Affective disorders in children and adolescents: Addressing unmet need in primary care settings

Affective disorders are common among children and adolescents but ma?, ofte n remain untreated, Primary cai-e providers could help fill this gap becaus e most children have primary care. Yet rates of detection and treatment for mental disorders generally are low in general health settings, owing to mu ltiple child and family, clinician, practice, and healthcare system factors . Potential solutions may involve 1) more systematic implementation of prog rams that offer coverage for uninsured children; 2) tougher parity laws tha t offer equity in defined benefits and application of managed care strategi es across physical and mental disorders; and 3) widespread implementation o f quality improvement programs within primary care settings that enhance sp ecialty/primary cal e collaboration, support use of care managers to coordi nate care, and provide clinician training in clinically and developmentally appropriate principles of care for affective disorders. Research is needed to support development of these solutions and evaluation of their impacts. (C) 2001 Society of Biological Psychiatry.