BHIPP Bulletin

Volume 7, Issue 11

May 2022

This month's BHIPP Bulletin is a contribution from Carisa Parrish, PhD, Associate Professor in the Department of Psychiatry and Behavioral Sciences at Johns Hopkins School of Medicine, Director of Pediatric Health Psychology, Johns Hopkins Children's Center and BHIPP Consultant. Additionally, this month's BHIPP Resilience Break focused on "Avoiding Provider Burnout" and was presented by Mary Ann Booth, MD, BHIPP Consultant. To view the full session recording, slides, and related resources: click here!

May is Mental Health Awareness month, and includes recognition of National Children’s Mental Health Awareness Day. The pandemic and other adverse events have unfortunately prompted much-needed attention to children’s mental health, including a renewed focus on caregivers’ well-being, over the past few years. Multiple studies have highlighted the high toll that the pandemic has taken on children and families. National experts in child mental health, pediatrics, and children’s hospitals declared a National State of Emergency in Child and Adolescent Mental Health. This was followed by the US Surgeon General announcing a National State of Emergency for Children’s Mental Health for the first time in our nation’s history.

My own work has focused on the critical and powerful role that parents and caregivers can play in supporting children’s emotional health and development. In grown-up world, it can be easy to forget how much kids experiencing stress rely on adults to cope. Social determinants of health result in exposure to stress that increases a child’s risk for mental health problems. In this issue of the BHIPP newsletter, let’s consider how to support parents and caregivers. In addition to emotional support, pediatric providers can provide strategic anticipatory guidance to reduce stress and promote the well-being of children and adolescents.

The Centers for Disease Control (CDC) compiled an update on facts about children’s mental health over the past 10 years (2013-2019). Here is a sample of what they reported:

• In kids ages 3-17 years, ADHD and anxiety were the most common diagnoses
• Older children and teens are at risk for depression and suicide, with 20% of 12-17 year olds experiencing a major depressive disorder, 36% feeling sad/hopeless, and nearly 19% seriously considered attempting suicide

Research by the CDC continues to highlight the troubling prevalence of suicide among youth. Here are some sobering findings:

• During Feb 21, 2021 through March 20, 2021, suspected suicide attempt visits to emergency departments were 50% higher than during the same period in 2019, for girls ages 12-17 years; for boys, it was 3.7% higher.
• Suicide continues to be the 2nd leading cause of death  for youth (10-14 years old).
• Suicide rates vary by group; some groups have a higher risk than others.

Understanding the facts can help mobilize resources. For example, when state officials in Rhode Island identified an increase in suicide attempts involving over-the-counter medications among girls <18 years, they mobilized a multi-agency team to launch a campaign to provide free medication locks and other safety measures to the public. Their campaign is called: Over-the-counter does not mean on the counter. Despite myths to the contrary, suicide is preventable. More than 90% of people who attempt suicide and survive NEVER die by suicide. Preventing children’s access to lethal means of self-harm is a powerful way to keep kids safe.

So what can pediatricians and pediatric providers do? The data are troubling, the topics are delicate, and stressed out kids and teens are everywhere. When we tackle problems with babies and toddlers, we identify the risk (e.g., sleep position) and teach parents how to prevent the problem. We appreciate cultural differences and potential barriers, and with kindness, we support parents to keep kids safe. Mental health protections require our awareness so that we can act mindfully.

Keep kids safe from the top 3 suicide mechanisms

Firearms

Hanging/suffocation

Overdose/self-poisoning

Assess safety, consistently

The number one root cause of suicide is lack of assessment for suicide risk.

Restrict access to lethal means

Prevention helps kids stay safe

Take a mindful pause

Being mindful reduces mistakes of inattention

References and Resources

Assessing and Responding to Youth Suicidal Ideation - BHIPP Quick Tips for Providers

Children's Mental Health Awareness Day - American Psychological Association

National Children's Mental Health Awareness Day - Substance Abuse and Mental Health Services Administration

Children's Mental Health Awareness - National Child Traumatic Stress Network

Attending: Medicine, Mindfulness, and Humanity - Dr. Ronald Epstein, MD

Coronavirus Guide for Parents - UNICEF

Mental Health Awareness Month - American Academy of Child and Adolescent Psychiatry

Tip: check out the “Facts for Families” tip sheets on a wide range of topics (e.g., advocating for your child, when to seek help, how to find help, mental health insurance).

Talking to Children About the Tragedy in Texas

BHIPP released a special edition newsletter in light of the school shooting in Texas with compiled resources for talking to children after mass violence. Share these resources with the families you serve that may be experiencing increased emotional distress during this time.

To access the newsletter, click here.

BHIPP provides free services including care coordination, telephone consultation with child and adolescent psychiatrists, and resource and referral networking to emergency medicine professionals. To learn more about BHIPP Crisis services, click here. To request our services, call 855-MD-BHIPP (632-4477).

The Maryland Governor's Challenge to Prevent Suicide Among Service Members, Veterans and their Families is looking for primary care practices to participate in the pilot launch of the Trained Military Assistance Provider Program and provide feedback on the content's applicability and usefulness in their practice. A dedicated link will be provided to participants in June 2022 to register and access the on-demand training. Interested parties should contact Hannah Rodriguez at [email protected] no later than June 15th.