Youth health clinic

The Youth Health Clinic is neither a "shelter for troubled children" as parents think, nor a "place that can only look at psychological problems" as students think. It is specifically for adolescents aged 10-24 as defined by the WHO, covering physical development, mental health, behavior, etc. An integrated outpatient clinic that meets all-dimensional needs for intervention and health science popularization. You can find corresponding solutions here, ranging from acne in adolescence and aunt's pain, to study weariness, sexual confusion, and signs of addictive behavior. There is no need to hide illnesses and avoid medical treatment just because you are afraid of being "discussed."

When I was attending a clinic last Wednesday afternoon, I met a 16-year-old girl who came in dodgingly, holding on to the hem of her school uniform. The first thing she said when she entered the door was "Doctor, can I not let my mother outside know what I am asking?" When her mother registered before, she told the clinician, "My girl has been a little rebellious recently, please arrange for a doctor to persuade her to study." However, the girl closed the door and said that she had not been to her aunt for three months and did not dare to tell her mother for fear of being scolded for "promiscuous."

This is actually the common misunderstanding that most people have about adolescent health clinics: parents think that only children with "psychological problems and disobedience" need to come. Children feel that coming here is "admitting that they are sick", and would rather find answers on the messy Internet than come to ask professionals.

In fact, there are still different voices in the industry regarding the positioning of this clinic. Some pediatricians in general hospitals believe that the essence of adolescent problems is growth and development. It is enough to expand the pediatric adolescent clinic, and there is no need to open a new outpatient clinic to waste resources. ； But more practitioners doing child mental health and public health research don't think so - the period from 10 to 24 years old is too special. They are neither children who have to listen to their parents for everything, nor adults who can be completely responsible for themselves. Many problems are intertwined. For example, if you meet a child who is tired of studying, go to the pediatrician to check that there is no problem, go to the psychiatry department and say he is a little anxious and prescribe medication, and finally find out that he has scoliosis and is in pain after sitting for a long time and cannot concentrate on class. Do you think one department can solve it?

I met this 14-year-old boy last month. His parents escorted him here. They said he stayed up late every day playing games and dropped 20 places in his grades. He was beaten and scolded to no avail. He went to a separate psychological department before and was diagnosed with a game addiction. Long-term behavioral modification was required. The child was particularly resistant. The first thing he said to me when he saw me was, "I just feel my heart beats fast and my neck hurts when I sit there studying. I forget the pain when I play games. I don't mean not to want to learn." Later, we jointly evaluated him with orthopedics, nutrition, and psychology, and found that the curvature of his cervical vertebrae had straightened, and he suffered from insufficient blood supply to the brain after sitting for long periods of time. He suffered from headaches and dizziness when he studied, so he subconsciously avoided it. I adjusted his sitting posture, prescribed medicine to relieve muscle tension, and gave him two short-term cognitive conditioning sessions. After a follow-up visit two weeks later, he was told that he could now sit and study for 40 minutes a day without touching his mobile phone. His parents were shocked and said that they never thought it was a physical problem before.

Of course, this is not to say that this clinic is omnipotent. Many colleagues around me complain that the adolescent health clinics opened in many places just have a brand name. Either only psychiatrists are available to treat physical problems, or physical problems are not covered, or children are given dozens of pages of questionnaires to fill in. The children are resistant to it in the first place, and they don't want to come after filling it out. Nowadays, the operating models are different in various places. For example, our hospital adopts a rotating system of all departments. There are people in the psychology, endocrinology, orthopedics, gynecology, and nutrition departments every day. You can ask all you want to ask after you register once. The disadvantage is that the registration fee is twice as expensive as that of ordinary outpatient clinics, and it is difficult to get an appointment. ； Some community hospitals adopt a first-diagnosis consultation model. A dedicated health manager will first talk to the child for an hour to find out what the problem is before transferring to the corresponding department. Although it may require an extra trip, it is cheaper and can be covered by medical insurance. It is also quite popular. There is really no one who is better than the other. It all depends on the local resources.

To be honest, in the past two years that I have been practicing as a clinician, the most regrettable thing is that many parents wait until the problem becomes serious before sending them here. Either their children have not been in school for half a year, or they have already engaged in self-harm. In fact, many small signs have been exposed for a long time - for example, a child who used to talk and laugh suddenly suddenly spends the whole day all day long. If you are locked in a room, suddenly gain or lose weight, or even just casually mention "I am so tired from school", you can bring it to have a chat. Even if there is no problem in the end, it is better to give your child some correct knowledge about sex and exercise than to search randomly on pornographic websites and forums by himself, right?

Last week, there was a 17-year-old boy who secretly registered on his own. He held it in for a long time before asking whether wearing a condom would affect pleasure or give his girlfriend gynecological diseases. They chatted for more than 40 minutes and left with a red face. He said that he no longer had to look for answers on messy websites. You see, this is the most practical meaning of the existence of this clinic. It has never been about "treating diseases". It is about leaving a safe, non-judgmental place for these children who are stuck between adulthood and childhood. They can ask questions that they dare not tell their parents or teachers, so that they can grow up in a down-to-earth manner without so many worries.