We need better mental health services (for toddlers too)

These recent days have been tough for many Americans. Orlando, known to many as the happiest place on earth for its theme parks and resorts, cannot seem to catch a break. Unspeakable violence and unimaginable tragedy struck the magical city just hours apart. I am deeply mourning the loss of life at the Pulse nightclub as well as that of the toddler snatched and drowned by an alligator steps away from an iconic Disney resort. I can tell by the weary faces I see out in public and in our practice that many feel much the same. The mass murder, with its elements of terrorism, mental health issues, and firearm politics, touches me as a health care professional.

Pediatrics, like family and internal medicine, is on the front lines of mental health screening, diagnosis, and treatment. Most people think of their pediatrician as the person who gives their kids shots and treats strep throat, but a very significant percent of my day is dedicated to mental healthcare. A pediatrician is often the first one to ask a new mother about feelings of depression, so-called baby blues, or anxiety. We ask parents of infants and toddlers about their frustrations with parenting and try to be hyper vigilant about spotting signs and patterns of abuse. As children age, we inquire about functioning in the home and classroom in hopes of identifying anxiety or depression. Our teens fill out screening questions at each visit in hopes of identifying trouble early. Many come to us seeking help with anxiety, sleeplessness, or depression — or we find these issues hidden in headaches, belly aches, or behavior changes. When we identify a child who is struggling, we ask about homicidal and suicidal ideation. Pediatricians now prescribe medicines that were previously only thought of as coming from psychiatrists.

We do this because as a profession we know that access to mental health is spotty in many areas of the United States. Therapists and child psychiatrists in particular are often hard to come by, with waiting lists months long. In many areas, insurance coverage is limited and these visits can be expensive, especially when therapy is needed frequently. As a group, we are committed to improving the mental health of children by improving their access to this type of care. Many of us have started partnering with psychologists and social workers in our own offices, which allows us to access care for our patients immediately.

But we cannot do this alone. As a group we need the help of the non-medical community in pushing for greater access to quality mental health care. You can do this by insisting your local, state, and national elected representatives prioritize mental health treatment by earmarking dollars and not just “thoughts and prayers.” We need you, specifically, to reach out to your neighbor, coworker, and family to ask them honestly how they’re doing, how they’re handling a difficult event, and how can you can help them. We need you to approach children, even difficult ones, with love and kindness, asking not what is wrong with this kid, but how you can help them. We need to you reach out to us when you spot trouble and to let us help you when your loved one is slipping away. Working as a team is the best way to improve our nation’s mental health.

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