The pediatrician already has a trusted, long-term relationship with patients and families that can help in providing a safe stigma-free environment for care.
One in every five children suffers from a mental disorder that could jeopardize their health long into adulthood, yet few receive the services they need because of a shortage of mental health experts, social stigma, costs or other barriers.
Pediatricians have a unique opportunity to promote the healthy social-emotional development of children, as detailed in an American Academy of Pediatrics (AAP) policy statement, "Mental Health Competencies for Pediatric Practice," published in the November 2019 Pediatrics. The statement and an accompanying technical report, "Achieving the Pediatric Mental Health Competencies," update 2009 guidance and incorporate new research on early brain development, trauma-informed practice, and team-based care.
The statement describes the pediatrician's role in recognizing and addressing trauma and other threats to mental health and recommends ways to incorporate mental health practice into pediatric settings.
"The mental health problems we see in children are on the rise, and suicide rates are now the second leading cause of death for children as young as 10," said Jane Meschan Foy, MD, FAAP, lead author of the statement. "Yet research tells us that children are resilient and that certain factors – such as early positive and nurturing relationships – can help protect them from chronic stress or early adverse experiences."
AAP recommends that pediatricians:
Partner with families, youth, other medical specialists, local educators and social service providers to identify gaps in key mental health services in their communities and work to address the deficiencies.
Pursue training, certification or other educational strategies to improve their mental health practice, with a priority given to suicide prevention.
Explore collaborative care models, such as the integration of a mental health specialist as part of the medical home team.
Build relationships with mental health specialists, including school-based providers, to identify and provide emergency care to children and teens at risk of suicide and to co-manage children with mental health conditions.
The statement calls for medical schools and residency training programs to provide additional education and resources on mental health, while providing evidence-based clinical approaches for pediatricians to incorporate in their practices.
"Pediatricians have a unique, trusted relationship with their patients," Dr. Foy said. "They want to help children grow healthy minds, just as they grow healthy bodies."
Additional Information from HealthyChildren.org: