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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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10 ways to help families through the holidays
November 17, 2020
If you’re like most pediatric primary care providers (PCPs), you’ve seen an increase in child mental health issues due to COVID. Research shows that the pandemic, with its consequent disruption and isolation, has increased adolescents’ risk of trauma, depression, and anxiety. Families are dealing with grief, the anxiety of whatever “school” means this week or this month, and, in many cases, loss of income. Families of color and low-income families have been hardest hit by the pandemic itself, by the economic and social fallout, and by the attendant impairment of mental health. And now come the holidays.
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Working with challenging families
October 13, 2020
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?
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Promoting healthy grief
September 16, 2020
COVID-19 has changed the way children experience the death of a loved one. Although difficult under any circumstance, bereavement is even harder when mourners can’t gather. Barriers to comforting mourning rituals and supportive social communities can make it harder for children to grieve in healthy ways, while increasing the risk for maladaptive grief reactions.
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Building family resilience
July 23, 2020
“Families provide a kind of protective membrane for children when crazy things are happening around them,” said William Saltzman, PhD. Dr. Saltzman is a faculty member of the REACH program Child/Adolescent Training in Evidence-Based Psychotherapies. “Families really have been on the front line throughout the pandemic,” Dr. Saltzman said. “It’s been a rollercoaster ride from the beginning, with abrupt school shutdowns; the exhaustion of becoming the 24/7 caregiver, teacher, playmate, and breadwinner; and now having to figure out largely on their own how to navigate the upcoming school year.”
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How to talk with patients about racism
June 29, 2020
Once pediatric primary care providers (PCPs) recognize the importance of having conversations about race with their patients and families, the next question is how to begin.
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Your patients need you to talk about race
June 23, 2020
“The first thing clinicians need to know about racism and discrimination is how important it is to talk about it.” Open, honest, and effective conversations about race and racism are crucial to young people’s mental health.
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Helping patients deal with trauma
May 19, 2020
A medical appointment can be intimidating and scary for a child with a history of trauma. Still, this visit might be the first time a patient shares that they have been sexually or physically abused or that they are terrified to live with their fighting parents during COVID-19. Your role as a primary care provider (PCP) is critical. Your interactions with your patient need to feel safe. As constrained as your time is, you must make every minute count toward establishing a connection.
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Alleviating coronavirus anxiety
March 14, 2020
We don’t have to tell you that virtually everyone feels anxious about the spread of COVID-19. An appropriate level of anxiety can be helpful if it inspires people to follow CDC recommendations on hygiene and social distancing. An unnecessary level of anxiety, however, can impair both mental and physical health. Many of your patients and families are suffering from unhealthy anxiety–whether they present with possible COVID-19 symptoms or come in for an unrelated complaint.
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Suicide crisis among Black youth
February 12, 2020
As suicidality among adolescents generally has declined in the past three decades, suicide attempts among Black adolescents have risen, according to a November 2019 article in Pediatrics. A report to the Congressional Black Caucus (CBC) says that rates of suicide death have risen more for Black youth than for any other racial or ethnic group. A growing concern is that Black youth are less likely to report suicidal thoughts but more likely to attempt suicide; Black males are more likely to suffer injury or death as a result. Suicidality is also increasing among younger children. The reasons for these changes are not clear. However, the risk factors for suicidality and underlying mental health conditions among Black children and youth are myriad.
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