analyzed records for more than 1.8 million children and adolescents. They also documented smaller but clear increases in visits for ADHD, depression, autism spectrum disorder and trauma-related diagnoses, underscoring a broad rise in pediatric behavioral-health needs.
Primary Care Is Becoming The Front Line
Study authors and local pediatric clinicians say this shift is turning pediatric offices into a de facto front line for mental-health care, even though many practices do not have enough staff or specialized training to manage complex conditions, report author Megan Cole Brahim told The Boston Globe. Clinicians interviewed by reporters pointed to pandemic-related trauma, social-media pressures and greater public awareness as key forces behind surging anxiety among teens. Researchers note that expanded mental-health screening in primary care probably explains part of the increase, but say the size of the jump suggests there is more going on than better detection alone.
Emergency Departments Are Backed Up
State data show that downstream, the system is already stretched. The Massachusetts Health Policy Commission reported that 44% of children who went to an emergency department for behavioral-health reasons in 2023 waited more than 24 hours for a psychiatric bed, a figure that dropped to about 30% in 2024, according to the Massachusetts Health Policy Commission. The commission’s analysis links those long waits to a shortage of inpatient beds, delays in clinical evaluation and gaps in community-based services. The resulting backups have become a priority for hospitals, state officials and child-health advocates who are trying to clear bottlenecks and keep kids from boarding in ERs.
School Clinics Face A Funding Cliff
Schools have tried to catch problems earlier. A four-year, $5 million pilot that launched in 2022 placed free urgent mental-health clinics inside 23 public schools, but the philanthropic grants that pay for the program are scheduled to run out in June 2026, leaving districts and providers scrambling to hold on to clinicians and bilingual family-support staff, according to reporting by The Boston Globe. School leaders credited the added staff with fewer suspensions, fewer emergency calls and earlier interventions that kept students in their classrooms. Program organizers are now chasing new foundation and state funding to keep the clinics open while local budgets stay tight.
New Beds Are Coming, But Not Fast Enough
Hospital leaders say more inpatient capacity is on the way, just not soon. Boston Children’s Hospital plans to build a new $640 million pediatric psychiatric campus in Brighton that would add roughly 116 beds, with the first building expected to open around 2029, according to a press release from Boston Children’s Hospital. The expansion is expected to relieve some of the ER backups, but persistent workforce shortages and strong demand across Massachusetts mean the added beds are not expected to provide a quick fix for access problems.
What Might Help
To ease the pressure on families and primary-care practices, the JAMA study’s authors recommended expanding integrated mental-health teams in pediatric offices, boosting clinician training and strengthening insurance coverage so lower-income families are more likely to get care, according to JAMA Network Open. In the near term, state leaders will face a pivotal test as school-clinic grants expire in June and policymakers decide whether to extend or scale those pilots, redirect money elsewhere or push harder on inpatient expansion. The choices made over the next several months are expected to shape mental-health access for thousands of Massachusetts children for years to come.
