Diagnosis & Treatment
Diagnosing mental health issues in children can be challenging because many behaviors seen as symptoms of mental disorders, such as shyness, anxiety or emotional outbursts, can occur as a normal part of a child's development. Behaviors become symptoms when they occur often, last a long time, occur at an unusual age or significantly disrupt the child's and/or family's ability to function.
A comprehensive evaluation is necessary to diagnose most emotional, behavioral or developmental disorders. This involves a complete medical history and physical examination to rule out any underlying medical conditions or medication side effects. A mental health provider uses interview and assessment tools to evaluate a child for a mental health disorder. This interview includes gathering details about the type and duration of a child’s symptoms, observation of the child’s attitude and behavior, and reports from parents, teachers and other adults – a careful process that guides treatment decisions.
Outpatient Treatment Options
Our core outpatient services, including evaluations, consultation and treatment, are provided in our Child and Adolescent Psychiatry Clinic at 66 Bramhall Street on the Maine Medical Center/Barbara Bush Children’s Hospital campus. To make child mental health services more accessible, we also offer two grant-funded programs in collaboration with pediatricians in southern and mid-coast Maine:
- The Child Psychiatric Access Project (CPAP) guarantees participating pediatricians timely phone access to a child psychiatrist during regular office hours to troubleshoot and, if a patient needs to be seen by a mental health professional, the ability to make these arrangements promptly. There are six pediatric practices participating in CPAP, which currently is a pilot program that also includes periodic educational sessions to help caregivers better understand child mental health issues and the treatment resources available.
- Primary Care - Mental Health Integration Project is another important initiative aimed at improving access to mental health services. This project pairs primary care physicians with a behavioral health provider to make mental health expertise more readily available and facilitate treatment in the primary care setting. Currently, nearly 50 practices including pediatric and family medicine practices, both in the Maine Medical Center Physician-Hospital Organization (PHO) and elsewhere throughout the state, participate in this program.
Our clinic is also part of Maine Mental Health Partners, a nonprofit organization whose mission is to build and sustain a high-quality, integrated system of mental health providers across the southernmost 11 counties of Maine. The goals of this MaineHealth-sponsored system are to ease access to care for clients and to reduce the cost of care delivery by sharing resources among providers. One innovative service advanced by this organization is telepsychiatry, using interactive teleconferencing to evaluate patients in areas not served by onsite mental health providers.
Our Portland Identification and Early Referral (PIER) Program focuses on early intervention for youth at risk of psychotic illness, including schizophrenia and bipolar disorder. The state's only community-based early-intervention program for children and adolescents at risk for these serious mental illnesses, the PIER program is designed for individuals between the ages of 12 and 35, who are the most responsive to early mental health treatment. Through a trained referral network of more than 2,500 community professionals, as well as an expert clinical team that engages children and adolescents and their families in treatment, PIER seeks to stem the progression of serious mental illness in young people who are experiencing some of the early warning signs of psychotic illness.
Inpatient Treatment Options
When patients are in crisis and hospitalization is required for psychiatric issues, inpatient treatment is provided through BBCH or the child or adolescent units at Spring Harbor Hospital. Typically, admission is appropriate when young patients present an imminent risk to themselves or others, or are unable to function at a lower level of care due to their psychiatric symptoms. Our team of pediatric mental health professionals works closely with children, their families and other caregivers to achieve maximum treatment results. Unit programming includes comprehensive psychiatric evaluation, medication management, individual and family therapy, educational and consultation services for parents, and on-site academic instruction.
We also offer an array of patient and family support resources, including a support group for families of children with mental illness.
We offer a full array of the most effective treatment options for children with emotional and/or behavioral problems. These include:
- Individual cognitive behavioral therapy (CBT) – “Talk therapy” that focuses on changing an individual's thoughts (cognitive patterns) in order to change his or her behavior and emotional state.
- Family therapy – Psychotherapy in which the members of a family participate, with the aim of improving communications and the ways in which they relate to each other. Positive change is most often achieved when the family is involved, and that is why we encourage parents and other adults to participate in family therapy sessions.
- Group therapy – Psychotherapy in which a group of patients meet to describe and discuss their problems together under the supervision of a therapist
- Psychopharmacology – The use of drugs to treat certain mental and psychological disorders. Psychotropic medications are substances that affect brain chemicals related to mood and behavior; they are carefully monitored and only administered in conjunction with individual therapy.
- Creative therapies – Approaches such as art therapy or play therapy can be helpful, especially with young children who might have trouble communicating their thoughts and feelings.
- Adolescent Dialectical Behavior Therapy – An outpatient group and individual therapy program to help adolescents manage intense feelings, stay out of crisis, avoid hurting themselves, maintain relationships, and recognize and understand their feelings on their own.