Over the years, research has indicated that providers under-identify patients in need of mental-health services when they rely solely on clinical impressions. One large study found that pediatricians identified only one of five children with behavioral-health problems, whereas they correctly identified 93% of those without, using only their clinical impressions 3 . Similarly, another found over 40% of children with behavioral- health problems who were not in treatment were not identified by their PCP 4 . Studies have found that the identification of potential problems increases when
- parents indicate to the health-care provider that they have a concern; and
- standardized tools are used to screen.
Screening tools are not diagnostic. Identifying a concern on a behavioral-health screen does not mean that the child has a behavioral, mental, or health problem. It means that the child is at greater risk for having one and should undergo further assessment.
- Weitzman CC and Leventhal JM. Screening for behavioral health problems in primary care. Curr Opin Pediatr. 2006;18:641-648
- Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry. 2003:60:837-844
- Lavigne, JV, Binns HJ, Christoffel KK, Rosenbaum D, Arend R, Smith K, Hayford JR, McGuire PA. Behavioral and emotional problems among preschool children in pediatric primary care: Prevalence and pediatricians' recognition. Pediatrics. 1993;91:649-655
- Brugman E, Reijneveld SA, Verhulst FC, Verloove-Vanhorick SP. Identification and management of psychosocial problems by preventive child health care. Arch Pediatr Adolesc Med. 2001;155:462-469
- Additional reference: 2000 Report of the Surgeon General's Conference on Children's Mental Health: A National Action Agenda
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