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What's the Best Way to Treat Mental Health Problems in Kids?

Research finds the emerging field of integrative behavior health shows promise.

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No one knows for sure, but the U.S. Centers for Disease Control and Prevention estimates that between 13 and 20 percent of youth ages 3 to 17 experience a mental health problem each year. This includes diagnoses of attention deficit hyperactivity disorder (ADHD), anxiety, depression, autism spectrum disorders and Tourette syndrome.

In fact, many mental health problems that continue into adulthood – including substance abuse and behavioral problems – actually begin during childhood and adolescence. This issue raises many questions; maybe the most pressing is, what’s the best way to treat mental health problems in children?

The U.S. does not have a broad pediatric mental health system in place, but the vast majority of young people do go to the pediatrician. A new health care field is emerging called integrative behavioral health care, where behavioral interventions are delivered in primary care settings, such as the pediatricians’ office. But what’s the evidence say on the effectiveness of this approach?

Several recent meta-analyses look at the evidence on offering mental and behavioral health interventions to children in pediatrician’s offices.

The first review was published in the Journal of the American Medical Association in 2015 by researchers from the University of California Los Angeles. The authors identified 31 randomized-controlled studies that evaluated the effect of offering behavioral and mental health interventions as part of routine primary care and compared it to the standard care provided by pediatricians. More than 13,000 children participated in the studies.

The authors found that offering mental health treatments as part of primary medical care for children led to significant improvements in childhood mental health. A young person who received integrated mental and physical health care was 66 percent more likely to experience a positive outcome compared to a young person who received standard care.

The integrated health care was more effective for youth who were diagnosed with a mental health or behavioral problem or showed some symptoms of a mental health problem. Preventative treatment programs were less effective.

A second review article published this year by the American Academy of Pediatrics looked specifically at integrated health programs focused on preventing behavioral and mental health problems in babies and children up to age 5.

The authors used data from 44 studies to determine whether interventions delivered during routine wellness visits helped improve children’s behaviors. The studies also looked at whether coaching by primary care providers helped improve parenting behaviors.

The authors found that this integrative approach holds promise for helping to prevent serious problems and improve children’s behavior. They also found that the data available on preventative programs are scattered; researchers need to study the mechanisms that lead to behavior change in children, the best ways to convince parents to participate in these types of interventions, and which populations benefit the most from integrated health care.

The take-home message: Mental and behavioral health issues are a serious problem among youth in the U.S. today. Integrative programs that offer mental health prevention and treatment programs as part of regular wellness visits for kids are a promising way to address this problem.

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