News/Media
Dealing with mental health issues in injured student athletes
When student athletes can’t play, their mental health may suffer.
Read MoreDon’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.”
Read MoreAssessing and treating substance abuse
“The risk of substance use starts at about age 10,” said Sam Chang, MD, a child and adolescent psychiatrist on the REACH faculty. “Prevention has to start before that. By the time kids reach adolescence, the horse has left the barn.”
Read MoreIs 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?
Read MoreWhen and how to send kids to the emergency room
“The first thing I would say to any clinician is that it’s never wrong to send a child to the emergency room,” said Amy Dryer, MD, pediatrician and REACH faculty member.
Having spent 10 years in a hospital emergency department, Dr. Dryer is intimately familiar with the criteria ER physicians use to decide to admit psychiatric patients: a medical condition, suicidal ideation with a lethal plan, homicidal ideation, or active psychosis.
However, she emphasized that your decision to refer to the ER doesn’t hinge on whether the patient is likely to be admitted. “If what they’re telling you makes you uncomfortable,” she said, “go ahead and refer them.”
Read MoreAfter you screen for anxiety, then what?
As you’ve heard, the US Preventative Service Task Force (USPSTF) recently issued draft guidelines recommending that primary care providers (PCPs) screen all adults aged 19 to 64 for anxiety disorders. Guidelines recommending anxiety screening for children aged 8 to 18 were finalized last week. The question is, if the screener indicates that anxiety is an issue, then what do you do? Patty Gibson, MD, a psychiatrist on the REACH Adult Behavioral Health faculty, shared some basics from the course to answer the question.
Read MoreTreating pediatric trauma
“The biggest predictor of having something bad happen to you is having had something bad happen to you in the past,” said Brooks Keeshin, MD. Dr. Keeshin, a child abuse pediatrician and child psychiatrist at the University of Utah, co-developed the new REACH Institute course Addressing Trauma in Pediatric Primary Care. At least 66% of…
Read MoreOne 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?
Read MoreIEP 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.
Read MoreADHD medication “holidays”?
As summer rolls around, families may ask whether their children can have a “holiday” from their psychoactive medication, especially for attention-deficit hyperactivity disorder (ADHD). We asked Lawrence Amsel, MD, MPH, a REACH faculty member and associate professor of psychiatry at Columbia University, to lay out the pros and cons.
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