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The latest evidence, clinical insights, and practical perspectives on pediatric mental health — written specifically for primary care clinicians.
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Helping patients deal with trauma
May 19, 2020
A medical appointment can be intimidating and scary for a child with a history of trauma. Still, this visit might be the first time a patient shares that they have been sexually or physically abused or that they are terrified to live with their fighting parents during COVID-19. Your role as a primary care provider (PCP) is critical. Your interactions with your patient need to feel safe. As constrained as your time is, you must make every minute count toward establishing a connection.
Read ArticleAlleviating coronavirus anxiety
March 14, 2020
We don’t have to tell you that virtually everyone feels anxious about the spread of COVID-19. An appropriate level of anxiety can be helpful if it inspires people to follow CDC recommendations on hygiene and social distancing. An unnecessary level of anxiety, however, can impair both mental and physical health. Many of your patients and families are suffering from unhealthy anxiety–whether they present with possible COVID-19 symptoms or come in for an unrelated complaint.
Read ArticleSuicide crisis among Black youth
February 12, 2020
As suicidality among adolescents generally has declined in the past three decades, suicide attempts among Black adolescents have risen, according to a November 2019 article in Pediatrics. A report to the Congressional Black Caucus (CBC) says that rates of suicide death have risen more for Black youth than for any other racial or ethnic group. A growing concern is that Black youth are less likely to report suicidal thoughts but more likely to attempt suicide; Black males are more likely to suffer injury or death as a result. Suicidality is also increasing among younger children. The reasons for these changes are not clear. However, the risk factors for suicidality and underlying mental health conditions among Black children and youth are myriad.
Read ArticleHelping patients & families cope with chronic disease
January 27, 2020
In treating young patients who have chronic physical conditions, health care professionals focus — as they must — on alleviating the physical suffering caused by the disease. However, as a graduate of the REACH course Patient-Centered Mental Health in Pediatric Primary Care, you know the importance of supporting the mental and emotional health of young patients and their caregivers. A new article in Pediatrics highlights the importance of mental health care for families dealing with chronic illness.
Read ArticleNew AAP policy on mental health in pediatric care
November 13, 2019
The American Academy of Pediatrics (AAP) has released a new policy and an accompanying technical report on mental health competencies for pediatric clinicians. REACH faculty member Cori Green, MD, MS, is a lead author of both documents. We asked Dr. Green, director of behavioral health education and integration at Weill Cornell Medicine in New York City, what the AAP policy and technical report mean for alumni of the REACH program Patient-Centered Mental Health in Pediatric Primary Care. “I hope they’ll be excited to see that what is being endorsed by AAP is essentially what they were taught in their REACH training,” Dr. Green said. In the technical report, the REACH course is described as a promising practice in continuing medical education.
Read ArticleBuilding a team to counter school refusal
October 15, 2019
“When it comes to school refusal, getting all the adults on the same page is the bottom line,” said James Wallace, MD, a REACH faculty member. “Until you have that, you have nothing.” Dr. Wallace, who teaches child psychiatry at the University of Rochester (New York) Medical Center School of Medicine and Dentistry, described an approach to school refusal that unites primary care providers, schools, and mental health professionals in helping families make choices that support regular school attendance. “An evidence-based approach to school refusal, and the anxiety or depression that usually underlie it, includes cognitive behavior therapy and sometimes medication,” said Dr. Wallace. “But there’s a third piece: getting all of the adults involved, including the parents, to address the social-emotional components of school attendance in a consistent way.”
Read ArticleHelping patients deal with school shooter anxiety
September 18, 2019
According to the National Center for Education Statistics, 92% of public schools had formal active shooter plans in 2016, and 96% conducted lockdown drills. These measures are intended to keep children safe, but they may do as much harm as good. The title of a September 4 New York Times article sums it up: “When Active Shooter Drills Scare the Children They Hope to Protect.” We asked REACH faculty member Jasmine Reese, MD, MPH, about how students react to active shooter drills and what pediatric primary care providers (PCPs) can do. Dr. Reese is Director of the Adolescent and Young Adult Specialty Clinic at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida. “We have yet to see data on whether these drills are causing more anxiety and other mental health issues among students,” said Dr. Reese. “But it seems clear in practice that they can either cause anxiety and depression or exacerbate existing issues.”
Read ArticleHelping patients manage the transition to college
July 24, 2019
“Going to college is exciting, but students need to know that this experience, though positive, may also be stressful,” said REACH faculty member Elena Man, MD. Dr. Man recommends resources and strategies that pediatric primary care clinicians can use to prepare patients for this significant transition to a new environment for learning, living, and friendships.
Read ArticleHow PCPs can prevent teen suicide
June 10, 2019
“It’s not just that we’re more aware of adolescent suicide,” said Michael Scharf, MD, chief of child and adolescent psychiatry at the University of Rochester Medical Center and a REACH faculty member. “The rate really is going up. Teen suicide is still rare, but it’s increasing.” Primary care providers (PCPs) can help teens at risk of suicide, first of all, by being willing to talk about it. “Some people think that asking about suicidal ideation makes the kid more likely to act,” said Dr. Scharf. “But evidence shows that asking either has no impact or has a relieving effect; it frees the patient to talk about the issue.” “You need to think ahead of time of what to ask and how, so you feel comfortable,” said Dr. Scharf. “You need a go-to way to assess risk and how likely the kid is to follow through.” (See Resources below.) The assessment results can range from “nothing to do here” to “send this kid to the emergency department.” “The tricky part,” Dr. Scharf said, “is what to do in between.”
Read ArticleEvery Investment Gets More Children the Care They Need
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