Higher standards for pediatric mental health a must

By Amanda Shockey

“It’s just a phase; he’ll grow out of it.” “She’s just being dramatic, ignore her.” “He is just being a teenager, give him some space.”

Most are guilty of saying, hearing or thinking these phrases at one point regarding children/ teenagers. Pediatric mental health is a very real concern though that should be taken seriously.

National statistics show one in five children need mental health services. Considering recent school shootings, how many could have been prevented had the assailant gotten proper mental health attention?

Mental illness is treatable when properly diagnosed with an appropriate treatment plan. Patients with mental health concerns may receive crisis care, but without proper follow-through, their mental illness may be left untreated.

Addressing mental health concerns early allows patients to gain appropriate coping mechanisms. For pediatric patients who need help, the emergency room is available for immediate crisis.

Emergency room visits for mental illness concerns are rising. More mental health facilities must be available for these patients for proper follow-up care. If no funding is available for new facilities, creating relationships among specialties is another option.

Without mental health facilities or combined care plans, ERs will continue to be overcrowded, diagnoses could be missed and follow-up care lacking.

Data collected by the Children’s Hospital Association in Kansas show a steady increase of ER visits nationally for mental illness complaints, with a significant increase from 2001-’10. Once discharged from the ER, where do they go?

Is there access to mental health facilities for follow-up? Do families skip follow-up care because their child is “better”? These questions must be addressed to give proper care to the growing pediatric mental health population.

How comfortable are pediatricians treating patients with mental health concerns? The University of Hartford and Child Health & Development Institute, of Connecticut, evaluated this question. It sent a survey to pediatricians describing a sample patient the pediatricians were to diagnose as either attention deficit/ hyperactivity disorder (ADHD) or depression, then determine a treatment plan.

Most pediatricians referred the patient with depression to mental health specialists, but would treat the patient with ADHD. Sixty percent of the pediatricians diagnosed the sample patient correctly, but only

41.2 percent of the pediatricians were confident in their diagnosis. If a pediatrician is not confident in a diagnosis, how accurate is treatment?

If a pediatrician is not comfortable providing treatment for a patient with mental illness, how does that patient get proper care? A Boston study found many pediatricians don’t want responsibility for diagnosing or treating mental health problems except ADHD.

The same study evaluated the working relationship between 18 pediatricians and 37 mental health specialists and how this combined care benefited patients. Most pediatricians and mental health specialists agreed that patients received more timely/better care, which stresses prevention, early access to care and patient satisfaction.

This relationship between primary and mental health care has the potential to help patients access proper treatment and maintain consistent care among providers.

Building mental health facilities is another option for handling increased patient load. This process is expensive and takes time.

For example, Children’s Hospital of the King’s Daughters (CHKD) in Virginia is seeking state approval for a $50 million mental health facility that will take four years to complete.

CHKD has seen a 40 percent increase in children coming to the ER for mental health evaluations over the past four years. There are four inpatient behavioral health units in the area that CHKD can refer.

However, bed spaces are limited, and patients travel out of the area for treatment until space is available. Not all parents are able to travel distances, causing patients to not get needed care.

Overall, pediatric mental health is a growing concern nationwide. There must be a higher standard for the diagnosis and treatment of pediatric mental health.

Building new facilities demands time and money that may not be readily available. A more convenient option would be to implement combined care among pediatricians and mental health specialists.

Having a mental health specialist on hand to assist with treatment could go a long way in providing better care. Early diagnosis and treatment could prevent a bigger crisis from occurring later.

Amanda Shockey, RN, is a doctor of nursing practice student in WVU’s School of Nursing. This commentary should be considered another point of view and not necessarily the opinion or editorial policy of The Dominion Post.

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