Upfront

Mental health checkups may soon be standard protocol at all pediatrician offices. In an effort to address the rise in attention-deficit hyperactivity disorder, autism, anxiety and depression among children, the American Academy of Pediatrics (AAP) is calling for pediatricians to consider mental health during every patient visit.

The academy is advising pediatricians to ask families about how their children are doing in school, whether they are getting along with other kids and whether they are happy.

Twenty-one percent of American children and adolescents meet the diagnostic criteria for a mental health disorder, yet due to a shortage of pediatric mental health care providers, only one-fifth of them receive treatment, AAP says.

“There’s a lot of opportunity for prevention, and for dealing with these issues early to avoid more serious emotional disturbances,” says James Perrin, MD, a member of AAP’s Task Force on Mental Health and pediatrics professor at Harvard Medical School and the MassGeneral Hospital for Children.

The recommendations are also intended to help pediatricians develop a stronger network of community mental health providers for referrals, and to encourage more regional efforts to improve psychological care for children, Perrin says. The Massachusetts Child Psychiatry Access Project, for example, is working to promote the involvement of psychiatry and psychology with primary care activities and already provides pediatricians help in identifying area behavioral and mental health providers, Perrin says.

“This is an important problem for America’s kids and families, and a wonderful opportunity for collaboration with psychologists,” Perrin says, adding that he would welcome an AAP partnership with psychologists and APA to develop continuing-education courses for pediatricians on the importance of screening and identifying mental health problems.

Along with the new guidelines, AAP also released a toolkit to help primary-care clinicians more effectively identify and manage mental health issues. The toolkit includes screening tools, step-by-step care plans, parent handouts and other mental health resources that can be printed and distributed to patients. With these enhancements to their practices, pediatricians can help families build resilience in their children, recognize mental health problems and better coordinate care.

APA’s Executive Director for Professional Practice Katherine C. Nordal, PhD, commends the academy for these new recommendations.

“They represent an important step forward to achieve integrated care for our children and adolescents,” she says.

To bring these recommendations to life, Nordal is encouraging child and adolescent psychologists to reach out to their local pediatricians to engage more fully in mental health consultation and referral activities.

—A. Novotney