RETHINKING HOW CARE
IS DELIVERED TO TEENS
The health care system is designed by adults, for adults, according to Dr. Angela Diaz, director of the Mount Sinai Adolescent Health Center. “When it doesn’t work for young people, we call them non-compliant or hard to reach,” she said. “But it’s actually the system that’s hard to reach. Our model for delivering high-quality care to young people has been developed from almost 50 years of experience and innovation. We’ve seen first-hand how adolescence presents a spectrum of distinct and consequential health issues, and why adolescent care needs specialized services—and a wholly different approach to young people themselves.”
This is an understanding that’s now being embraced by national and global public health leaders. “Adolescents need specific attention, distinct from children and adults,” the World Health Organization said in releasing a major report in May 2014. In the United States today, there are more than 42 million adolescents between the ages of 10 and 19. Worldwide, one in six people is a teenager. And in the words of WHO’s chief family health official, “The world has not paid enough attention to the health of adolescents.”
Noting that teens and young adults are in a phase when biological development outpaces psychosocial maturity, WHO advocated a set of guiding principles that mirrors the teen-focused, developmentally appropriate approach to health care that we created in 1968 and continue to innovate.
Our model, in fact, is widely considered a gold standard. Clinical practitioners and health policy leaders come to us from around the world to see what we do and how we do it. And at the invitation of governments, foundations and nonprofits, we’ve visited health centers in this country and others on almost every continent—from Vietnam and Mongolia to Nigeria, Latin America, Australia and the Virgin Islands—to help them design programs that engage vulnerable young people and provide them with vital health and wellness services.
It’s in that context that the New York State Health Foundation has created a blueprint of the Mount Sinai Adolescent Health Center as a model for the state and the nation. The blueprint encourages health care providers and policy makers to replicate our method of providing comprehensive and inter-disciplinary services—primary care, sexual and reproductive health, mental health, social services, dental and optical care—in one stand-alone center focused entirely on adolescents and young adults. It includes guidelines to help providers implement key parts of the model or phase it in over time, tailoring the model to their needs and capabilities.
Key to our teen-friendly and developmentally appropriate approach is our dedication to recruiting staff in all disciplines and at all levels who truly love young people and care deeply about their health. “That’s the common theme of everybody who works here,” says our medical director, Dr. Anne Nucci-Sack. “If you don’t love teenagers, you won’t last here very long.”
Our staff is specially trained and experienced in adolescent care and we give them the flexibility to be responsive to the unique and changeable needs of each and every patient. And we instill our code of confidentiality and stress the importance of treating our teens with compassion and respect. We insist that our center be a safe and welcoming place for every young person who comes to us—no judgment, no stigmas. A place where all that matters is keeping our teens healthy, helping them develop coping skills and resilience and guiding them on a path to become strong adults.
Jacqueline Martinez Garcel, former vice president of the New York State Health Foundation, on why our approach should be a model for the state—and the nation.
“Adolescents have unique health care needs, and our health system should not approach their care the same way it does children or adults.”
“If left unchecked, health problems and behaviors that arise during adolescence… have a serious impact on the health and development of adolescents today, and potentially devastating effects on their health as adults tomorrow.”