Primary Care and Child Mental Health

Abstract

Mary, a timid, sweet 8-year-old girl, has vomited intermittently over the last 2 weeks, but only on school mornings. She will not eat on school mornings, cries, says her belly hurts and that she cannot go to school. She has missed 4 days of school. Mary experienced difficulty separating in kindergarten and first grade, but those exacerbations were milder and quickly resolved. She will not visit her friends at their houses. Mary often comes into her parents’ bed during the night. Her mother worries about her poor appetite and abdominal pain. The pediatrician has known the mother, Mrs. Heinz, for years and notes that Mrs. Heinz frequently worries about her children. Now, Mary worries. Mary worries that her mother may die while she is at school. Her mother tries to reassure her, but Mary is not reassured. Her father thinks she just needs to “get over it.” Mary has Separation Anxiety Disorder and Functional Abdominal Pain [80% of children with Functional Abdominal Pain exhibit anxiety [1].]

Mental illness, including suicide, accounts for over 15 percent of the burden of disease in established market economies, such as in the United States. This is more than the disease burden caused by all cancers.

NIMH Statistics