Sleep Smart: Back-to-School Edition

REACH faculty, Dr Kowatch, emphasizes that it’s essential for caregivers to recognize the challenges that can arise when transitioning from summer to a more structured school routine. “Parents have got to anticipate there may be an adjustment period for the first week or two.”

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How Social Media is Impacting Teens

The most important question that we can ask teens isn’t if they use social media, it’s how. Just last May, the Surgeon General’s advisory on social media use in youth exposed some shocking statistics: Among 13 to 17-year-olds, up to 95% use social media, with 35% saying they use social media “almost constantly.”

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Responding to the Alarming Rise of Depression in Adolescent Girls

Gain a deeper understanding of the challenges faced by adolescent girls and the proactive steps clinicians can take to support them.

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Supporting mental health needs in rural areas

Rural healthcare providers can be overwhelmed—and understaffed with specialists. Discover how REACH inspired Elizabeth Wallis, M.D., to build a community to support her patients.

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One teen, 10 psychiatric drugs. This must stop!

On August 27, The New York Times ran an article by Matt Richtel titled “This Teen Was Prescribed 10 Psychiatric Drugs. She Is Not Alone.” It documents the practice of “polypharmacy”: prescribing multiple medications—most of which have not been tested either in children or in combination with one another—to manage young patients’ depression or anxiety.

That young patients are being prescribed potent cocktails of untested drugs is obviously wrong. The question is, how did we get to this point, and what can we do about it?

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Overcoming anxiety about the news

In the wake of the Texas school shooting tragedy, your young patients–and their families–may be experiencing anxiety that can affect normal functioning. That anxiety can manifest in many ways, from reluctance to go to school to increased aggressive tendencies. 

In fact, pediatric primary care providers (PCPs) have been observing the effects of news consumption on their young patients for years now. The spike in anxiety at the beginning of the Covid pandemic is another example. Families may be experiencing trauma as they watch scenes of devastation and displacement in Ukraine. Every act of terrorism or mass violence inspires more fear. The examples go on.

As your families’ trusted PCP, you can influence how patients and families deal with anxiety over recent events and the continuous barrage of bad news that characterizes today’s media culture.

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8 Tips for Working with Mental Health Therapists

Many patients who have mental health conditions need talk therapy in addition to the treatment you provide as the pediatric primary care provider (PCP). If you practice in an area where therapists are available, we hope you have developed referral relationships, as you learned in your REACH training. You may also see patients who are already working with a therapist.

In either case, the communication between you and the therapist makes a huge difference in the quality of care the two of you provide.

To learn how PCPs and therapists can collaborate to improve the mental health of children and adolescents, we talked with clinical psychologist Kevin Stark, PhD, a founder of The REACH Institute’s CATIE program, and pediatrician Hilary Bowers, MD, director of behavioral and mental health services at Children’s Primary Care Medical Group, a large pediatric practice in San Diego and Riverside counties in California.

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Is it ADHD? Or something else?

Attention-deficit hyperactivity disorder (ADHD) is one of the most common behavioral health disorders, affecting approximately 9% of all children and adolescents. About 75% of pediatric patients with ADHD have comorbid mental health conditions, ranging from oppositional-defiant disorder to anxiety and mood disorders.

What is a busy clinician to do? How do you discern whether a child who is, say, having difficulty focusing at school and at home has ADHD, anxiety, both, or something else?

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IEP and 504 school accommodations for mental health needs

Children with mental health diagnoses may need special accommodations in order to succeed in school. Patients with attention-deficit hyperactivity disorder (ADHD) or autism come immediately to mind. However, children with depression and anxiety disorders may also struggle in the classroom.

Pediatric primary care providers (PCPs) and therapists can help families get the school accommodations their children need. Mark Wolraich, MD, REACH faculty member and retired professor of pediatrics at the University of Oklahoma Health Sciences Center, emphasizes that children are best served when professionals take a team approach to mental health care.

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Don’t panic about panic attacks

“The impairment from a panic attack doesn’t come from the episode itself,” said REACH faculty member James Wallace, MD. “It comes from the patient’s and family’s reaction.”

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