With Dr. Renee Fay-Leblanc and Dr. Gita Rao of Greater Portland Health 

A regular column with Dr. Renee Fay-Leblanc and Dr. Gita Rao of Greater Portland Health featuring answers to questions from community members. Do you have a question? email [email protected]

Renee Fay Leblanc
Gita Rao

Autism is a frequent topic of conversation and people think cases in children seem to be rising in immigrant communities. What is happening? 

Autism affects all communities regardless of race. According to the U.S. Centers for Disease Control and Prevention (CDC), the prevalence of autism across all communities in the U.S. has increased in the past decade. One important reason for the increased numbers is the growing emphasis on early identification of kids with autism. Parents and healthcare providers are now more aware of signs of autism in young children, which we know can show up in infancy and toddlerhood. Healthcare providers ask parents questions in routine medical visits to help identify children, at young ages, who may have autism. With growing education on autism, sometimes a teacher, family member, or friend may be the first to identify signs. As our community awareness of autism grows, the number of children diagnosed also increases. So why does early diagnosis of autism matter? The earlier that signs of autism are identified, the more quickly the child and family can receive services to support development and learning. Early connection to services makes a big impact on the health of a child, and early support services for autism can greatly impact a child’s learning, social skills, and communication. Ultimately, this leads to kids being more ready for kindergarten and having better long-term learning potential.   

My son is turning 13 and I’m afraid he’ll do drugs. We didn’t have this problem back home and I don’t know what to do to keep him safe. 

Parents and other trusted adults have a strong influence on choices kids and teens make. Regular family conversations can  make a big impact on a child’s decisions. Ask what they have heard about alcohol, marijuana, drugs, and vaping. Make clear statements that using drugs or alcohol are harmful to their health and can negatively affect their thoughts, school work, sports, and friendships. Personalize the message to what children enjoy doing, and explain how using drugs can get in the way of their goals. Take time to ask kids about friendships, as peers can also influence the choices kids make in the community. Help them define what makes a good friend, and be clear that true friends should never ask them to try something risky or dangerous to their health. Ask if they have had to say “no” to a friend before. It even helps to practice different ways to say “no” if they are offered drugs. Tell them you are a safe, trustworthy adult to ask when they have difficult questions about drugs or alcohol. Also, practice healthy choices. Kids learn a lot by watching a parent, so model healthy choices regarding alcohol use and avoiding drugs and tobacco.  

Sometimes kids use drugs and need help to stop using. Signs include a decline in school grades, changes in mood, or changes in relationships. This is not a parent’s fault, but does give a parentis an opportunity to support their kid in getting help.  Don’t be afraid to ask for help, whether it’s related to prevention of drug use or treatment. Help is available in our communities and kids can stop using drugs with proper support.  Contact the child’s healthcare provider, school, or other resource – such as 211 – for support. 

What can immigrants do to access mental health services, especially because it’s stigmatized in many cultures?

Mental health and physical health are closely connected. Symptoms like stress, fear, and worry can affect physical health and cause nausea, body pain, and difficulty with sleep. Talking with a mental health provider can help alleviate stress, fear, and worry, and that helps improve physical symptoms. Greater Portland Health (GPH) has mental health counselors and providers who specialize in mental health treatment. They are embedded within primary care, and patients come to the health center for these appointments, just like for any other appointment. No one in the waiting room will know what services anyone is seeking at the health center. In addition, all medical information – including information about mental health – is confidential. Staff and providers at GPH do not share this information with anyone unless the patient provides specific authorization. 

Why is it so hard to get an appointment at GPH? Are there not enough staff? 

At Greater Portland Health, the majority of appointments are made over the phone. Appointments are open daily for urgent issues. For problems that are more chronic (have been going on for a long period of time) or for routine visits, appointments are scheduled farther in the future. A specific type of appointment, like a Civil Surgeon Exam, may take longer to get as there are limited appointments for this kind of visit. For those who feel they need to be seen sooner than a scheduled appointment, GPH has nurses on staff who can talk with patients over the phone to assess whether a need is urgent. 

Why do I have to wait so long in the waiting room when I arrive for an appointment

? Many medical practices turn patients away if they are a few minutes late for their appointment so that providers can stay on time. Greater Portland Health realizes that patients often rely on public transportation, other rides, or walking, to get to appointments. We try our best to see people, even when they arrive late. As a result, our providers sometimes get behind schedule. The best way to prevent this is for all patients to try to arrive a little bit early or on time for their appointment. This keeps everyone on track. In addition to arrival time, sometimes patients require more time than expected. Usually, providers only have 15-20 minutes with each patient. When patients need more time, providers get behind schedule.