TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion and thought leadership area. Today’s topic concerns youth mental health–and how specialized telehealth can provide remote psychiatric backup to assist pediatricians in making critical treatment decisions. The author, Andy Flanagan, is CEO of Iris Telehealth, where he draws on experience as a three-time CEO and senior leadership roles at Siemens Healthcare, SAP, and Xerox to guide the company’s mission of improving behavioral health outcomes for patients and clinicians.

Meta’s $16.7 billion settlement with a coalition of state attorneys general puts a number on something health systems have felt for years without a dollar figure attached. Youth mental health has become a public health infrastructure problem, and the infrastructure absorbing most of the impact isn’t behavioral health. It’s primary care.

New survey data from Iris Telehealth shows that when a child starts struggling with attention, mood, or behavior, 42% of parents try home strategies first. Another 23% bring the issue to a teacher or school counselor. Only 11% go directly to a mental health professional. Everyone else eventually lands somewhere else first, and for most families, that somewhere is a pediatrician’s office.

Pediatricians are absorbing psychiatric decisions that used to require a specialist referral, and telehealth can put that backup in the room with them instead.

Pediatricians have become the default specialist

Sixty percent of parents in our survey said their pediatrician or healthcare provider is where they get information on supporting their child’s behavioral or emotional health, ahead of friends and family, online resources, and school staff combined.

The same pediatrician parents go to for guidance is often the one prescribing the medication that guidance leads to. Among parents whose children have taken medication for a behavioral or emotional challenge, 44% said a pediatrician wrote it. Only 38% said a child psychiatrist did.

A prescription for a child’s mood or attention shapes how they sleep, eat, and function every day. Pediatricians are handling more of that decision themselves, and a child psychiatrist is rarely in the building to weigh in alongside them.

Fewer pediatricians will be available right when more families need one

The pediatricians absorbing this load today are about to become scarcer. A study published this year projects that pediatrician demand will grow 2% between 2025 and 2037, while the supply of pediatricians actually available to see patients drops by more than 10% over that same period.

Workforce adequacy, the measure of how well supply meets demand, falls from 92.3% today to 81.2% by 2037. Families in non-metropolitan areas and the South will feel that gap hardest, and general pediatrics is already projected to rank 14th out of 21 medical specialties for workforce adequacy by then.

At the same time, the number of families raising a mental health concern at a pediatric visit keeps climbing. A JAMA Network Open study of 1.8 million children’s insurance claims found that visits involving a mental health diagnosis rose from 5.7% in 2014 to 9.7% in 2023. Anxiety drove most of that increase, with related visits climbing more than 250% over the decade.

For a pediatric practice, that means fewer providers on staff and more children walking in with a mental health concern attached to their visit, a combination that leaves less time and specialized support for each one. Parents aren’t asking to skip straight to medication, either. Only 7% think it should be the first step, and 45% want skill-building tried before it. What they don’t have is a clear signal for when to move from that skill-building to professional guidance, the equivalent of a pediatrician tracking height and weight at every visit regardless of symptoms.

Integration bridges the pediatric access gap that primary care can’t close alone

Pediatricians shouldn’t have to become child psychiatrists. What they need is specialist support embedded directly into the visits already on their calendar. By integrating telebehavioral health clinicians into existing primary care workflows, health systems put expert guidance right at the point of care — specifically when specialists make critical prescribing decisions. The pediatrician is no longer left managing complex cases in isolation simply because the nearest child psychiatrist is half an hour away, or completely non-existent in their county.

AI plays a valuable, supporting role in this integrated model that’s strictly focused on efficiency. Used for triage support, ambient documentation, and identifying potential referrals, AI lightens the administrative burden that often makes specialist collaboration hard to sustain. It supports the clinical team, but it never makes clinical decisions.

While policy shifts, like Meta’s recent settlement over youth app safety, target the digital environment straining kids’ mental health, regulatory fixes don’t solve the immediate clinical access crisis. That requires accessible, expert care. Telebehavioral integration gives health systems the scalable infrastructure needed to support pediatricians today, starting with the very next patient on the schedule.