Developing primary mental healthcare for children and adolescents

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Abstract
Governmental initiatives to enhance child and adolescent mental healthcare are giving renewed impetus to work in primary care. This review identifies and discusses critically new findings in this area. Research reviews and new studies continue to highlight the burden of unidentified and hence untreated psychopathology among children attending primary care. Expression of parental concern appears to provide important help in improving recognition. Shared protocols have been developed for primary care use for clinical conditions such as attention deficit hyperactivity disorder, but adherence to protocols is still limited. Randomized controlled trials have shown the feasibility and efficacy of suitably adapted therapeutic interventions for adolescent depression in primary healthcare and in educational settings. Surveys indicate a significant amount of child and adolescent mental health work by social services in countries such as the UK, and attest to the usefulness of protocols to attend to children in foster care. The new role of primary mental health worker has the potential to help support the interface between primary and specialist child and adolescent mental health services. There is increased interest in further clarifying and enhancing the role of primary care child and adolescent mental health services.