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Pediatr Rheumatol Online J. 2017 Dec 28;15(1):85. doi: 10.1186/s12969-017-0214-9.

Mental health care for youth with rheumatologic diseases - bridging the gap.

Author information

1
Division of Pediatric Rheumatology, Vanderbilt University Medical Center, Monroe Carell Junior Children's Hospital at Vanderbilt, 2200 Children's Way, Doctor's Office Tower 11240, Nashville, TN, 37232, USA. alaina.m.davis@vanderbilt.edu.
2
Division of Pediatric Rheumatology, Albert Einstein College of Medicine, Children's Hospital at Montefiore/ Albert Einstein College of Medicine, 3415 Bainbridge Avenue, Bronx, NY, 10467, USA.
3
Section of Pediatric Rheumatology, Riley Hospital for Children at Indiana University Health, 705 Riley Hospital Dr, Indianapolis, IN, 46202, USA.
4
Division of Rheumatology, The Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South St, Ste 10253, Philadelphia, PA, 19146, USA.
5
The Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, Center for Pediatric Clinical Effectiveness, 2716 South St, Ste 10253, Philadelphia, PA, 19146, USA.
6
The Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, PolicyLab, 2716 South St, Ste 10253, Philadelphia, PA, 19146, USA.

Abstract

Youth with rheumatologic diseases have a high prevalence of comorbid mental health disorders. Individuals with comorbid mental health disorders are at increased risk for adverse outcomes related to mental health as well as their underlying rheumatologic disease. Early identification and treatment of mental health disorders has been shown to improve outcomes, but current systems of care fall short in providing adequate mental health services to those in need. Pediatric rheumatologists are uniquely positioned to provide mental health screening and intervention for youth with rheumatologic diseases due to the frequency of patient encounters and ongoing therapeutic relationship with patients and families. However, additional training is likely required for pediatric rheumatologists to provide effective mental health care, and focusing efforts on providing trainees with mental health education is key to building competency. Potential opportunities for improved mental health education include development of clinical guidelines regarding mental health screening and management within pediatric rheumatology settings and incorporation of mental health didactics, workshops, and interdisciplinary clinic experiences into pediatric rheumatology fellowship curricula. Additional steps include mental health education for patients and families and focus on system change, targeting integration of medical and mental health care. Research is needed to better define the scope of the problem, determine effective strategies for equipping pediatric rheumatologists with skills in mental health intervention, and develop and implement sustainable systems for delivery of optimal mental health care to youth with rheumatologic diseases.

KEYWORDS:

Medical education; Mental health; Pediatrics; Rheumatologic diseases

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