Academic Pediatrics and Children's Mental Health

 I couldn't be happier to see the this month's issue of Academic Pediatrics hit the 'stands' this week, with two important contributions to the literature on children's mental health. First, Guevera et al looked at the importance of co-location as a facilitator of mental health consultation.  It is a survey study, with all of the limitations of a survey, and yet found two really interesting things:  only 17% of those surveyed had on-site consultation available, but those folks were 6.58 times more likely to consult a mental health worker.  (They also found that the busier practitioners were less likely to refer)   This work implies that we need to encourage co-location if we want collaborative practices.  Next,  two important articles about health disparities.  Zuckerman et al  found looked at household language and parental perception of the risk of developmental delay-  they found that parents who spoke primarily Spanish were far less likely to perceive a developmental problem in their children (when adjusted for gender, age, family poverty status, insurance status, parental education of survey respondent).  The authors can't tell whether this means that there are fewer developmental problems in the Latino community, or if the parents in that community are less likely to be concerned about them;  clearly that distinction will have a major impact in how we design our systems.  Finally Coker et al looked at utilization of services in black and white-  African-American kids in the 5th grade were much less likely to use services than were whites, although the problems like ADHD, ODD, conduct disorder and depression were present in both groups in equal measure.  As stated in the accompanying editorial, 

Understanding the reasons for lack of engagement of certain groups that have been traditionally disenfranchised is not simple. Strengthening the therapeutic alliance in primary and specialty care may afford unique opportunities for recovery.

Nice job, Academic Pediatrics.

Full disclosure: As Treasurer of the Academic Pediatric Association, I chair the Journal Committee that provides oversight to Academic Pediatrics, a small but increasingly useful member of the Pediatric journal community.