Primary care
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Stepped-care (SC) models have been adopted in primary care settings as a method for treating mental health conditions within primary care. In a SC model, a patient's symptoms are assessed, and an intervention is prescribed that matches the severity of symptoms. Thus, the SC model offers a variety of steps and levels of treatment that range from low to high intensity. Progression in treatment is monitored on a weekly basis and patients are stepped up or down in level of care depending on their clinical response to the intervention.
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Social media and technology use has increased over the past several years. Inappropriate use or overuse of social media and internet can lead to increase in mental health disorders. ⋯ Parents should be educated on keeping open lines of communications with their teens to help navigate appropriate technology behaviors and put proper boundaries in place. Counseling interventional programs and educational programs can be utilized to help prevent cyberbullying and treat those who have been affected.
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Attention-deficit hyperactivity disorder is a neurodevelopmental disorder involving dysregulation of multiple neural circuits, manifesting in symptoms such as inattention, impulsivity, and hyperactivity. Diagnosis requires onset of symptoms before age 12 years. ⋯ Management involves pharmacologic agents, such as stimulant and/or nonstimulant medications, and providers should monitor closely for any adverse effects. Nonpharmacologic interventions may be implemented and can be used in conjunction with pharmacotherapy, although medications should be at the forefront of treatment.
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Late-life depression is common but underrecognized and undertreated leading to significant morbidity and mortality, including from suicide. The presence of comorbidities necessitates screening followed by a careful history in order to make the diagnosis of depression. Because older adults tend to take longer to respond to treatment and have higher relapse rates than younger patients, they benefit most from persistent, attentive therapy. Although both pharmacotherapy and psychosocial treatments, or a combination of the two, are considered as the first-line therapy for late-life depression, most data support a combined, biopsychosocial treatment approach provided by an interdisciplinary team.
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Review
ACE: "What Happened to You" Screening for Adverse Childhood Experiences or Trauma-Informed Care.
Trauma is common within the United States. It is important for individuals to understand how trauma may affect their health and how trauma in childhood can have adverse effects on a child's development and health. ⋯ When screening for trauma, it is important to take a family-centered approach and provide appropriate referrals if a patient screens positive for trauma. Primary care providers are essential players in addressing and preventing trauma.