Treating Teens ‘Where They Live’: Researchers find that primary care may be the best route
How can we improve the mental health of depressed youth, a critical population to target, given their relative absence from the mental health sector? That was the question posed by clinicians at a Southern California community mental health clinic who found their statistics disconcerting: Depressed teenagers were underrepresented in their clinic, and those that had been treated were found to be severely depressed at two-year follow-up. Committed to a turnaround, the clinicians assessed the limitations of their own therapeutic approaches, created a new “practice-friendly” cognitive-behavioral treatment (CBT) manual to ensure consistency of care, formed a close partnership with an urban outpatient clinic, and incorporated a measurement system to standardize data collection. They launched a controlled trial to compare the effectiveness of old and new treatment approaches, and benefited from a high rate of family participation in the study.
Yet, despite these efforts, they were surprised when only 39 of 349 adolescents met criteria for depression. The results, published in Administration and Policy in Mental Health and Mental Health Services Research, prompted a review and system analysis of where depressed youth “live”, determining that the primary care/pediatric setting should be the locus of a mental health care system for adolescents. While barriers remain (notably reimbursement), researchers concluded that “finding the fit” that efficiently connected depressed teens with a system of care in a setting compatible with where they might be likely to seek care would ultimately ensure that more teens receive the help they need.
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