Anna Scandinaro
Primary care practitioners are often called upon to differentiate normal from abnormal irritability, but little education is provided to prepare them to do so. Assessing the mental health of a child is a challenging task. This study used appreciative inquiry to answer the question, “How do family medicine practitioners assess and treat irritability in school aged children?” To gain an initial perspective on how practitioners in Family Medicine (FM), Pediatrics (PED), and Psychiatry (PSY) evaluate and treat school-aged children, 17 volunteers participated in in-depth interviews. The participants in primary care expressed frustration over the lack of time and specialized knowledge they had to accurately assess children, even though they were often the first clinician consulted when problems arose. There were clear and sometimes contradictory differences between how practitioners with a general vs. specialized practice assessed mental health status in the clinic setting. In addition, input on treatment approaches revealed that medication prescription was more common in primary care and therapy preferred by the PSY participants. School referrals were common pathways to the FM and PED clinic, where practitioners often focused on assessing functional status to assess normal vs. abnormal irritability. Based on the initial assessment, FM and PED participants often referred the child to more specialized treatment, particularly when complex medication prescription was involved.