News Briefs

What families want when their child has a mental illness: Primary care doctors are critical to detecting mental illness among children. Yet in a nationwide survey of families conducted by the National Alliance on Mental Illness (NAMI) in 2009, only 34% of the 554 respondents said their primary care doctors were knowledgeable about mental illness; 59% indicated that their doctors were not knowledgeable about its treatment. To correct this knowledge gap, NAMI has released the results and analysis of the survey in a 15-page report, as well as a brochure for primary care physicians on how to communicate with families and provide the support and resources they seek. According to the respondents, whose children were diagnosed as having mental illness before age 18, the “top five” most helpful things for a doctor to say are that there is hope, the family is not alone, their child's illness is not their fault, “I understand,” and their child has many strengths. The report outlines steps for primary care physicians to take when a family raises concerns about a child's mental health. Physicians are urged to listen, ask questions, screen and evaluate, refer families to mental health professionals, follow up and collaborate with mental health providers, provide treatment if specialists are not available, and provide encouragement. Families in crisis welcome information, and physicians are urged to make handouts, reading lists, and information on local support groups and workshops available to their clients. The Family Experience With Primary Care Physicians and Staff report and the brochure “What Families Want From Primary Care” are available at www.nami.org.

Recommendations from the Commission to End Health Care Disparities: Racial and ethnic disparities in health care in the United States are long-standing and well documented, with complex origins. For more than a decade, providers have been urged to undertake “step 1” in eliminating disparities: systematic collection of basic demographic data from their patients. But research shows that most do not do so or do so in nonsystematic ways. To address this problem, the American Medical Association's (AMA's) Commission to End Health Care Disparities has issued a report that provides recommendations for collecting and using patient demographic data in the ambulatory setting. The recommendations are intended not only for health professionals but also for vendors of electronic health record (EHR) systems, policy makers, hospitals, health plans, and insurers. Along with detailed guidance on when and how to collect demographic data and what data to collect, the 26-page report describes uses for such data (for example, for quality improvement and ensuring equity), barriers to collection (for example, perceived legal barriers and staff discomfort about race), and barriers to data use (for example, small sample sizes and lack of statistical expertise. Collecting and Using Race, Ethnicity and Language Data in Ambulatory Settings is available on the AMA Web site at www.ama-assn.org/ama.

New framework proposed for DSM-5. The American Psychiatric Association (APA) has released the organizational framework proposed for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The chapters and categories of disorders have been restructured to reflect current scientific thinking about how various conditions relate to each other and how these relationships may influence care. APA is inviting comments from the public and mental health and other professionals who use the manual for both diagnostic and research purposes. Currently, the 16 chapters in DSM-IV-TR are organized on the basis of underlying vulnerabilities and symptom characteristics, and this has led to many patients' receiving multiple diagnoses within and across disorder groups. The new framework arranges chapters by general categories, such as neurodevelopmental, emotional, and somatic, to reflect the potential commonalities in etiology within larger disorder groups. Public comment is invited through June 15 on the draft framework and the latest proposed revisions to diagnostic criteria, both available on www.dsm5.org.