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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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Supporting mental health needs in rural areas
April 20, 2023
Rural healthcare providers can be overwhelmed—and understaffed with specialists. Discover how REACH inspired Elizabeth Wallis, M.D., to build a community to support her patients.
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Dealing with mental health issues in injured student athletes
March 14, 2023
When student athletes can’t play, their mental health may suffer.
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Don’t panic about panic attacks
February 24, 2023
“The impairment from a panic attack doesn’t come from the episode itself,” said REACH faculty member James Wallace, MD. “It comes from the patient’s and family’s reaction.”
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Assessing and treating substance abuse
January 24, 2023
“The risk of substance use starts at about age 10,” said Sam Chang, MD, a child and adolescent psychiatrist on the REACH faculty. “Prevention has to start before that. By the time kids reach adolescence, the horse has left the barn.”
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Is it ADHD? Or something else?
December 14, 2022
Attention-deficit hyperactivity disorder (ADHD) is one of the most common behavioral health disorders, affecting approximately 9% of all children and adolescents. About 75% of pediatric patients with ADHD have comorbid mental health conditions, ranging from oppositional-defiant disorder to anxiety and mood disorders. What is a busy clinician to do? How do you discern whether a child who is, say, having difficulty focusing at school and at home has ADHD, anxiety, both, or something else?
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When and how to send kids to the emergency room
November 15, 2022
“The first thing I would say to any clinician is that it’s never wrong to send a child to the emergency room,” said Amy Dryer, MD, pediatrician and REACH faculty member. Having spent 10 years in a hospital emergency department, Dr. Dryer is intimately familiar with the criteria ER physicians use to decide to admit psychiatric patients: a medical condition, suicidal ideation with a lethal plan, homicidal ideation, or active psychosis. However, she emphasized that your decision to refer to the ER doesn’t hinge on whether the patient is likely to be admitted. “If what they’re telling you makes you uncomfortable,” she said, “go ahead and refer them.”
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After you screen for anxiety, then what?
October 24, 2022
As you’ve heard, the US Preventative Service Task Force (USPSTF) recently issued draft guidelines recommending that primary care providers (PCPs) screen all adults aged 19 to 64 for anxiety disorders. Guidelines recommending anxiety screening for children aged 8 to 18 were finalized last week. The question is, if the screener indicates that anxiety is an issue, then what do you do? Patty Gibson, MD, a psychiatrist on the REACH Adult Behavioral Health faculty, shared some basics from the course to answer the question.
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Treating pediatric trauma
September 20, 2022
“The biggest predictor of having something bad happen to you is having had something bad happen to you in the past,” said Brooks Keeshin,
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One teen, 10 psychiatric drugs. This must stop!
September 8, 2022
On August 27, The New York Times ran an article by Matt Richtel titled “This Teen Was Prescribed 10 Psychiatric Drugs. She Is Not Alone.” It documents the practice of “polypharmacy”: prescribing multiple medications—most of which have not been tested either in children or in combination with one another—to manage young patients’ depression or anxiety. That young patients are being prescribed potent cocktails of untested drugs is obviously wrong. The question is, how did we get to this point, and what can we do about it?
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Registration closes August 7 for REACH’s Practical Behavior Management in Pediatric Primary Care (PBM) course taking place August 21. This evidence-based training is designed to help pediatric primary care clinicians effectively incorporate behavior management strategies into…
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