Editor’s Note: This week’s blog has been written by guest author Richard Abidin, EdD. Dr. Abidin is a Professor Emeritus of Clinical and School Psychology in the Curry School of Education at the University of Virginia, where he served as Director of the Clinical Psychology program. He is the author of the Parenting Stress Index™, Fourth Edition, an inventory designed to evaluate stress in the parent-child system.

Integrative health care is a system in which quality health-care services are provided to individuals, families, and communities. One hoped-for side effect is that the cost of health care will be reduced or contained by the efficient use of resources.

I would like to briefly describe, to stimulate the thinking of others, one example of how integrative health care was done some 40 years ago.

The pediatric group practice that was caring for my own children asked me to come to their practice to discuss how to identify children who should be referred for either mental health or special education services. That request was the catalyst for creating a system of integrated psychological and medical services, and it also was the beginning of what would become the first edition of the Parenting Stress Index (PSI).

The practice provided me with a small exam room that served as my office two days per week. I was given access to the medical records of those families whom I saw or was consulted on, and I placed a copy of my notes and homework prescriptions in the patients’ files. I used the practice’s billing and support personnel, and the practice received 30% of my billings as an overhead charge.

How did the system work? I received referrals from the pediatricians or sometimes from the families themselves. The pediatricians’ referrals would come via two sources: the pediatricians’ interactions with the child or parent or the results of the Parenting Stress Index screening that I developed (and later published with PAR). I typically had a 30- to 40-minute session starting on the hour, followed by 5 minutes for notes and 15 minutes for consulting with the pediatricians or receiving a new referral.

With this system, we found that almost 100% of patients referred for mental health or special education services followed through with appointments, versus the typical referral follow-through rate of 50% or less. The high rate of follow through on the referrals was due to the pediatrician walking the parent to my office and introducing me. The parent and I would speak for a few minutes about their concerns and then set up an appointment. Eventually, the results of the PSI screening became the major generator of referrals by the pediatricians.

Over the years, the Parenting Stress Index has been refined to meet the changing needs of children, parents, and the clinicians who support them and today is in its fourth edition.

As the new school year approaches, children and teenagers can experience a range of emotions, from the normal excitement associated with new teachers and activities to more serious or long-term anxiety about school.  Mental Health America, a national advocacy organization that addresses mental health and substance abuse conditions, offers tips to help children and teens adjust as they return to school.  Their suggestions include the following.

• Know that your child’s mental health is just as important as their physical health.


• Start the conversation! Talk to your child about your expectations as well as his/her expectations for the upcoming school year. Take time to listen to your child and discuss aspects of the new school year that he or she is worried about.


• Remember to let your child know that it’s normal to feel nervous about the start of school.


• Spend time each day talking to your child about what happened in school. Be open to hearing the good and the not so good. Give your child positive feedback about his or her new experiences.


• Praise and encourage your child to become involved with school activities and to try new things.


• Attend school functions and stay involved in your child’s education and engaged with school staff.


• Be proactive in learning about how your child is developing not just physically, but socially and emotionally, as well. If you are aware of what’s typical for your child's stage of life, you will be able to tell more readily when things may not be right.


• Know the signs of bullying.

For the full story or to locate additional resources for a healthy back-to-school season, visit the Mental Health America Web site.

On May 9, the Substance Abuse and Mental Health Services Administration (SAMHSA) held a virtual event in honor of National Children’s Mental Health Awareness Day.

The event focused on telling the stories of young adults who have had substance abuse or mental health issues and have developed ways to overcome their challenges. This is an especially important group for SAMHSA to focus on, as nearly 30 percent of young adults ages 16 to 24 years have had a mental health condition in the past year. PAR was a proud sponsor of this important event.

Watch the virtual event, visit SAMHSA online, or comment below to get involved!