RT Journal Article SR Electronic T1 Primary care experiences of providing mental healthcare for children in the USA during the COVID-19 pandemic: a qualitative study JF BMJ Paediatrics Open JO BMJ Paediatrics Open FD BMJ Publishing Group Ltd SP e001497 DO 10.1136/bmjpo-2022-001497 VO 6 IS 1 A1 Jane Garbutt A1 Sherry Dodd A1 Shannon Rook A1 Lauren Ericson A1 Randall Sterkel A1 Katie Plax YR 2022 UL http://bmjpaedsopen.bmj.com/content/6/1/e001497.abstract AB Background The increased demand for mental healthcare associated with the COVID-19 pandemic adds to the already high unmet mental health needs among paediatric patients, resulting in a declared ‘mental health emergency’. The study objective was to describe paediatric primary care providers (PCPs’) experience of meeting their patients’ needs for mental healthcare during the pandemic and to identify opportunities to optimise care.Methods 19 paediatricians and 2 nurse practitioners completed a 30 min video interview in May 2021. Interviews were recorded and transcribed, and transcripts were analysed using consensual qualitative research methods.Results Participants reported marked increases in patient mental health needs during the COVID-19 pandemic. These included new diagnoses of anxiety and depression and increased treatment needs for patients with a prior mental health diagnosis. They identified that the mental health needs of their patients were greater, more severe and more challenging to manage with the resources currently available. While they were frustrated with the lack of communication and support from their mental health colleagues, and felt isolated and overwhelmed, they approached the increased demand for mental healthcare with a growth mindset. This outlook included providing care, seeking help to improve their skills and engaging with local resources such as the Child Psychiatry Access Project (CPAP).Conclusions Our findings suggest that urgent action is needed to better support paediatric PCPs to provide mental healthcare in our community. Providers identified an ongoing need for timely access to and effective communication with mental health providers to guide care in the medical home. This need could be addressed immediately by providing training for new and experienced clinicians, expanding the scope of CPAP programmes to include patient assessment and supporting implementation of integrated behavioural health programmes into the medical home.All data relevant to the study are included in the article or uploaded as supplementary information.