In recent years, professional organizations such as the American Academy of Child and Adolescent Psychiatry (AACAP) and the American Academy of Pediatrics (AAP) have begun to address the need for primary care-based mental health services. For example, in 2005 the AAP obtained an Improving Mental Health in Primary Care Through Access, Collaboration, and Training (IMPACT) grant to address this matter (4). The AAP began developing continuing medical education, webinars, electronic discussion forums, and regional and national meetings for pediatricians and other primary-care professionals (4). Horwitz et al. (5) surveyed 1,000 graduating pediatric residents in 2007 (and achieved a 63.8% response rate) to determine the pediatricians' self-rated competence in diagnosing and treating common psychiatric disorders and the amount of training they received during residency to manage such problems. Although they found that 86% of respondents received the ACGME-required amount of training in developmental and behavioral pediatrics (4 weeks) or more, only 42%, 24%, and 17% of respondents reported high competence in diagnosing ADHD, depression, and anxiety, respectively (5). Even fewer respondents reported high competence about their ability to treat these disorders: 26% for dosing ADHD medications and 7% for dosing antidepressant/anxiety medications. This study suggests that the current mandatory training in the diagnosis and treatment of children's mental health problems during pediatrics residencies does not translate into self-perceived clinical competence.