Psychological and Behavioral Health

PSYCHOLOGICAL AND BEHAVIORAL HEALTH - (click  to jump to specific module section)

• Screening
• Referral/Treatment
• Management of Suicidality

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Screening

Learning Objectives:

1. Describe the importance of screening all adolescents about mental health issues including depression, anxiety, non-suicidal self-harm, and suicidal ideation
2. Describe the importance of asking suicidal patients if there is a plan
3. Compare the presentation and diagnosis of ADHD between early, middle, and late adolescence and young adults

• Readings
  1. ​Practice parameter for the assessment and treatment of children and adolescents with suicidal behavior. American Academy of Child and Adolescent Psychiatry. J Am Acad Child Adolesc Psychiatry 2001;40(7 Suppl):24S-51S.
  2. Maslow GR, Dunlap K, Chung RJ. Depression and Suicide in Children and Adolescents. Pediatr Rev 2015;36(7):299-308; quiz 309-10.
  3. Kelly P. Posttraumatic stress disorder. Pediatr Rev 2012;33(8):382-3.
• Videos
  • ​Anxiety and Depression (video)

1. MCPAP (Massachusetts Child Psychiatry Access Project). Available at http://mcpap.org - section For Providers contains
   • Diagnostic Resources
   • Screening and Toolkits

• PediCases. Available at http://pedicases.org/archives/index.html
  1. Depression - Too Tired to Sleep
• Online Resources
  1. SAHM Youth Providers 2.0 Topic Guide - Mental Health.  

• Outpatient (adolescent clinic, primary care clinic, child and adolescent psychiatry)
• Inpatient (wards, PICU)
• Emergency department

Referral/Treatment

1. Assess patient readiness for change/intervention
2. Discuss outpatient treatment of depression/anxiety in adolescents including pharmacologic treatment and mental health utilization.
3. Know behavioral and pharmacologic treatments for ADHD

• Readings
  1. ​Zuckerbrot RA, Cheung AH, Jensen PS, Stein RE, Laraque D, Group G-PS. Guidelines for Adolescent Depression in Primary Care (GLAD-PC): I. Identification, assessment, and initial management. Pediatrics 2007;120(5):e1299-312.
  2. Cheung AH, Zuckerbrot RA, Jensen PS, Ghalib K, Laraque D, Stein RE, et al. Guidelines for Adolescent Depression in Primary Care (GLAD-PC): II. Treatment and ongoing management. Pediatrics 2007;120(5):e1313-26.
  3. Wolraich M, Brown L, Brown RT, et al. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics 2011;128(5):1007-22.
• Websites and Online Resources
  1. ​J. Shalwitz, T. Sang, N. Combs, K. Davis, D. Bushman, B. Payne (2007). Behavioral Health: An Adolescent Provider Toolkit. San Francisco, CA: Adolescent Health Working Group, San Francisco.
     • Special section on resources - http://cshca.wpengine.netdna-cdn.com/wp-content/uploads/2011/07/Behavioral-Health-Toolkit.pdf

• Online Resources
  1. ​Office of Adolescent Health - Adolescent Health Topics - Mental Health. Available at: http://www.hhs.gov/ash/oah/adolescent-health-topics/mental-health/

• Outpatient (adolescent clinic, primary care clinic, child and adolescent psychiatry; work with outpatient social work)
• Inpatient (wards, PICU, psychiatry)
• Partial hospitalization - child and adolescent psychiatry
• Emergency department

Management of Suicidality

1. Describe the importance of asking all adolescents about suicidal ideation and, if present, if there is a plan
2. Know the resources in your area for referral of an actively suicidal adolescent (crisis team, psychiatric or medical ED, psychiatric hospital)
3. Examine the basis of safety planning and how to counsel parents/guardians of safety plan 

• Websites and Online Resources
  1. ​MCPAP (Massachusetts Child Psychiatry Access Project) Available at http://mcpap.org
     • Suicide Prevention in the Primary Care Setting in section “For Providers”
  2. The Cornell Research Project on Self-Injury and Recovery
  3. The Trevor Project

• Outpatient (adolescent clinic, primary care clinic, child and adolescent psychiatry; work with outpatient social work)
• Inpatient (wards, PICU, psychiatry)
• Partial hospitalization - child and adolescent psychiatry