By Rebecca Kincaid, MD
I joined the Gifford pediatrics team in the spring of 2022. I’m excited to live in a community where everybody knows each other. Plus, I love to ski and be outside so I know my husband and I picked the right area to live and work. I am excited to share my enthusiasm with the team and our patients. I am very much an extrovert and love getting to know my patients and their parents, following them through such a long period in their lives.
I am very interested in mental health care, especially for teenagers.
As you grow and develop, even into your early twenties, there’s still plenty of brain development happening. That’s why legally kids are not supposed to drink alcohol until they’re 21 and why there’s a lot of concern about kids smoking cigarettes, vaping and using marijuana products. Those things can affect your mental development even entering adulthood.
My interest in teenage mental health care has to do with some of the experiences I’ve had in my life. It was difficult for me to talk to my parents about certain emotional issues or troubles at school. As a teenager, I did some therapy that helped me work through some of those anxieties getting in the way of my functioning. It made a huge difference for me and got me to where I am today.
One of the wonderful benefits of therapy is just to have a third party, outside of your emotional support bubble (parents, siblings and friends). Someone who’s not emotionally connected or tied to you, to help you work through some of those difficult things is really important.
For me, it’s about being very warm, friendly and clear that there’s no judgment.
Teenagers specifically are going through a time in their lives when they’re appropriately separating themselves from their families. They’re emotionally preparing for when they leave the house and have to take care of themselves. There’s a natural pull away from the family as they develop a sense of independence. Because of this, if they are struggling, it may be tough for loved ones to figure out how they can help. That’s why it’s so important they have a third party like a therapist or a pediatrician that they know and trust. It’s just an extra person, outside of the family, to talk to about the complicated
stuff. Everybody needs at least one trusted adult they can ask anything to and not feel judged or worry about getting in trouble. If that’s not a parent, friend or loved one, I take it as an honor and privilege to be that extra trusted adult in their life.
I try to spend a few minutes talking with them without their parents, because sometimes there are embarrassing things they don’t want to say in front of them. I always tell them, you can say anything and I don’t have to tell your mom and dad as long as I feel like you aren’t going to hurt yourself or hurt someone else. If safety is involved, I have to get a parent involved. But, I think just being very honest from the beginning about what’s private and what’s not helps teenagers feel safe.
Sometimes it takes several visits to get to the root of the issue. If I’m particularly worried about a patient’s mental or physical health and I feel like I haven’t quite earned their trust yet, after the first visit I’ll say, “Let’s follow up on this in a few weeks,” and have them return so we can continue to establish that relationship. All while making it clear to the teen that I care and want to make sure they get better.
I like to refer to annual physicals as wellness visits.
I do find that it’s kind of tough seeing teenagers consistently. We are used to taking our little kids in for regular appointments. Up until kindergarten, we see kids frequently. But after kindergarten, and especially into teenage years, those visits start to drop off. Kids don’t come in every year for their wellness visits because they’re busy. Between sports or extracurricular activities, it’s hard to take time off to come in and see their doctor. But even though life gets in the way, it is still so important to keep your kids coming in every year for their wellness visit, because that wellness visit continues the established relationship and connection with the teen and their family. We also need to identify issues that may be a concern to their parents and how deep those issues go. When it comes to mental health care, screening all of our teenagers for depression, anxiety, thoughts of self-harm and suicidality is incredibly important. A wellness visit is the best time to start talking about those kinds of things. Calling an annual physical wellness visit encompasses more of the whole person, which includes physical and mental health needs. One great thing about working in primary care at Gifford is that there is a large spectrum of health concerns we cover.
If we see a lot of kids with lead poisoning in the community, we make adjustments and do more lead screenings so that we’re catching kids before they get sick. The same is happening here with mental health. A rapidly growing amount of kids in this country have depression and anxiety. Suicide is one of the leading causes of death in teenagers. So, we’ve adjusted and are screening every patient for mental health care issues when they come in for their wellness visit. I have been surprised to see children filling out screening questionnaires that say they’ve thought about harming themselves several times in a week. Their parents are shocked by this as well. They have no idea. When we start getting into it, there’s a lot that these kids and teens aren’t telling people and we can help prevent it from reaching a severe point if we screen. If we don’t ask, a lot of kids are just going to keep it to themselves.
I think teens can bounce back from the mental toll the pandemic has taken on them.
I’ve felt very sad for many of my teenage patients in high school. This is the most important time socially for a teenager because they’re creating long-term social bonds and friendships. Kids missing out on not having proms, graduations and celebrations of these major milestones in their lives have been sad. One thing I feel strongly about is that as adults, we still have to model for our children what it is to be part of a community and what it is to be a family so that we can help each other. I think that if we can come together as a community and show that we care about each other and can step up and help each other, we will heal as a community and the kids can recover from all the things they’ve missed. Kids are resilient, but they still need help.
Summer is the perfect time to have your child or teen see their pediatrician for a wellness visit. I am currently taking on new patients. Please give us a call at (802) 728-2420. For more information, you can visit our Primary Care/Pediatrics page by clicking here.
