Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • AAP Policy
    • Topic/Program Collections
    • Policy
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effect on Pediatric Health
    • More Collections...
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Alerts
    • Table of Contents
    • Insights
  • AAP Career Center
  • Subscribe
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • AAP Policy
    • Topic/Program Collections
    • Policy
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effect on Pediatric Health
    • More Collections...
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Alerts
    • Table of Contents
    • Insights
  • AAP Career Center
  • Subscribe

Journals Blog

  • Visit AAP News on Facebook
  • Follow AAP News on Twitter

Are Brief Treatments for Adolescents with Mental Health Issues and Substance Use Effective?

Rachel Y. Moon, MD, Associate Editor, Digital Media
December 29, 2020

The prevalence of mental health problems and substance use in adolescents has increased in recent years – and certainly we have seen skyrocketing increases in mental health problems during the pandemic. There are also some data that, in certain adolescent populations, the use of some substances (alcohol, cannabis) has also increased during the pandemic. 1

Many pediatricians and primary care clinicians have not received much training in treating mental health problems and so may feel uncomfortable with these patients.

Screening, brief intervention and referral to treatment (SBIRT) is an approach that clinicians have used for adolescents with substance use issues. It includes screening using validated surveys, a brief motivational interviewing intervention, and a protocol for referring patients with more severe symptoms to behavioral treatment. Trials using this approach have demonstrated short-term positive impact, both on decreasing substance use and improving mental health problems.

Now, in a Pediatrics article being released this week, Parthasarathy et al report on 3-year outcomes in adolescents in the Kaiser-Permanente health system who screened positive for both substance use and recent mood symptoms (10.1542/peds.2020-009191). These adolescents had been randomized to receive one of the following:

  • SBIRT by a pediatrician
  • Referral to a behavioral clinician for SBIRT
  • Usual care

For this analysis, adolescents randomized to SBIRT by a pediatrician or behavioral clinician were compared to those who received usual care. There were a total of 185 adolescents in the SBIRT group and 104 in the usual care group.

Adolescents who received SBIRT had:

  • Lower odds of a diagnosis of depression at 1 year (OR 0.31; 95% CI 0.11, 0.87) and at 3 years (OR 0.51; CI 0.28, 0.94)
  • Lower odds of a diagnosis of substance use at 3 years (OR 0.46; 95% CI 0.23, 0.92)
  • Fewer visits to the emergency department (RR 0.65; 95% CI 0.44, 0.97)

These results are encouraging, but it should be noted that this study was conducted in a health system that provides behavioral health. Most pediatric primary care practices do not have embedded behavioral health providers. Additionally, this may be more difficult in practices that care for patients who are uninsured or underinsured for either physical or behavioral health and may not have access to such care. Many pediatricians and other primary care providers are receiving additional training in treating patients with mental health issues through CME offerings (one example is the REACH Institute’s Patient-Centered Mental Health in Primary Care (PPP) program), and this article may help to convince you of the benefit of doing so if you haven’t already.

Reference:

1. Dumas TM, Ellis W, Litt DM. What Does Adolescent Substance Use Look Like During the COVID-19 Pandemic? Examining Changes in Frequency, Social Contexts, and Pandemic-Related Predictors. J Adolesc Health, 2020 pp. 354-361.

  • Legal Performance-Enhancing Substances and Substance Use Problems Among Young Adults
  • Brief Behavioral Interventions for Substance Use in Adolescents: A Meta-analysis
  • Trajectories of Maternal Postpartum Depressive Symptoms
  • Facebook
  • Instagram
Copyright © 2020 American Academy of Pediatrics

Advertising Disclaimer »

Download PDF
Share
Are Brief Treatments for Adolescents with Mental Health Issues and Substance Use Effective?
Rachel Y. Moon, MD
December 29, 2020
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Email Blog Post

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Are Brief Treatments for Adolescents with Mental Health Issues and Substance Use Effective?
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Digital Edition Current Issue
  • Latest Daily News
  • Archives
  • Collections
  • Columns
  • Advertising
  • Subscribe to AAP News Magazine
  • Terms of Use
  • Privacy Statement
  • FAQ
  • Contact Us
  • 2021 AAP Journals Catalog
  • Pediatrics
  • Pediatrics in Review
  • Hospital Pediatrics
  • NeoReviews
  • AAP Grand Rounds
  • AAP Career Center
  • shopAAP
  • AAP.org
  • AAP News
  • Visit AAP News on Facebook
  • Follow AAP News on Twitter
American Academy of Pediatrics

© 2021 American Academy of Pediatrics