International wars and conflict enhance our sense of danger and may cause worry about what will happen in the days and weeks ahead. A range of emotions (e.g., outrage, fear, anxiety and sorrow) are common and can change as the situation evolves. They can create safety concerns for the region that reach into our own […]

When a child or adolescent reports “I hear voices”, it naturally causes concern for parents and healthcare clinicians alike. The immediate question is “what is the cause”? This, followed by “what to do about it?” An optimal approach to assessing “voices” in youth includes a culturally sensitive, trauma-informed, and family-centered philosophy. The metaphysical experience of […]

Addressing MEDI-CAL ENHANCED CARE MANAGEMENT (ECM) Today’s newsletter describes California’s new Medi-Cal Enhanced Care Management program, a resource for obtaining Community Supports that can assist individuals in overcoming a variety of life challenges that contribute to worsening of healthcare problems.    THE ISSUE:  Medi-Cal members with unmet social needs are at higher risk of poor […]

For many children, the anxiety of a new school year is not just one of nervous excitement about a new year beginning.  For many it may be a youth’s severe concern about the risk of victimization as a result of peer bullying.   Awareness of the potential that a youth may be experiencing bullying should be […]

Grief as a response to significant loss is normal. However, the mourning that occurs during periods of grief has features that overlap with depression and anxiety. This makes it occasionally confusing to distinguish one from the other and to know how to help patients heal appropriately. In previous DSM versions, mental health professionals were to exclude […]

The challenges of addressing behavioral health problems in children and adolescents remain an ongoing dilemma because of the high incidence of youth with significant problems, coupled with the ongoing difficulties for families and providers in accessing and optimizing care in a coordinated and comprehensive manner.  Particularly in the arena of prescribing psychotropic medications, there are concerns […]

A recent report from researchers in Colorado presents concerning data about the impact of cannabis legalization with findings of a significant increase of marijuana use in teens and young adults who have committed suicide.   Analyzing data from 2014 when cannabis was legalized in the state through 2017 showed the number of individuals committing suicide who […]

This newsletter is based on a clinical consultation asking about adjusting ADHD treatment in an adolescent based on concerning side effects. This is probably a scenario that is common for many primary care providers, so we thought it would be useful to present the question and clinical discussion in this format. Clinical Question: This is […]

Obsessive-Compulsive Disorder (OCD) is a psychiatric condition characterized by obsessive and distressing thoughts that leads compulsive rituals that may lower one’s stress level (1). The prevalence of pediatric OCD has been noted to be between 1-3% (2) and in US adults, the lifetime prevalence of OCD has been noted to be 2.3% (3). Although OCD […]

In our ever-evolving multicultural society, it is critical for providers to engage with patients and their families with sensitivity and empathic awareness of their social and historical backgrounds.  While the specifics of each group’s experiences and needs will vary, providing effective quality care should reflect congruence with the practices described herein. Partnering with American Indian […]