ECG’s radio show and podcast, Healthcare Upside/Down, offers unfiltered perspectives on what’s working in US healthcare and what’s not. Hosted by ECG principal Dr. Nick van Terheyden, each episode features guest panelists who explore the upsides and downsides of healthcare in the US—and how to make the system work for everyone.
“Growing up happens in a heartbeat. One day you’re in diapers, the next day you’re gone. But the memories of childhood stay with you for the long haul. I remember a place, a town, a house like other houses, a yard like a lot of other yards, on a street like a lot of other streets. And the thing is—after all these years—I still look back, with wonder.”
You may recognize that from the final episode of “The Wonder Years,” which aired in 1993.
I recall being struck by the family unit that we saw in that series—centered on the dinner table, with everyone sitting down for a meal. It feels like a thing of the past. Social media and the mobile phone have done a real number on home life and conversation, not only distracting us with constant alerts and notifications but also painting a picture that suggests everyone else is living some picture-perfect life. A new public health advisory on the risks that social media poses for young people only underscores the seriousness of the matter.
Such misleading portraits only compound a rate of depression that is quite frankly jaw-dropping. Nearly 1 in 5 people in the US live with mental health conditions, and since the pandemic, we’ve seen similar rates in children, with some data suggesting 1 in 3 teenagers report feeling sad or hopeless, and nearly 1 in 5 have seriously considered suicide.
At a time when waiting for an appointment with a behavioral health professional can take weeks or even months, what is a parent to do?
Monika Roots, MD, is a child and adolescent psychiatrist and co-founder, president, and chief medical officer of Bend Health, which offers a virtual-first, family-based mental health platform that facilitates access to coaches, therapists, and psychiatric providers. She joins us on Healthcare Upside/Down to talk about the need for innovative approaches to reach families in need. Below are a few excerpts.
Understanding how young people perceive today’s world.
“It’s important for us as adults to take a step back and think about what kids and teens are going through. It’s very different from when we grew up. They are seeing issues of civil unrest, there’s a threat of nuclear war, there is racial unrest, there’s the pandemic of isolation; and they’re now thinking that mass shootings in school may happen to them. I think there’s also this drive for perfectionism that has really set very high bars for kids and teens. It’s difficult for them to feel like a mistake is okay. In addition to social media and a lot of information they’re exposed to without experience and wisdom, they’re going through a lot.”
The advantages of meeting children where they’re at.
“I used to have a private practice, and it was like seeing a child in a bit of a silo—they would come in dressed very well and be on their best behavior, because their parents wanted them to be on their best behavior. [Bend Health’s model is] around the idea of meeting people where they’re at. Being able to meet them at their pediatrician’s office—that’s where they’re showing up. Also focusing on the schools—how do we support their mental health in the school? And then thinking of home—you learn so much through digital care and seeing [children] online in their environment. Is it chaotic? Is there a lot of stress? When you take care of them in their actual environment, they have the best chance to actually get better.”
A partnership approach.
“We practice pediatric collaborative care. We want to partner with pediatricians because we empathize with what they’re going through. Parents will show up and say, ‘Please, my child has depression,’ and then next time they can see someone is six months. Six months in the life of a child is an eternity. So unfortunately, these pediatricians are put in a situation of fix it now, and they’ll prescribe a medication they’ve not been trained to actually prescribe. But this is the situation we’re in. There’s so much crisis, and [pediatricians] are coming at it with whatever tool they have, which frequently is medication. We really want to partner with pediatricians so we can support them and help families in [this] moment of crisis.”
On the podcast, Dr. Roots talks about phones at the dinner table, social determinants of health, and the lingering effects of the pandemic on adolescent mental health.
Edited by: Matt Maslin
Published June 5, 2023