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Summer Well Visits: Converting Mental Health Concerns Into Action
PEDIATRICIAN GUIDE
You're identifying the issues—here's how to get more families to follow through
You identify mental health concerns, provide referral information, and expect families to follow through. But some don't.
Research reveals the scope of the problem: only 18% of children complete mental health visits within 180 days of primary care referral. One of the factors in play is that the practices with high follow-through rates help parents understand why specialized care matters and how to access it.Good communication is crucial when discussing referrals. When you frame concerns as solvable problems and address parental fears directly, families are far more likely to take action.
Communication shifts that support families
Reframing the situation
Reframing the situation fosters partnership and hope, not blame or alarm. For practical techniques to guide these conversations, consider insights from Motivational Interviewing (MI).
Collaborative problem-solving
Shift from a diagnostic tone to a collaborative one: "You're seeing what I'm seeing. Let's figure out what's making things hard for your child."
Normalization
Clinical language can feel overwhelming and stigmatizing. When you frame concerns as problem-solving opportunities or compare them to familiar medical situations, you’re helping to normalize the concept of mental and behavioral challenges.
Compare mental health support to other needs: "Attention problems are like a fever. We need to understand the underlying cause to determine appropriate treatment. Just like the root cause of a fever could be the common cold, an ear infection, or heatstroke, the root cause of attention difficulties could be anxiety, ADHD, or a learning difference. We need to figure out ‘the why’ to move forward.”
High-impact phrases
Start with the parent’s experience rather than your clinical observations to foster engagement. Transforms the conversation from 'the doctor thinks something's wrong' to 'let's solve this problem together.'
"What's the hardest part of parenting [child’s name] right now?"
"Early support makes the biggest difference."
"You know your child best. Trust what you're seeing."
Connect symptoms to daily impact
Parents may be more likely to act when you connect seemingly unrelated issues to their child’s daily life, creating a sense of urgency and relevance.
"The worry [child's] experiencing makes bedtime take 2 hours and causes stomach aches before school. That's exhausting for your whole family."
"When struggles show up in multiple areas of [child's] life, comprehensive evaluation prevents the run-around between specialists who don't communicate. A whole-child assessment examines all contributing factors simultaneously, leading to coordinated treatment rather than fragmented care."
Many parents don't naturally make these connections between mental health concerns and daily problems. As their physician, help them see patterns across home, school, and social environments.
"Help parents act on referrals by creating urgency, offering hope, and clearing away obstacles."
Common barriers & evidence-based responses
Most parental resistance is about fear of the unknown. Directly address specific concerns (labels, timing, permanence) to remove the barrier to action.
When parents say:
"It's just a phase"
Respond with, "Even if temporary, we can help [child] get through it easier. What would it mean to cut this difficult time in half?"
"We'll wait and see"
Acknowledge their desire to see improvement, then emphasize that, "When children struggle in multiple areas, early support makes the biggest difference. What worries you most about getting an evaluation?"
For elementary-age children, emphasize summer evaluations: "Getting answers before the new school year helps teachers understand how to support [child] from day one."
"We don't want labels"
Reassure parents that seeking professional advice does not necessarily mean their child will receive a diagnosis or require long-term therapy. Clarify that, "This isn't about labels. It's understanding how [child's] brain works best so they can succeed."
"I need to check our insurance first"
Parents often express understandable concerns about coverage, which is constantly changing. Have staff prepared: "Most insurance plans cover mental health evaluations. The provider's office will verify your benefits and explain any costs upfront." Empower your staff to facilitate this initial step.
"I will research therapists online and think about it"
Some parents want to research multiple providers extensively, which often leads to inaction. You might say: "While you're welcome to research options, I specifically recommend [provider/clinic] because they use comprehensive assessment approaches that align with what [child] needs. Starting somewhere evidence-based is more important than finding the 'perfect' fit."
Reassure parents that seeking professional advice does not necessarily mean their child will receive a diagnosis or require long-term therapy. Clarify that, "This isn't about labels. It's understanding how [child's] brain works best so they can succeed."
"I need to check our insurance first"
Parents often express understandable concerns about coverage, which is constantly changing. Have staff prepared: "Most insurance plans cover mental health evaluations. The provider's office will verify your benefits and explain any costs upfront." Empower your staff to facilitate this initial step.
"I will research therapists online and think about it"
Some parents want to research multiple providers extensively, which often leads to inaction. You might say: "While you're welcome to research options, I specifically recommend [provider/clinic] because they use comprehensive assessment approaches that align with what [child] needs. Starting somewhere evidence-based is more important than finding the 'perfect' fit."
The follow-through formula
Before families leave your office, your practice can employ the following strategies to make the path forward clear and minimize attrition.
Make the concern concrete
"The challenges we've discussed are affecting [child's] confidence and your family's daily life. When sleep, school, and home all feel difficult, that's your signal that we need to dig deeper and find solutions."
Explain the process
“In the initial intake, you will speak to someone at [provider/clinic] about what your child is experiencing, their medical history, and your goals. You can decide what assessments you’re interested in. Then you will be connected with the right providers depending on the needs of your child.” Emphasize that the first appointment is often just about gathering information, not a long-term commitment.
Schedule follow-up
"I'm putting a reminder to call you in 3 weeks to hear how the evaluation went and discuss how we can support the treatment plan together." This personal commitment from you, the pediatrician, significantly increases follow-through and demonstrates your ongoing partnership.
When parents leave with concrete next steps and realistic expectations, they don't get lost between your recommendation and the specialist's office. The follow-up call ensures nothing falls through the cracks.
Bottom line
You're already identifying concerns effectively. The key to transforming those concerns into action is increasing the family’s urgency and hope, while systematically removing perceived barriers.
Nicole Garber, MD, Chief Medical Officer
Dr. Nicole Garber is triple board-certified in general psychiatry, child and adolescent psychiatry, and obesity medicine, bringing over 11 years of experience in pediatric mental health care.
How can Blackbird help?
If you recognize your child may need support and are interested in exploring mental health services, click here to get started. To speak to a Care Navigator, call (484) 202-0751 or email us at info@blackbirdhealth.com.
