When children have mental health concerns, where do parents go? According to new research published in Pediatrics, approximately one third of children receive mental health care solely from their primary care physicianThis finding underscores not only the need for trauma informed care but also importance of universal screening.

The DEF protocol gives pediatricians a basic framework to assess the mental health of their patients and families by checking in on their distress, emotional needs and barriers, and family issues. Should a mental health concern arise, pediatricians can help their patients receive the appropriate mental health treatment by following these simple steps to making a referral:


- Mention concerns you have identified

- Ask their ideas about what they need

- Ask permission to offer advice

- Assess their readiness to act on the referral

- Assess barriers to seeking additional care

- If their not ready to seek additional help, keep the door open and continue to return to your concerns at future visits

- When they begin to receive mental health treatment, promoting continuity of care with other providers


The lead researchers note that while pediatricians can effectively address mental health needs, more support for physicians and more collaboration between medical and mental providers is needed:

The study's findings help demonstrate that primary care is a good area to put more supports in place for children's mental health, Van Cleave said. These supports may include better access to child psychiatrists or mental health experts for questions that doctors might have about a child's treatment plan, as well as better communication with mental health experts involved in a child's care to make sure therapy is going well and the child is progressing along a good treatment path, she said.


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