Pediatricians being trained to treat kids’ physical, emotional needs

WASHINGTON — Parents turn to pediatricians when their children get sick, so now, the health care providers are being trained to treat body and soul.

“It’s my job to take care of the whole child,” said Dr. Lee Beers, a pediatrician with the Children’s National Health System, which is at the forefront of efforts to provide primary care physicians with the skills they need to screen for mental issues and treat basic problems.

At a time when many children with mental and behavioral issues aren’t being diagnosed and child psychiatrists are in short supply, pediatricians are stepping in to fill the void.

Beers, who heads the DC Collaborative for Mental Health in Pediatric Primary Care, says pediatricians are often the first provider a family goes to for help.   

“We need to make sure that the professionals who are seeing families and children on the front line are really prepared,” she said.

Education comes in numerous forms — from traditional lectures and classes to webinars. There’s also a concerted push for more avenues for direct consultation between pediatricians and mental health providers.

The goal is early intervention, to pick up on the first signs of trouble when they are the most treatable.

In that respect, Beers said, it is much like treating a lot of the physical maladies she sees all the time in her practice, such as asthma.

“If I don’t treat your asthma until it gets really severe, you are going to end up in the emergency room and hospitalized,” Beers said. “It is the same thing for mental and behavioral health concerns — the earlier we can provide treatment, the better outcomes are.”

Sometimes, a basic screening for mental health is as simple as a short questionnaire that gets a conversation going about a child’s mental and emotional well-being.

If the case is relatively simple, a trained pediatrician can prescribe medications and monitor treatment. If it is more complex, the primary care can work in concert with a mental health specialist.

In roughly 30 states and the District of Columbia, hotline programs are already in place that provide teams of child psychiatrists that pediatricians can call for guidance on individual cases.

Beers said this access to advice is important in all parts of the country, but especially for pediatricians in more remote areas where there is not a child psychiatrist within a 200- to 300-mile radius.

There are only about 8,900 trained child and adolescent psychiatrists in the entire country, and most are clustered along the coasts and in big cities.   Beers said it is no surprise that most kids with mental health disorders see their pediatrician first, adding these doctors already prescribe the majority of psychotropic medications.

According to experts at Children’s National, half of all lifetime cases of mental illnesses begin by age 14, and 75 percent by age 24. Thirteen percent of youth live with a serious mental illness, but only around 20 percent get any treatment.

The consequences can be dire. Teens with undiagnosed and untreated mental disorders have a 50 percent dropout rate, and are at far greater risk than other adolescents of suicide.

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