How to find out what type of mental health care your child needs

It can be confusing for parents to navigate the mental health system and know what type of care their child needs, according to Greg Ramey, pediatric psychologist and executive director for the Center for Pediatric Mental Health Resources at Dayton Children’s.

Not everyone needs to see the same type of doctor for mental health, especially as a shortage of psychiatrists can mean long wait times for an appointment.

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Dayton Children’s Mental Health Resource Connection is a referral line where trained staff help parents figure out what type of care their child needs.

They don’t just give out a list of providers in your zip code, Ramey said, but actually spend time on the phone to learn more about the child and their family situation.

“The vast majority of our referrals can be very competently cared for by clinicians at the Master’s (degree) level,” Ramey said, referring to counselors and social workers. “Those folks are very skilled at dealing with a myriad of problems, having to do with discipline issues, family dynamics and parenting.”

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The next level up is the doctoral level, which is psychologists like Ramey, who has a Ph.D. They are skilled at treating patients with anxiety, depression, severe eating problems and severe conduct problems.

“These folks have more training in the diagnosis and treatment of children with mental disorders,” he said.

Psychiatrists have the highest level of training — a medical degree — and can prescribe medication.

“Their expertise is in the medical management of psychiatric problems,” Ramey said.

A psychiatrist is needed in an acute, serious situation where there is not time to do intense therapy, he said, such as a suicidal individual.

“You need to kind of jump start them on something that will help them be amenable to therapy,” Ramey said.

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Psychiatrists also treat those with psychosis — which involves a break with reality, or experiencing delusions or hallucinations.

“That’s an area where medication is absolutely essential,” Ramey said. “There’s really not a talking therapy for youngsters with severe disorders like that.”

Most of the time children who are on medication are also being seen by a therapist or psychologist, he said.

“Because child psychiatrists would be the first to tell you that medication is a means to an end and not a goal in itself,” he said. “It’s a way to help kids get better, with the goal being eventually for them to not be on medication forever.”

Nurse practitioners also can prescribe medication and help fill in the gaps where there is a shortage of psychiatrists. Multiple nurse practitioners can work under one supervising psychiatrist.

“There will never be enough trained child psychiatrists to meet the need,” Ramey said.

He suggested that families utilize the Mental Health Resource Connection referral line to get matched with the best type of professional for their particular situation. Parents often call asking for a psychiatrist, but by the end of the call, they’ve discovered their child actually needs to see a counselor.

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“We don’t want families and children turning to medication as a way to solve an underlying mental health issue,” he said. “Medication is not going to solve an abuse situation … We’re not going to put a 3-year-old on medication because they are having temper tantrums.”

Contact the Dayton Children’s Mental Health Resource Connection at 937-641-4780 from 8:30 a.m. to 5 p.m. Monday through Friday.

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