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.
It’s 10:30 Monday morning, and you’re 45 minutes behind. Earlier, you had to confront a receptionist about coming in late again. You have to get out today by 4:30 so you can get to your daughter’s softball game. Beating under all this stress is worry about your mom, who has been diagnosed with stage 2B breast cancer.
Although some schools have been open in person for months, some larger districts are just beginning to welcome students back on campus. Children, families, educators, and medical professionals have mixed feelings. To help you support different patient populations as they return to school, we talked to Jennifer Walton, MD, MPH, a co-author of a call for an “URGENT Coordinated Effort to Re-Open Schools” by the National Medical Association (NMA). Dr. Walton is chair of the NMA’s Pediatric Section, an assistant professor of clinical pediatrics at The Ohio State University, and a developmental behavioral pediatrician at Nationwide Children’s Hospital.
You’re in the consultation room with Anita, who first brought her 15-year-old son Vic to you two weeks ago. Vic has been suspended from school several times for increasingly dangerous behavior. Anita uses a wheelchair because she has multiple sclerosis. Today she is distraught. Last night, she forbade Vic to leave the house, but he went anyway. He didn’t come home last night or go to school this morning. Anita has called everyone she can think of, but no one knows where he is. The police won’t help until he has been missing at least 24 hours. Anita has come to you as a last resort. When you saw Vic, you were troubled by his history of uncontrolled behavior and his uncooperative stance. You were hoping to get him to open up in a follow-up visit. But now Anita is here alone, frantic because she doesn’t know where Vic is. What do you do?
“The opportunity to learn information to help me manage psychiatric conditions in my patients in this time where demand clearly outweighs supply of services, is going to be excellent for me as a PCP in my community.”