Recognizing and responding to adolescent depression.
We have seen that depression is increasingly recognized as a problem which affects adolescents as well as adults. Race by itself is not a factor which increases vulnerability to depression, but the multitude of sociodemographic, biological, and personal factors contributing to the development of depression are not fully understood. Research is needed to better understand how these factors interact in order to better develop prevention strategies and treatment modalities. With regard to treatment, adolescents are truly underserved. There is an awkward fit between the traditional mental health system and the developmental needs of adolescents. Unlike the majority of depressed adults who receive some treatment from general practitioners and medical clinics, adolescents do not tend to visit their pediatricians when they are depressed. One proposed solution is the adolescent comprehensive health care clinic providing a holistic approach to assessment, early intervention, and collaborative treatment between primary provider and mental health worker. Data from our adolescent program suggest that this approach has been successful in dealing with the problem of depression, especially in its early stages. Again, more research is needed to support these preliminary findings, but we believe that the adolescent comprehensive health care approach can be an effective, efficient way of addressing the health needs, mental and physical, of our teens at risk. Federal money for research must be made available, liberalization of health insurance must occur, and state-sponsored services must be developed so that these programs can be made more effective and can be brought to more of the adolescents who need them.
Department of Pediatrics, St. Francis Hospital and Medical Center, Hartford, CT 06105-1299.
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D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D000296:Adolescent Psychiatry / Q000379:methods*; D003237:Connecticut; D003866:Depressive Disorder / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D006297:Health Services Accessibility / Q000592:standards; D006785:Hospitals, University; D006801:Humans; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*