Caring for young minds: general practitioners’ self-assessed competence in child and adolescent psychiatry

INTRODUCTION: Since the 1990s, mental ill-health among children and adolescents in Sweden has risen steadily, now ranking among the highest in Europe. Despite this, general practitioners' and resident physicians' education in primary healthcare in child and adolescent psychiatry is limited. Nevertheless, these professionals are expected to possess broad competence in managing mental ill-health in young patients. This study of general practitioners and resident physicians in primary healthcare regarding children and adolescents with mental ill-health aims to map (1) the self-assessed amount of education in child and adolescent psychiatry, (2) self-perceived competence in different types of symptoms, and 3) self-perceived competence when prescribing psychiatric medications. METHODS: A cross-sectional study was conducted using web-based questionnaires completed by 184 general practitioners and 144 resident physicians in Sweden's second-largest region. Data were analysed using Pearson's Chi-squared test, Fisher's exact test, Spearman's correlation test, and the Holm-Bonferroni method. RESULTS: Most participants reported limited education in child and adolescent psychiatry. Further, they reported lower competence in managing mental ill-health and prescribing drugs for children (6-12 years) compared to adolescents (13-17 years). Particularly low competence was reported in self-harm, eating disorders, and substance-related disorders. CONCLUSIONS: The growing prevalence of mental ill-health among children and adolescents is increasing pressure on primary care, with more young patients seeking help and higher expectations on providers. This study reveals that general practitioners and resident physicians often feel insufficiently prepared to manage these cases, highlighting gaps in medical training and emphasizing the need for strengthened medical school curricula, residency programs, and continuing medical education.