Who should undergo a behavioral health evaluation?

If you have any concerns regarding your child’s mental health or behavior, please schedule a visit with your child’s primary care provider to discuss them further. They may determine that a more thorough evaluation is warranted by themselves or a clinician in our Behavioral Health Center of Excellence. Examples of such concerns include:

• Depressed or irritable mood lasting more than three consecutive months
• Anxiety interfering with your child’s functioning (ability to attend school, engage with friends, participate in extracurricular activities)
• Persistent school avoidance
• Aggressive behavior
• Self-harm thoughts, behaviors, attempts
• Difficulty with attention/focus interfering with learning or participation in activities
• Hyperactive and/or impulsive behavior causing disruptions at home or school

How do I schedule a behavioral health evaluation? Will the visit be with my regular pediatrician?

Since most CPCMG pediatricians and clinicians are trained to evaluate and treat ADHD, anxiety, and depression, you can start by calling and directly scheduling an ADHD or Behavioral Health Initial visit with your child’s primary care clinician. If you are unsure what visit type to request, you can simply request a visit for “behavior concerns.” Your primary care clinician may consider a referral to one of the Center of Excellence (COE) members based on the complexity of your concerns. Please note that a member of the COE may not be located at your usual clinic site, but all efforts will be made to schedule with a clinician closest to you.

Do I need authorization from my health insurance to have a behavioral health evaluation?

No. Health plans do not require prior authorizations for these visits.

Are telehealth visit options available?

We recommend that most initial appointments be in-person, allowing for more personal engagement with patients and their families. However, we understand that certain circumstances make a telehealth option more practical. Please contact the health care team before your appointment to discuss this possibility. Most follow-up visits are offered either in person or via telehealth.

Does my child need to be physically present for the visit?

We strongly recommend that the patient be present and participate in visits, but certain circumstances may make it more reasonable for only the parents or caregivers to be present (e.g., severe developmental delay, severe agitation/aggression, or elopement risk). Please contact the health care team before your appointment to discuss any concerns.

Once the appointment is scheduled, what should we expect?

To make the best use of the appointment time, your clinician will request that you and your child (age-dependent) complete a series of questionnaires on MyChart BEFORE the visit. Completing these before the appointment day will expedite the diagnosis and establishment of a treatment plan. For ADHD evaluations, an assessment from the teacher (or multiple teachers if middle school-aged or older) is required. Please print this form at home and give it to your child’s teacher(s). We request you scan the completed form and send it back as an attachment in a MyChart message or bring it to the office before the appointment.

If you do NOT have an active MyChart account, please contact your local CPCMG office to sign up. If you cannot activate your account before your appointment, please arrive 30 minutes before the visit to complete all questionnaires.

How should we prepare for the visit?

If your child was already evaluated by an outside psychiatrist, psychologist, or counselor, a copy of the latest note or evaluation will be essential, including a list of any medications used in the past. Please provide a copy if your child already has an individualized educational plan (IEP) or 504 plan. Please make every effort to submit these electronically (or bring multi-page documents to the office) BEFORE the appointment date.

Why are some of the questionnaire items so personal?

A comprehensive understanding of your child and family’s medical, behavioral, and social history helps with accurate diagnosis and developing an effective treatment plan. Please know that we respect your child and your family’s privacy, and all information shared will remain confidential. However, we are legally bound to notify appropriate authorities of any safety concerns about your child or family members.

How long will the visit last, and what happens if we run out of time?

Most initial visits last 30-60 minutes. To make the best use of the appointment time, please complete all questionnaires and provide relevant records to your healthcare team BEFORE the visit. When more time is needed, a follow-up appointment will be scheduled to complete the evaluation. Some clinicians may also request that initial evaluations be performed as a two-visit process.

What should we expect to occur during the visit?

The visit will consist of an interview with you and your child. If your child is 12 years or older, we also request a private, confidential interview with them as long as they are comfortable with it. All information discussed during the visit will be confidential unless concerns about your child’s or family’s safety are raised. 

EXAMINATION

The visit will start with your child’s weight, height, heart rate, and blood pressure measurements. These are important for assessing baseline health. Some medications can affect these vital signs, so regular measurements must be documented. A brief exam may also be necessary to listen to the heart rhythm and look for medical indicators of underlying disease or evidence of self-harm.

Will any labs or studies be ordered?

Labs may be ordered for some patients to check for medical reasons for certain physical symptoms such as fatigue, restlessness, abdominal pain, and headaches. The need for labs will be determined by your clinician.

Are therapists or psychologists available at CPCMG?

A limited number of CPCMG offices have Integrated Health Therapists (IHTs) at the clinic. However, most patients need to find a therapist or psychologist outside the medical group. You can contact your health plan to check which therapists are within your network. You can also contact your primary care clinician for recommendations. Finally, the Psychology Today website is a good place to start an online search for a therapist.

Will my child be prescribed medication during the visit?

Not all patients who undergo an initial evaluation will need medication. A treatment plan that is tailored to your child’s individual needs will be established and may include medication for some.

Will my child or teen have time with the clinician without me in the room?

We offer all patients 12 years and older time to discuss their concerns and thoughts privately with the clinician if they feel comfortable doing so. In certain circumstances, a private interview may also be offered to younger patients.

What types of information might the clinician keep confidential from me as a caregiver, and what might be reported to an official entity such as the police?

If your child discloses any information that indicates they may be unsafe, this will be shared with you. All appropriate measures will be taken to ensure your child’s safety. If concerns are raised that your child or family is at risk for domestic violence, abuse, or neglect, Child Protective Services (CPS) and/or the police will be notified. All other information will be kept confidential unless your child grants permission to share it.

How often will we follow up?

If your child is prescribed medication, a follow-up visit is required at least every two to four weeks while the dose is adjusted. Once a stable medication and dose are established, a visit is required once every three months. These visits can be either in-person or by telehealth, and questionnaires need to be completed before each appointment. We request that you always schedule the follow-up visits with the clinician who regularly manages your child’s medication.

If medication is NOT started, a follow-up appointment may still be recommended to ensure your child remains safe and well.

Do I need a MyChart account?

Yes. An active MyChart account (AND a teen MyChart account for patients 12 years and older) is needed to complete questionnaires, communicate with your child’s clinician, request medication refills, schedule follow-up visits, and conduct telehealth visits.

When should my child see a psychiatrist instead of a pediatrician?

While our pediatricians and advanced practice providers diagnose and manage many behavioral and mental health conditions, we are not trained to manage ALL disorders. Your child may be referred to a psychiatrist if multiple complex co-existing diagnoses are suspected (e.g., bipolar disorder, schizophrenia), if their symptoms do not respond to standard treatment interventions, or if they have rapidly worsening symptoms.