xiv Introduction Children and adolescents without symptoms or functional impairment may also benefit from mental health care. Parents or teachers (or both) may believe a child has a behavioral disturbance, even when the child exhibits behavior that is typical for his or her developmental stage, a situa- tion likely to produce conflict and distress. In addition, many children and adolescents without perceived or actual current problems are at increased risk for mental health problems by virtue of their social circum- stances or their exposure to trauma and adversity. They and, in fact, all other children and adolescents can potentially benefit from efforts to enhance their emotional resilience: any of them may encounter toxic stress, trauma, or loss, with the risk of untoward mental health effects. The term mental health care in this book encompasses care of children and adolescents who are experiencing the full range of social-emotional and behavioral health challenges, including substance use. This broad definition is not to suggest that pediatric clinicians are themselves respon- sible for the full range of mental health care but rather that pediatric clini- cians provide a medical home and, often, medical subspecialty care to children and adolescents who may experience the full range of mental health challenges. Authors use the term primary care clinicians (PCCs) in the book to encompass pediatricians, family physicians, internists, nurse practitioners, and physician assistants who provide a medical home to children and adolescents. Authors use the term pediatric clinicians in the book to encompass not just PCCs but also pediatric subspecialists, who may have a consultative role in mental health care (eg, developmental- behavioral pediatricians, adolescent specialists), and subspecialists who have a primary care role in circumstances that require frequent, close supervision (eg, pediatric hematologists/oncologists who care for children with cancer, pulmonologists who care for children with cystic fibrosis, endocrinologists who care for children with type 1 diabetes mellitus). Pediatric PCCs have frequent contact with patients and their families, often beginning prenatally or early in the child’s life. This longitudinal relationship is at the heart of “the pediatric advantage,” outlined in Box 1. Pediatric subspecialists also enjoy this advantage through long-term rela- tionships with patients and families in the care of their patients’ chronic medical conditions or developmental disabilities. The book informs pedi- atric clinicians about the opportunities for mental health care that are inherent in this advantage. 00-MHCC_fm.indd 14 4/5/18 12:06 PM
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