“Focusing on Children’s Mental Health. Mental disorders often receive less attention than do other illnesses, and diagnosis of mental ill health in children can be especially challenging. In the USA, 21% of children are thought to meet criteria for diagnosis of a mental illness, with a further 16% showing some impairment; yet only about 20% of children who could benefit from mental health or drug use services receive them. Recognising the seriousness of this situation, the Amerian Academy of Pediatric Task Force on Mental Health, led by pediatrician Jane Meschan Foy, has published a series of recommendations aimed at improving community mental health services.

In view of the obstacles to providing effective primary mental health care for children, a substantial part of the Task Force’s report is devoted to preparative and organisational work at community and practice level. Educationalprogrames in child psychiatry are being designed for primary care clinicians. Emphasis is to be placed on building relationships with schools, mental helth services, and social care providers, to enable consistent and appropriate care to be provided to families throughout childhood, from the early age when a pervasive developmental disorder might become manifest to adolsescence when drug use services could be needed. The series includes algorithms for primary care focused on pediatric mental health, including routine screenng for mental heath problems.

Althought the risk of leaving mentally well children with an inappropirate burden of medicalisation and stigma must be kept to a minimum, the American Academy of Pediatrics’ initiative is welcome and timely—-evidence suggests that early intervention for children with behavioral problems is effective. The UK’s Healthy Child Program emphasis parental disadvantages, including low income and mental health problems, which place children at risk. In the USA, the system of reimbursement for health care provision can make it difficult for primary care physicians to provide effective pediatric mental health care. As reform brings uninsured Americans into the domain of health insurance, evaluation of mental health treatment and outcomes in children will be key to the success of the Academy’s initiative.”

Of those who die from suicide, more than 90% have a diagnosable mental disorder

(Source: NIMH, Suicide in the U.S. Statistics and Prevention)