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April 6, 2020

Pediatric Mental Health Care Must Be Family Mental Health Care

Author Affiliations
  • 1MedStar Georgetown University Hospital, Department of Psychiatry, Georgetown University Medical Center, Washington, DC
  • 2Harvard Medical School, Boston, Massachusetts
  • 3The Dimock Center, Roxbury, Massachusetts
  • 4Department of Pediatrics, Boston University Medical Center, Boston, Massachusetts
JAMA Pediatr. 2020;174(6):519-520. doi:10.1001/jamapediatrics.2020.0065

Pediatric mental health (MH) concerns, including depression, anxiety, loneliness and social isolation, and suicide, have increased markedly in the last decade and are critical factors associated with population health. While effective interventions for these conditions have been developed and pediatric health care professionals increasingly address MH concerns as a central component of clinical practice, our health care systems have not met the challenge of providing evidence-based treatment to all young people who need it. Too many children never receive adequate MH assessment1 or timely intervention,2 and access to specialty MH clinicians is inadequate. In addition, the treatments that are delivered are often incomplete and ineffective, particularly for the most vulnerable children. The current state of care delivery must be improved to implement high-quality care more broadly and produce better outcomes.

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    1 Comment for this article
    Accounting for Progress in Child Mental Health
    Edward Schor, MD | Department of Pediatrics, Stanford University School of Medicine
    The article is a good one and covers most of the issues and ideas that have been raised over the past years. (It is somewhat ironic that family systems therapy never took hold in a major way, as it addressed child mental health within the family unit).  Some additions to the article would be to measure the success of child mental health services by changes in the parents' knowledge, attitudes, and behaviors vis-a-vis their child to measure the success of linking families of these children with effective community-based family support services; to make parental mental health screening a routine part of pediatric well-child care; and to routinely assess for family and social circumstances that are affecting children's behavior and mental health, as the majority of those problems arise from such circumstances.