As a parent of two millennials, I know the joys and challenges of raising young adults. Every parent can appreciate advice from friends, family, and experts, especially when it comes to the health and well-being of their children. But how about getting advice from the president-elect of the American Medical Association? I had the opportunity to meet Dr. Patrice A. Harris, MD, MA, this past March during her SXSW panel on mental health. Dr. Harris, a longtime psychiatrist-member of the American Psychiatric Association (APA) and a practicing psychiatrist trained in child, adolescent, and forensic psychiatry, will become the President of the AMA on June 11, 2019. Harris has diverse experience as a private practicing physician, public health administrator, patient advocate, and medical society lobbyist, and is an adjunct assistant professor in the Emory University Department of Psychiatry and Behavioral Sciences.
UpwellBeing invited Dr. Harris to share her expertise in this exclusive interview on three very important areas in mental health that parents should be aware of—depression and bipolar disorder, eating disorders, and the opioid crisis.
UpwellBeing: You’ve worked across the healthcare spectrum. What are a few of the biggest issues you will focus on as president-elect of the AMA, and why?
Dr. Harris: I will focus on the AMA’s three overall strategic arcs—improving health outcomes, attacking the dysfunction in healthcare, and innovation in medical education. And consistent with those areas, I will also amplify the importance of mental health integration into overall health and healthcare, increasing diversity in the physician workforce, and continuing the AMA’s work on addressing the opioid epidemic.
UpwellBeing: Let’s focus on one of the significant issues our youth and their families are dealing with today—depression, including bipolar disorder . What are the key issues and opportunities here that people need to understand?
Dr. Harris: The first key issue and opportunity is to make sure children and adolescents receive the correct diagnosis. A lot of families come to me unsure if their child or adolescent is experiencing normal reactions to different stresses that we all face growing up, or if they have in fact developed a brain disorder/mental illness. After the diagnosis is clear, it is critical to ensure that a treatment plan is developed that matches the patient’s diagnosis. Finally, it is important for parents and patients to know that treatment is available for their specific needs, and that they are not alone.
UpwellBeing: What are the biggest misconceptions about bipolar disorder? What are the symptoms?
Dr. Harris: Bipolar disorder is an illness of the brain with extreme changes in moods, energy, thinking, and behavior. Again, the first task for parents or caregivers is to get an accurate diagnosis. Bipolar disorder is a treatable chronic disease. So it is very important to match the treatment plan with the diagnosis. There are no one-size-fits-all approaches for illnesses of the brain. As with many brain disorders/mental illnesses, thoughts of suicide can be co-occurring. Thoughts of suicide and/or a preoccupation with death should always be taken seriously. Parents and youth should avail themselves of local and national resources including suicide prevention hotlines when faced with this issue.
UpwellBeing: Let’s move on to another area that impacts our youth and needs to be better understood—eating disorders. What are the issues and opportunities here?
Dr. Harris: The first opportunity is to distinguish eating disorders from disordered eating. Disordered eating can be related to stress, poor nutritional habits, and food fads. These are common problems for youth. But when the disordered eating worsens in severity, there can be a diagnosis of anorexia or bulimia. Parents may first see a preoccupation with food and body image. The challenge here is that many youth hide these symptoms from their families and friends. I recommend that if a parent has questions about eating disorders that they seek advice from their primary care physician or other health professional for initial guidance and recommended next steps. Finally, it is important to note that while eating disorders are more common in girls than boys, we cannot say that boys aren’t at risk for developing eating disorders.
UpwellBeing: You mentioned that one of the AMA’s and your focus areas is going to be the opioid crisis. What should we be doing as a country, community, and as individuals?
Dr. Harris: The AMA Board of Trustees convened the AMA Opioid Task Force in 2014 and I was appointed the Chair of this Task Force. Many physicians and physician societies had been working on the epidemic prior to 2014, so we wanted to amplify that work and further coordinate and collaborate future endeavors. At present, we know that the opioid epidemic has evolved. Most of the overdose deaths are now related to illicitly manufactured fentanyl and heroin. Recent CDC data shows a plateau in the overdose death rate. While there has been progress, the overdose death rate is still at an unacceptably high level. We have also seen the number of opioid prescriptions decrease since 2012. Naloxone, which is the overdose reversal antidote drug, is more readily available. We have seen some increase in treatment capacity, but not nearly enough. So, at this juncture, the AMA is laser-focused on increasing funding to increase access to medication-assisted treatment (MAT) with the three medications that are FDA approved and evidence-based for the treatment of opioid use disorder. We also want to reduce the regulatory and administrative burden and barriers to our patients getting treatment, which gets back to one of the AMA’s strategic goals to attack the dysfunction in healthcare. The good news is we are having some success in getting Medicaid and commercial insurers to eliminate the need for prior authorization for MAT.
UpwellBeing: If a parent suspects that their child is having issues with opioids or fentanyl, what should they do?
Dr. Harris: For those who are fortunate enough to have insurance, including Medicaid, contact your insurance company first to find out what facilities and physicians are covered under their insurance plan. Many states and counties have toll-free crisis and access lines you can contact to get guidance on where to access treatment. You can also connect with your primary family care provider to get guidance.
You can confidentially contact crisis counselors at the American Foundation for Suicide Prevention for no cost 24/7/365 at 1-800-273-TALK or text TALK to 741741.