Module 10: Eating Disorders

Building Systems for Health Mental Development

Mental health can be considered an independent element that can be nurtured and enhanced, rather than simply the absence of problems. Optimizing mental health in children can positively affect their physical health, competence, and life satisfaction.1

Infancy, childhood and early adolescence are key periods in life in which to promote healthy social and emotional development.2 Recent research has revealed ways in which children’s natural resilience can be nurtured, giving them the emotional tools they need to maintain positive mental health.

This is also an ideal time to take action to prevent mental disorders. Half of all mental disorders have their onset before age 14.3 Presently, mental health problems in children are not formally addressed until they reach the clinical level. For every child diagnosed with a mental health problem or disorder, there are others with significant problems that haven’t yet reached the clinical level, and many more still whose behavior or moods concern their parents.4 Effective early intervention can minimize the impact of problems and disorder on a child’s life and the costs to society.3

Yet providing proactive care of this kind requires rethinking how we deliver mental health care in the first place. Taking a public health approach toward children’s mental health care holds the potential for moving from ideas to action.5

Pediatric primary care providers are among most critical participants in the movement to implement a public health approach to mental health care. Pediatric providers work with children and families during their formative years. Through the framework of the patient-centered medical home, providers can deliver the promotional and preventive mental health care that is currently unavailable to many children and youth in the United States.

This module will

  • Define “mental health;”
  • Discuss current system models for mental health care and health care;
  • Describe a public health approach to mental health care for children and youth;
  • Explain ways that pediatric primary care providers can implement aspects of a public health approach to mental health care at the practice level.

Note: Within this module, references to mental health problems and disorders also include substance use disorders and conditions.

“Americans assign high priority to preventing disease and promoting personal well-being and public health; so too must we assign priority to the task of promoting mental health and preventing mental disorders….”

-- U.S. Department of Health and Human Services. (1999). Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.


  1. Miles, J., Espiritu, R.C., Horen, N., Sebian, J., & Waetzig, E. (2010). A Public Health
    Approach to Children's Mental Health: A Conceptual Framework. Washington, DC:
    Georgetown University Center for Child and Human Development, National Technical
    Assistance Center for Children’s Mental Health.
  2. J. Meschan Foy for the American Academy of Pediatrics Task Force on Mental Health (2010). Supplement article introduction. Pediatrics. 125(Supplement 3), S69–S74. doi:10.1542/peds.2010-0788C
  3. Kessler, R.C., Berglund, P., Demler, O., Jin, R., Merikangas, K.R., & Walters, E.E. (2205). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Co-morbidity Survey Replication. Archives of General Psychiatry. 62(6), 593–602.
  4. Wissow, L., Anthony, B., Brown, J., DosReis, S., Gadomiski, A., Ginsburg, G., Riddle, M. (2009). A common factors approach to improving the mental health capacity of pediatric primary care. Administration and Policy in Mental Health. 35, 305-318.
  5. Shea, P, & Shern, D. (2011). Primary Prevention in Behavioral Health: Investing in our Nation’s Future. Alexandria, VA: National Association of State Mental Health Program Directors (NASMHPD).

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