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One-Stop Pediatric Care

Mental health pros are now embedded at some doctor’s offices



Mental health pros are more common at pediatric offices.

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For the 20 percent of children experiencing anxiety, behavior problems or more significant mental disorders each year, timely access to a mental health professional can alleviate a serious issue. Physical and mental health impact one another, says Jennifer Mautone, PhD, a psychologist at Children’s Hospital of Philadelphia, but in the past they’ve been treated separately. But “recently, there’s been a move to a patient-centered home” says Mautone, and a growing trend of behavioral health providers embedded within a pediatric practice makes getting care more convenient for young patients and their families.

Easy early access

When Jennifer, a mom from Newark, DE, took her son for a sick visit, she mentioned issues he was having adjusting to kindergarten, including hitting, kicking, and not listening at school or at home. Her pediatrician mentioned a behavioral health consultant in the practice and made an immediate introduction. Within a week of meeting with the therapist, teachers reported better behavior at school. “For us, early intervention was key,” Jennifer says. “I’m glad I mentioned it that day,” she says, “things were taken care of sooner, before the behavior became a pattern.”

A physician is the first line to assess what’s going on, says Rosemary Szczechowski, Psy.D. a behavioral health consultant with Christiana Care in Wilmington, DE. “The unknown will prevent people from reaching out,” says Szczechowski, of families making appointments with mental health providers. With a collaborative approach to care, if a family mentions a concern the pediatrician can make the introduction to a behavioral health provider during the appointment and immediately begin a treatment plan.

“Traditionally, we’d give a card (mental health provider referral) and assume a follow up, and not know if they did,” explains Allen Friedland, MD, a pediatrician at Christiana Care. “Now we bring the specialist to the family right then and there. We can act swiftly and get people to services much faster,” says Friedland.

Barriers to treatment

Fear of the unknown: The many barriers to treatment for children with behavioral issues include stigma, wait time or insurance coverage. “Sometimes you have a concern and you just don’t know where to go,” says April Douglass-Bright, Head of General Pediatrics at Children’s Regional Hospital at Cooper University Health Care in Camden, NJ. Pediatric behavioral health providers can help determine what sort of care is needed and where to seek appointments, even if only office follow-ups are required.

Money: “Anything that’s done under pediatric coding is typically covered by insurance,” says Douglass-Bright. In addition, in most cases, there is no bill or additional co-pay for the initial visit with the behavioral health specialist at the pediatrician’s office. 

Time: A shortage of mental health providers exists across the nation, and as a result, there are often waiting lists with providers; it can take months to get an appointment. “We can get started on healing right now and not have to wait for months,” says Friedland.

Benefits to your child

“I can’t stress enough, the earlier kids have access to mental health, the better they’ll be,” says Douglass-Bright. Providers can take a preventative approach, and care for the entire patient, she says. Easy communication with the primary doctor and immediate feedback about a patients’ mental health allows a pediatrician to stay continuously in the loop. “Families who have never experienced mental health care are often surprised. It’s been a very positive response,” says Mautone of parent feedback.

Because children are already comfortable at a pediatrician’s office, in the safety of the exam room, they’ll often open up. Parents are very thankful for the seamless transition of care. “You don’t have to wait six weeks for an appointment,” agrees Szczechowski. “That’s so important when you’re worried about your child.”

 

Common Conditions

Anxiety, depression and ADHD are the most common pediatric mental health conditions treated in-office. Other conditions treated include:
Adjustment difficulties to life changes
School concerns
Disruptive behavior problems
Sleep concerns
Family communication difficulties

SOURCE: April Douglass-Bright, Head of General Pediatrics at Children’s Regional Hospital; Cooper University Health Care in Camden

 

Types of Practitioners

Licensed clinical social workers help clients with issues such as addiction, abuse or mental illness and are required to have a master’s degree.

Clinical psychologists are trained and licensed to diagnose and treat people with mental disorders.

Psychiatrists are physicians who specialize in the prevention, diagnosis, and treatment of mental illness. They receive additional training and serve a supervised residency and can prescribe medication, which psychologists cannot do.

 

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