In 2004, the American Academy of Pediatrics (AAP) Board of Directors appointed the Task Force on Mental Health and charged it to assist pediatricians and other primary care clinicians* in enhancing the mental† health care they provide. The task force determined that 3 goals were important to accomplishing its purpose:
The task force recommended addressing the goals sequentially; that is, before implementing the clinical process proposed in this report, clinicians need to (1) accomplish system changes such as payment for mental health services provided by primary care clinicians1,2 and development of clinical relationships with mental health specialists,3 (2) achieve mental health competencies,4 and (3) enhance their office systems by applying chronic care methods to the care of children with mental health problems.5 Strategies the task force used to address these goals are summarized in the introduction to this supplement.6
In this...
Comments
Take care of the pediatrician, to take care of the child
Sir, The American Academy of Pediatrics Task Force on Mental Health, has published a series of recommendations aimed at improving community mental health services (1). The recommendations emphasized four targets for an effective action on mental health: family, school, children, and environment. We would have enclosed a fifth category: pediatricians. In facts, much should be done to improve doctors’ - and namely pediatricians' - opinion on disability and their perception of disabled children’s quality of life, as shown by recent reports (2,3,4): a bad opinion about handicap can influence their action. Recently, we administered a questionnaire to 130 neonatologists who work in two Italian regions: Tuscany and Veneto; they had to respond anonymously to a series of questions to assess their psychological background and their burnout. We were surprised that, among other answers, 56.4% of them declares that it is not worth living with a mental disability; and that 11.1% of them (and this is not a negligible rate) declares that it is not worth living with a physical disability. We incidentally report that burnout, age or gender do not influence these answers, while among those who consider religion important in their life, these rates are significantly lower(personal unpublished data). These data should be seriously taken into account: if doctors have a negative insight on disability, they can negatively influence patients’ and parents’ choices and expectations, and might influence their own behavior(5).
REFERENCES: 1. Foy JM, Kelleher KJ, Laraque D; American Academy of Pediatrics Task Force on Mental Health. Enhancing pediatric mental health care: strategies for preparing a primary care practice. Pediatrics. 2010 Jun;125 Suppl 3:S87-108. 2. MENCAP: Death by indifference. Report. Available at the following URL: http://www.mencap.org.uk/document.asp?id=284 3. Council for disabled children: Disabled children's manifesto for change. Available at the following URL: http://www.ncb.org.uk/edcm/manifesto/downloads/dc_manifesto.pdf 4. Janse AJ, Sinnema G, Uiterwaal CS, Kimpen JL, Gemke RJ. Quality of life in chronic illness: children, parents and paediatricians have different, but stable perceptions. Acta Paediatr. 2008 Aug;97(8):1118-24. 5. Bellieni CV, Buonocore G. Flaws in the assessment of the best interests of the newborn. Acta Paediatr. 2009 Apr;98(4):613-7.
Carlo V. Bellieni (Siena), Rosanna Ciampa (Padua) , Pier Luigi Righetti (Padua), Giuseppe Buonocore (Siena).
Conflict of Interest:
None declared