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Mental health is a top concern for youth and families, as identified in a recent Children's Hospital Colorado community health needs assessment, as well as assessments conducted by numerous other hospitals, local health departments and community-based organizations. But what does this mean for primary care physicians? Should this concern affect the front-line care provided by a family doctor?
The Pediatric Mental Health Institute created a Youth Action Board (YAB) at Children's Colorado in 2013 to provide youth a voice regarding mental health issues. According to past and present board members, family physicians should have a place in the conversation about the mental health of our teens and children.
"I wish my primary care physician would've told me that mental illness could be treated just as much as a physical illness," says YAB graduate Kristen Torres, now a junior at Colorado State University studying clinical psychology. "Family care physicians should check in more with and ask questions directly about the mental health of their patients. Physicians shouldn't beat around the bush or avoid asking hard questions."
Current YAB member Cora Galpern adds: "Preventative care is key. We know that catching these problems earlier leads to better care."
Galpern stresses that parents often need a lot of support and education around mental health issues, as well. Treating mental health as a common health challenge and providing basic information can go a long way toward de-stigmatization.
Because mental illness is often an emotionally charged issue, Galpern suggests that family doctors practice not only the aforementioned openness, but some discretion, as well. While we need to be matter-of-fact about the existence of mental illness, it can be a shock for families to learn that someone in their family might be struggling with these issues. Be open with parents who have concerns about their teens and children and involve the teen or child in discussions to maximize their care and benefit.
It is also helpful to have a list of mental health resources in your area in case your conversations with families require follow-up for mental health care. Be aware of the nearest emergency department for emergencies and have a list of trusted mental health practitioners who assess and serve various age ranges and/or diagnoses.
"The stigma around mental health causes individuals to avoid talking about mental health or mental illness," says Torres. "Healthcare providers should ensure they do not fall into the category of those not talking about mental health so they can provide the best care possible."