Many mental health experts estimate that 20 percent of children experience a mental health disorder at some point during childhood, and that more than 10 percent suffer from a serious emotional disturbance. According to a new brief from the National Center, titled Supporting Early Childhood Mental Health, diagnosing and treating these problems early is becoming an important focus of primary care—the first entry point to the health care system.
“Because most children are routinely seen multiple times in primary care for recommended well-child visits, there are numerous opportunities for primary care clinicians to look for children who may have—or may be at risk for—early behavioral health issues,” explains EDC’s Senior Project Director Albert Yee, MD, MPH. By taking advantage of these opportunities and effectively collaborating with behavioral health and other providers, primary care providers are particularly well-suited to prevent behavioral health problems and to lessen their potential impact on children as they develop.
Why is early diagnosis important? Mental and behavioral health problems in children can be a sign of a budding lifelong disorder. Catching and treating these problems early can halt their progression into adult mental health disorders, which are both more difficult and more costly to treat.
The National Center brief notes that there are many advantages to addressing children’s behavioral health needs within primary care, including increased access to children and families, improvement in the effectiveness of the care, decreased medical costs, and improved patient and provider satisfaction. Providing this care in a familiar setting can also reduce the stigma that parents and children might otherwise face.
Not surprisingly, primary care providers are finding new ways of providing services to address children’s behavioral health issues. The services vary based on the size of the practice, its location and resources, and the needs of the community. Services range from mental health promotion to the prevention and treatment of diagnosed mental health disorders.
Grantees of Project LAUNCH—a SAMHSA grant program, which seeks to promote the wellness of young children from birth to age 8—are attempting some innovative approaches to providing mental health services in primary care settings. For example, Michigan Project LAUNCH has a masters-prepared clinician located in several primary health care offices to provide onsite mental health services to children and families. The office staff ensure that children and families complete the practice’s mental health screening tools. A mental health clinician meets with the family to review the screening results and discuss issues that have been identified. The clinician may also administer additional evaluations or refer the family to outside services as needed.
While many primary care practices may be concerned about the lack of staff training in behavioral health and/or a shortage of mental health professionals to refer families to, the Project LAUNCH team in rural Ohio overcame these obstacles by using a telemedicine approach (virtual meetings via the Internet) to link rural providers and families with behavioral specialists in the state capital. Families receive expert consultation without spending time and money to travel to a provider in another location.
If your community would like to integrate behavioral health into its primary care practices, Dr. Yee offers the following suggestion:
[Those who] recognize the potential benefits for children and families of integrating behavioral health into primary care and who want to undertake this agenda can learn from a body of experience that already exists in the field and use all the available resources to help implement model approaches for integration—there is no need to start from scratch.
Do primary care providers in your community play an active role in identifying children’s mental health problems and providing mental health services? Please share your comments below.