Editorial

Unheard, Unseen, Underserved: Addressing Adolescent Health in Primary Care

Marium Ahmed^1*

¹Department of Family Medicine, Liaquat National Hospital and Medical College, Karachi, Pakistan

The World Health Organization (WHO) defines Adolescence as the age range of 10-19 years, a period of transition from childhood to adulthood marked by rapid physical, psychological, and social change [1]. Adolescents make up one-sixth of the global population [2]. During this stage, they have strong concerns about their bodies and physical changes, often exacerbated by comparisons with peers who may be developing at a different pace.

Consultations with adolescents are most focused on acute problems, overlooking deeper issues related to sexual, mental, and psychosocial health. These aspects can be effectively addressed in primary care settings through structured screening, sensitive history-taking, and skill-building. Adolescent consultations require attentive time from healthcare providers and ensure privacy. Psychosocial screening tools such as HEADSS (Home, Education, Activities, Drugs, Sexuality, Suicide/ Mental health) and SSHHADES (Strengths, School, Home, Activities, Drugs, Emotions, Sexuality, Safety) can help clinicians identify psychosocial concerns and sensitive issues, including eating disorders and risky behaviors. These tools are widely implemented in Western healthcare settings to enhance adolescent assessments [3]. However, these critical issues are commonly missed during clinical encounters due to a lack of expertise and a symptom-driven approach [4]. Worldwide, adolescents feel reluctant to discuss their problems; adolescent care is an underexplored area that demands urgent attention [2]. Adolescents avoid seeking help for fear of judgment as they seem old in pediatrics and too young in adult clinics, leaving their health needs unmet in our country [5]. In low-income countries, discussions on mental health and sexuality remain taboo. Many parents and clinicians avoid these topics due to discomfort and limited training, leading to their being overlooked in adolescent care.

A comprehensive assessment for adolescent health from a primary care perspective is vital [4]. Training programs and skill-building for family physicians who care for adolescents should be incorporated into primary care [1]. The health policy reforms should be youth-friendly, ensuring privacy and sustainability in the provision of healthcare facilities for adolescents. The clinicians should provide care that is nonjudgmental, private, and courteous to leave a positive impact on their health. Primary care should take initial steps to help clinicians recognize and address adolescents' psychosocial needs by training practitioners, thereby creating safe places for adolescents' healthcare needs in our communities [6].

REFERENCES

1. World Health Organization. Global Accelerated Action for the Health of Adolescents (AA-HA!)-Second edition: Guidance to support country implementation. Available at: https://www.who.int/publications/i/item/9789240081765.

2. Poelker KE, Gibbons JL. Adolescents in the majority world. In Gielen UP, Roopnarine JL, Eds. Childhood and adolescence: Cross-cultural perspectives and applications. 2nd ed. Praeger/ ABC-CLIO 2016; pp. 263-96.

3. Waller D, Bailey S, Zolfaghari E, Ho J, Feuerlicht D, Ross K, et al. Psychosocial assessment of adolescents and young adults in paediatric hospital settings: patient and staff perspectives on implementation of the e-HEEADSSS. BMC Health Serv Res 2023; 23(1): 683. DOI: https://doi.org/10.1186/s12913-023-09621-2

4. Klein DA, Paradise SL, Landis CA. Screening and counseling adolescents and young adults: A framework for comprehensive care. Am Fam Physician 2020; 101(3): 147-58.

5. Mubeen Z, Fatmi Z, Hameed W, Asim M. Barriers and facilitators to accessing adolescents' mental health services in Karachi: Users and providers perspectives. BMC Health Serv Res 2024; 24(1): 157. DOI: https://doi.org/10.1186/s12913-024-10593-0

6. Hall J, Nesrallah S, Ras D, Bailie A, Brunskill H, Jutten E, et al. Youth participation in strengthening the quality of child, adolescent, and youth mental health in the World Health Organization European Region. J Adolesc Health 2024; 75(3): 519-21. DOI: https://doi.org/10.1016/j.jadohealth.2024.04.025