Parenting is not easy. Sometimes a child's behavior might mean that there is a mental health issue or it could be just a kid having a bad day. It's understandable that parents will not always be able to tell, but new research shows that even healthcare professionals, pediatricians, and family practitioners, can have trouble discerning what is behavioral and what is a more significant issue.
The study, conducted at Penn State College of Medicine, interviewed pediatricians, family practice primary care doctors as well as child and adolescent psychiatrists and found that specialists were more confident in their abilities to tell if a child who was irritable or acting out in some way had a mental health issue or not. Pediatricians and family doctors were not as sure of themselves when evaluating their young patients. GPs and pediatricians were also more likely to start with medication if they suspected a mental health issue, where psychiatrists were more likely to start with cognitive behavioral therapy.
With violence like school shootings and bullying surrounding teenagers and children, it's crucial for any healthcare provider to be able to correctly diagnose their patients so the right treatments can be found. Family doctors and pediatricians are usually the first stop for parents who are concerned about their children, so it's vital that they know what mental illness looks like in teens and children.
Anna Scandinaro, a medical student at Penn who worked on the research explained, "We need to start asking if there's anything we can do to prevent these things from happening. There's a lot of concern right now about children's mental health, and we wanted to compare how different practitioners go about trying to figure out who's going through normal irritability and who may benefit from additional treatment."
Irritability is part of life as children develop. A day or so of a moody teenager is the norm in most families, but if it continues and becomes chronic, or interferes with daily life, family activities or school, it might be part of a larger problem. The team at Penn interviewed family medicine doctors, pediatric doctors, and psychiatrists from a large teaching hospital. These providers see hundreds of patients combined and were asked about how they differentiate chronic irritability in their patients from the everyday grumpiness parents and providers alike expect from time to time.
Scandinaro explained, "We found that family medicine physicians and pediatricians feel as though they don't have the resources and the training they need to effectively evaluate irritability in the clinic setting, especially in the limited amount of time that they have. But at the same time, there is a national shortage of child and adolescent psychiatrists, increasing the need for primary care providers to be more comfortable in determining who needs to see a specialist. So even though the study was preliminary, it shows we need to improve education for primary care providers."
Time was a problem as was the availability of mental health services for children. Pediatricians and family doctors reported not having enough time with patients to evaluate them properly. Education was another issue. While it's expected that a specialist would have much more training than a general practitioner, the GPs and pediatricians in the study said that more training in mental health for children would help them narrow down issues more efficiently.
The team hopes to move forward with the research and try to develop a quick and accurate assessment tool for pediatric general practitioners to refer to when seeing patients who may have an underlying mental health issue.
It's especially necessary to get primary care doctors better trained, since most children and adolescents who receive mental health care, are treated in primary care settings. Check out the video below for additional information on the importance of mental health care for children.
Sources: Penn State School of Medicine, Primary Care Companion for CNS Disorders
