Can a pediatric-based brief behavioral treatment outperform assisted referral to outpatient mental health for youths with anxiety and depression?
In this randomized clinical trial, researchers discovered that a brief intervention delivered at the pediatrician’s office can indeed significantly help children and teenagers who are dealing with depression and anxiety. In addition, the young people who received this treatment actually fared better than those who were referred to outpatient mental health care.
This study reinforces what I have long believed — pediatricians can play an invaluable role in all areas of young people’s health. They are typically the first ones consulted when there are issues that need addressing and this alone makes them one of our most important resources for our children and young adults.
Anxiety and depression are common among young people, but sadly only a small number receive help. According to the National Institute of Mental Health, about one in four youths aged 13-18 suffer from anxiety at some point, and about one in nine suffer from depression. Yet only twenty percent of anxious youths and forty percent of depressed youths report having ever received mental health services for their symptoms. These statistics underscore the importance of the study’s findings. It’s possible to get the right help from your pediatrician’s office – a doctor who you are likely to visit anyway!
I have long advocated for educating and training pediatricians in the basics of brain disorders. When my son told me he was sure he had obsessive-compulsive disorder, the first thing I did was make an appointment for him with his long-time pediatrician. While the pediatrician concurred with my son’s self-diagnosis, his assistance stopped there. Not only did he not know how to treat OCD, he didn’t even know there is a specific treatment for the disorder. All he recommended was that our son “see a therapist.” Our family ended up on a wild goose chase of sorts, desperately trying to find the right help.
Of course I realize pediatricians can’t know how to treat all types of brain disorders. That’s beyond the realm of what we should expect. But they can have general knowledge, so they’re able to engage in basic therapy for anxiety and depression, and also know who and when to refer patients to when more specialized care is called for. If my son’s pediatrician had known there is a specific therapy needed to treat obsessive-compulsive disorder, we would have found appropriate help sooner rather than later, and more importantly, would have saved my son, indeed our whole family, months and months of needless suffering and turmoil.
Another interesting aspect of the above-mentioned study is that Hispanic participants, in particular, seemed to reap the most benefits from treatment at their pediatrician’s office, perhaps suggesting that this protocol might be an important tool in addressing ethnic disparities in care.
There have been so many recent advances in medicine, and an increase in specialties and subspecialties, that there is no way we can expect all health professionals to be experts on everything. But if they are educated enough to engage in basic therapies, or point their patients in the right direction toward appropriate treatment, it just might make all the difference in the world.
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