HCPLive Network

Improving Pediatric Mental Health Screening Isn't a Solo Act

Despite the fact that mental health disorders are prevalent in 21% of children, just a small percentage of pediatric patients with behavioral health issues receive adequate care, said Thomas L. Young, MD, of the University of Kentucky College of Medicine, Lexington, KY, during a presentation Tuesday at the AACAP 57th Annual Meeting in New York, NY.

Most mental health disorders are present in children by age 14, he noted, with mood disorders, anxiety, behavior disorders, and substance abuse being the most prevalent. But although one in every five pediatric visits involves a behavioral health issue—whether a child is exhibiting symptoms of ADHD or has chronic abdominal pain—the problems aren’t being recognized by pediatricians.

So what’s the answer? “Mental health is interwoven with physical health,” said Young. “An integrated model is critical in addressing these needs.”

Twenty years ago, the University of Kentucky College of Medicine established an integrated care program to help solve the problem of under-recognition of mental health disorders. According to Young, pediatricians weren’t screening for behavioral health issues, there was a lack of resources, and the wait for an appointment with a psychiatrist was 3-6 months. What’s worse, the attitude many physicians had was “don’t ask, and you don’t have to deal with it,” he said.

The institute conducted a study which revealed that many physicians didn’t believe they were equipped to assess mental health problems, and few reported concerns they had about patients to their parents. To close some of the gaps in care, University of Kentucky set up an integrated model in which mental health screening was conducted at well visits, a team of mental health professionals was available for consultation and referrals, and physicians were provided screening tools, assessment information, and treatment protocols. It also included a therapist who performed triage assessments and provided assistance in identifying psychosocial problem cases, as well as social workers and pediatric psychiatrists who could be called upon for consultations.

According to Young, researchers found that incorporating behavioral health consultants led to increased satisfaction rates from physicians and helped improve their ability to refer patients.

The keys to success for University of Kentucky's care model, he said, were as follows:
  • Raise awareness for need for mental health services
  • Address the financial and time issues involved
  • Make sure a behavioral consultant is available in the clinic for immediate contact with the patient or a quick call with the patient
  • Feedback must be provided to referring clinicians
  • Arrange resources for consultation and referral when needed
The organization plans to continue to develop the program by adding a second behavioral consultant and child psychiatrist to the team, improving resident teaching on child mental health screening, and implementing new tools for assessment and outcome screening, he said.

Further Reading
For patients with high-risk prostate cancer, testosterone recovery is shorter for patients receiving 18 months versus 36 months of androgen deprivation therapy, and is associated with improved quality of life, according to a study presented at the annual meeting of the American Society for Radiation Oncology, held from Sept. 14 to 18 in San Francisco.
Eight percent of children account for nearly one-quarter of emergency department visits and 31% of costs, according to a study published online Sept. 15 in Pediatrics.
For women undergoing assisted reproductive technology treatment, higher supplemental folate intake is associated with improved outcomes, according to a study published online Sept. 5 in Obstetrics & Gynecology.
Men with male pattern baldness may face a higher risk of developing an aggressive type of prostate cancer than men with no balding, according to a study published online Sept. 15 in the Journal of Clinical Oncology.
As with many rare diseases, the treatment options for patients with familial hypercholesterolemias are few and far between. In this segment, the panelists discuss several viable options for treating this condition.
The US Department of Health and Human Services is sending nearly $300 million to community health centers in an effort to boost access to comprehensive primary care.
The FDA has approved Baxter’s Rixubis [Coagulation Factor IX (Recombinant)], an intravenous prophylactic treatment intended to control and prevent bleeding episodes and assist with perioperative management for children 12 years and younger with hemophilia B.
More Reading
For patients with high-risk prostate cancer, testosterone recovery is shorter for patients receiving 18 months versus 36 months of androgen deprivation therapy, and is associated with improved quality of life, according to a study presented at the annual meeting of the American Society for Radiation Oncology, held from Sept. 14 to 18 in San Francisco.