The American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association issued a declaration of mental health emergency for children in 2021. Given high prevalence rates, many different professionals may be required to manage the population of children with mental health concerns. In a study of patients in a large primary care network in Northern California, approximately half of children and teens prescribed an SSRI by a pediatrician for mental health concerns were seeing only their primary care pediatrician, according to the study, “Anxiety and Depression Treatment in Primary Care Pediatrics,” in the May 2023 Pediatrics (published online April 17). Pediatricians are often the first point of care for youth with mental health issues like anxiety and depression, and SSRIs (selective serotonin reuptake inhibitors) are first-line medications for anxiety and depression. This study found that 53% of young patients on SSRIs were receiving care from a psychiatrist, therapist or other mental health subspecialists, and 33% were referred to mental health professionals for psychotherapy. Researchers reviewed medical charts, selected at random, of 110 children, ages 6-18, who were prescribed SSRIs for anxiety and depression at pediatric clinics in Northern California. In this study, 30% of patients had documented mental health subspecialist care. The study found 62% had documentation of a follow up appointment within a year: 48% had monitoring for medication side effects and 34% had monitoring for suicidality. Researchers concluded pediatricians should be encouraged to ensure that children and adolescents with anxiety and depression receive follow-up care, including monitoring for medication side effects, and that these patients receive evidence-based psychotherapy. More research is needed on various systems of care or depression and anxiety in children and teenagers.
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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.