I have been a pediatrician since 1974 and proud of it. I knew it was the most beautiful profession in the world when I was a child.
Faced with the unmet basic needs of thousands of children, which translate into poor health, I have developed a medical approach that focuses on their whole being to meet all of their needs. : social pediatrics in the community.
Psychological distress
Over the years, mental health has taken an important place in my practice and that of other teams across Quebec. The pandemic did not help. It has helped explode cases of psychological distress, severe anxiety and adjustment disorders in children already weakened by difficult living conditions.
Today, we treat and support many children with multiple trauma, post-traumatic stress disorder, multiple co-morbidities. Many are taking multiple drugs and many more have failed treatment.
Of course, pediatricians are not trained in psychiatry, but in our practice of community social pediatrics, we must improve our knowledge through continuing professional training to better care for the children who have been referred to us.
The key to our success is our agility to work in concert with local resources, and to act with multidisciplinary and intersectoral teams to increase our basic mental health skills and make them more effective.
In complex cases (suicide attempts, severe distress, major disorganization), we immediately send the most complex cases to psychiatrists and to the emergency department of large pediatric hospitals. However, these suffering young people are most often returned “to our good care”. As for our front-line mental health referrals from the CLSCs, several months and even a few years go by before the child is seen.
Knowing very well that the environment and mental health are linked to physical health, we act according to our team skills to prevent, relieve and put back on track these young people, in front of the deficiencies of resources in psychiatry and psychology and the widespread lack of services.
Efficient first line
Paediatricians trained in community social pediatrics have learned skills in preventing and alleviating emotional suffering in children, and even in mental health. We play an essential role when children wait to be seen in child psychiatry. The state of health of the child in distress is a priority for us.
We do not claim to cure psychiatric problems, but, as an effective first line, we can welcome, relieve and “save the furniture”, as they say.
Strongly a broader awareness of our responsibilities rather than a “not in my backyard” attitude.
Strongly a mental health training earlier in the medical curriculum and more elaborate for pediatricians and family physicians.
Strongly greater accessibility to child psychiatrists and psychologists.
Strongly respect the fundamental needs of children while respecting all of their rights and access to comprehensive care.
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