Pediatricians Should Screen for Anxiety, Other Mental Illnesses

The American Academy of Pediatrics is recommending that children’s doctors screen for mental health issues including ADHD, autism and anxiety disorders, such as Social Anxiety Disorder, at every appointment. The recommendations appeared as a series of reports in a supplement to the journal Pediatrics.

Nationwide 21 percent of children and adolescents have a mental health disorder. Yet, fewer than one in five receives appropriate treatment.

“You can’t be in community practice and to see kids who come in regularly with depression, anxiety, etc.” Says James Perrin, M.D. Dr. Perrin is a member of the task force that crafted the reports, and a professor at Harvard Medical School. He says that doctors can no longer pretend mental health is not their problem.

Dr. Perrin urges pediatricians to ask about a child’s happiness and his or her ability to get along with peers at every appointment. Special attention should be paid to specific milestones. Missing key development steps between the ages of 18 months and 2 years can indicate autism. Other important milestones not achieved by  the time children start school can indicate ADHD.

The reports also point out that simply asking about mental health issues removes some of the stigma. It also opens the door for parents to mention any mental health concerns they may have at future appointments. Children who receive early treatment have a better prognosis.

Each pediatrician should develop a network of mental health professionals in the community. Doctors do not need a firm diagnosis to make a referral, Dr. Perrin warns – only an indication that something might be amiss.

Most pediatricians are not well trained in screening for mental health issues. The American Academy of Pediatrics will put assessment tools and other information for doctors on the website, as a training aid.

Dr. David Fassler, a Vermont child psychiatrist worries that the new recommendations may be asking too much of busy pediatricians. He points out that time spent with each patient is limited, and that doctors should be adequately trained and compensated for this new responsibility. Dr. Fassler also echoes the concern that there is a shortage of child psychologists and other qualified professionals to treat childhood mental illness.

By Joni Holderman, [email protected], contributing reporter for Mental Health News.