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RESOURCES FOR PRIMARY CARE CLINICIANS: PEDIATRICIANS, FAMILY PHYSICIANS, NURSE PRACTITIONERS, PHYSICIAN ASSISTANTS, AND GENERAL PRACTITIONERS
"GLAD-PC" refers to GuideLines for Adolescent Depression - Primary Care. This guideline was developed through an extensive process of evidence-based literatures reviews, a survey of experts, a consensus conference with over 80 participants (including primary care clinicians, child psychiatrists and psychologists, policy makers, and depression researchers), a lengthy writing process that entailed repeated iteration and progressive refinement to produce a final version, guideline and toolkit endorsement by nearly 2 dozen leading US and Canadian professional and advocacy organizations (including the American Academy of Pediatrics and the American Academy of Child & Adolescent Psychiatry), the creation of a free, user-friendly "toolkit" for use by primary care clinicians managing adolescent depression, and final publication in the journal Pediatrics (Zuckerbrot R, Cheung A, Jensen PS, Laraque D, Stein REK and the GLAD-PC Cooperative Group. Guidelines for Adolescent Depression in Primary Care. I. Assessment and Initial Management. Pediatrics, 120:e1299-e1312, 2007; and Cheung A, Zuckerbrot R, Jensen PS, Laraque D, Stein REK and the GLAD-PC Cooperative Group. Guidelines for Adolescent Depression in Primary Care. II. Treatment, Management, and Follow-up. Pediatrics, 120:e1313-e1326, 2007).
The T-MAY guideline was developed by a comparable process as the GLAD-PC guideline. This guideline was developed to help primary care clinicians and mental health specialists work closely together in the optimal management of the all too common, but very difficult problem of aggression in children and youth. The two-part T-MAY guideline (one paper on assessment, and treatment) is in press in the journal Pediatrics (Knapp P, Chait A, Pappadopulos E, Crystal S, Jensen PS, & the T-MAY Steering Group. Treatment of Maladaptive Aggression in Youth (T-MAY). CERT Guidelines I. Family Engagement, Assessment & Diagnosis, and Initial Management. Pediatrics, in press; and Scotto Rosato N, Correll CU, Pappadopulos E, Chait A, Crystal S, Jensen PS, & the T-MAY Steering Group. Treatment of Maladaptive Aggression in Youth (T-MAY). CERT Guidelines II. Psychosocial Interventions, Medication Treatments, and Side Effects Management. Pediatrics, in press).
Despite well-documented levels of child mental health disorders in our nation’s youth, studies have repeatedly shown that most children with mental health problems are not identified and do not receive needed care. These children are not readily identified or referred for treatment due to concerns about stigmatization as well as a pervasive lack of awareness/knowledge among the general public, providers, and parents. Therefore, there is a need for consistent messages based on evidence-based information concerning what are the most pertinent early warning signs of mental illness; how to determine which children are at risk, and what steps to take when children exhibit such early warning signs. The "Action Signs" were developed to address this need. With funding from the Center for Mental Health Services and NIMH, REACH staff (P. Jensen, while at Columbia University) worked with national experts from the fields of epidemiology, public policy, and advocacy to identify clear, easily understood “action signs” that if present in a child, may warrant professional attention. Eleven action signs were identified, and then further vetted for clarity of language with focus groups of primary care physicians, teachers, parents, and youth, and are in press in the journal Pediatrics (The Overlook and Underserved: Action Signs to Identify Children with Unmet Mental Health Needs. Pediatrics, in press). The final "action signs" are a powerful, evidence based communication tool to assist doctors in teaching parents and teachers to more easily understand when a child requires a medical evaluation.
Click here to download the toolkit.
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