When a child or adolescent reports “I hear voices”, it naturally causes concern for parents and healthcare clinicians alike. The immediate question is “what is the cause”? This, followed by “what to do about it?” An optimal approach to assessing “voices” in youth includes a culturally sensitive, trauma-informed, and family-centered philosophy. The metaphysical experience of […]
Medi-Cal Enhanced Care Management Program 9/8/23
Addressing MEDI-CAL ENHANCED CARE MANAGEMENT (ECM) Today’s newsletter describes California’s new Medi-Cal Enhanced Care Management program, a resource for obtaining Community Supports that can assist individuals in overcoming a variety of life challenges that contribute to worsening of healthcare problems. THE ISSUE: Medi-Cal members with unmet social needs are at higher risk of poor […]
Bullying 8/22/23
For many children, the anxiety of a new school year is not just one of nervous excitement about a new year beginning. For many it may be a youth’s severe concern about the risk of victimization as a result of peer bullying. Awareness of the potential that a youth may be experiencing bullying should be […]
Co-Morbidity Between Intellectual Disability and Psychiatric Symptoms 7/25/23
The presence of Intellectual Disability (ID) increases the risk for co-occurring psychiatric disorders in child, adolescent, adult and geriatric patients. Behavioral and emotional problems are three times more likely to occur in these groups and they are frequently not recognized or appropriately treated. This said, problematic behaviors and emotions in this population may also be […]
Disruptive Behavior: Is It Anxiety or Something Else? 7/11/23
It is common for children and families to present to their primary care providers with concerns about behavioral problems and/or wanting to rule out ADHD. The typical presenting problem is severe temper tantrums or disruptive behavior in school. In some of these cases, the appropriate diagnosis is ADHD or another disruptive behavior disorder and treatment […]
How Should We Treat Grief & How to Distinguish it from Depression? 6/8/2023
Grief as a response to significant loss is normal. However, the mourning that occurs during periods of grief has features that overlap with depression and anxiety. This makes it occasionally confusing to distinguish one from the other and to know how to help patients heal appropriately. In previous DSM versions, mental health professionals were to exclude […]
Psychotropic Polypharmacy in Children and Adolescents 5/22/23
The challenges of addressing behavioral health problems in children and adolescents remain an ongoing dilemma because of the high incidence of youth with significant problems, coupled with the ongoing difficulties for families and providers in accessing and optimizing care in a coordinated and comprehensive manner. Particularly in the arena of prescribing psychotropic medications, there are concerns […]
Cannabis Use: Risks and Resources 5/3/23
A recent report from researchers in Colorado presents concerning data about the impact of cannabis legalization with findings of a significant increase of marijuana use in teens and young adults who have committed suicide. Analyzing data from 2014 when cannabis was legalized in the state through 2017 showed the number of individuals committing suicide who […]
ADHD Treatment Concerns in Adolescents 4/19/23
This newsletter is based on a clinical consultation asking about adjusting ADHD treatment in an adolescent based on concerning side effects. This is probably a scenario that is common for many primary care providers, so we thought it would be useful to present the question and clinical discussion in this format. Clinical Question: This is […]
4 Traits That Put Kids at Risk for Addiction 4/6/23
The looming question of “What can we do to curb the addiction crisis facing our youth?” has remained unanswered because there is no single way to reduce the drug and alcohol epidemic in our society. Traditional anti-drug education in schools that focuses on scare tactics and the message “Just Say No”, has been found to be […]