When you bring your keiki (child) in for a checkup, you expect the basics: height, weight, vaccines, a listen to the heart and lungs. We think the visit should also ask a bigger question — how is this child doing in body, mind, and ʻohana (family)? Here is why the medical evidence, and Hawaiian wisdom older than any clinic, both point the same direction.
Physical and behavioral health grow up together
According to the Centers for Disease Control and Prevention, anxiety, behavior disorders, and depression are the most commonly diagnosed mental health conditions in children — in 2022–2023, about 11% of children ages 3–17 had current diagnosed anxiety, and roughly 1 in 5 children has been diagnosed with a mental, emotional, or behavioral condition at some point. These struggles rarely announce themselves in an exam room. They show up as stomachaches with no medical cause, sleep problems, falling grades, or a kid who is suddenly “not themselves.” A checkup that only looks at the body will miss them.
What the pediatric experts say care should include
This is not our opinion alone — it is the standard the field is moving toward. The American Academy of Pediatrics’ Mental Health Competencies for Pediatric Practice policy calls for mental health care to be woven into pediatric primary care itself, not treated as someone else’s job. Its 2023 policy statement, Increasing Access to and Utilization of Behavioral Health Care Through Integrated Primary Care, goes further: when behavioral health lives inside the primary care practice, more families actually get help. The U.S. Preventive Services Task Force now recommends screening for anxiety in children ages 8 to 18 and for depression in adolescents 12 to 18 as routine preventive care — the same category as vision checks and immunization reviews.
What “working together” looks like at Ohana Care Clinic
Our practice was built psychiatric-first: Ohana Care Clinic grew out of OhanaPsych, so behavioral health is not an add-on here — it is the foundation. In practice, that means brief behavioral and developmental screening is part of well-child care; when a screen raises a flag, the handoff to a behavioral health provider happens inside the same practice, with shared records and a shared plan, instead of a referral letter to a stranger with a six-month waitlist. Your child’s story stays in one place, and their pediatric and behavioral health providers actually talk to each other.
A picture of what this can look like
Consider a 7-year-old brought in because he is not sleeping. The medical workup is reassuring — but a brief behavioral screen suggests anxiety is driving the sleepless nights. Because behavioral health sits inside the same practice, his parents leave that same visit with answers, a plan, and a follow-up already scheduled with a provider who shares notes with his primary care team. (This is a fictitious example, not a real patient.)
Lōkahi: whole-child care has deep roots here
Integrated care is presented in journals as an innovation. In Hawaiʻi, it is closer to a return. Native Hawaiian health frameworks — carried forward today by organizations like Papa Ola Lōkahi — understand wellbeing as lōkahi: balance and unity across physical, mental, emotional, and spiritual life, held within the ʻohana rather than the individual alone. To mālama (care for) a child means caring for all of it. That is the spirit we aim to practice in Hilo, in plain clinical terms: one team, one plan, the whole keiki.
Telehealth and in-person, honestly
About 85% of our care statewide happens by telehealth, and much of behavioral health care — parent guidance, therapy follow-ups, medication check-ins — works very well that way. But we will be straight with you: well-child physicals, vaccines, and hands-on exams need an in-person visit at our Hilo clinic. Most families end up with a mix, and we will always tell you which is which. We accept Medicaid (QUEST), Medicare, and most commercial plans, and interpretation and language assistance are available.
When to seek help now
If your child talks about suicide or self-harm, or you are worried about their immediate safety, do not wait for an appointment. Call or text 988 to reach the 988 Suicide & Crisis Lifeline — in Hawaiʻi, this connects to Hawaiʻi CARES, the state’s 24/7 crisis line (direct: 808-832-3100, toll-free: 800-753-6879). In an emergency, call 911.
Medically reviewed by George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP — President & Owner, OhanaPsych / Ohana Care Clinic
Date published: July 1, 2026 Last reviewed: July 1, 2026 Citations verified: July 1, 2026
References
American Academy of Pediatrics. (2019). Mental health competencies for pediatric practice. Pediatrics, 144(5), e20192757. https://publications.aap.org/pediatrics/article/144/5/e20192757/38256/Mental-Health-Competencies-for-Pediatric-Practice
American Academy of Pediatrics. (2023). Increasing access to and utilization of behavioral health care through integrated primary care. Pediatrics, 152(6), e2023062514. https://publications.aap.org/pediatrics/article/152/6/e2023062514/195464/Increasing-Access-to-and-Utilization-of-Behavioral
Centers for Disease Control and Prevention. (2025, June 5). Data and statistics on children’s mental health. https://www.cdc.gov/children-mental-health/data-research/index.html
Hawaiʻi State Department of Health. (n.d.). Hawaiʻi CARES 988. Retrieved July 1, 2026, from https://hicares.hawaii.gov/
Papa Ola Lōkahi. (n.d.). Mental and behavioral well-being. Retrieved July 1, 2026, from https://www.papaolalokahi.org/program/mental-and-behavioral-well-being
U.S. Preventive Services Task Force. (2022). Anxiety in children and adolescents: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-anxiety-children-adolescents
U.S. Preventive Services Task Force. (2022). Depression and suicide risk in children and adolescents: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-depression-suicide-risk-children-adolescents
This article is general health education from OhanaPsych and Ohana Care Clinic. It is not a substitute for a personal evaluation by a qualified clinician who knows your situation, and reading it does not create a provider–patient relationship. If you think your child may have a medical or mental health condition, reach out to us or another licensed provider. In an emergency, call 911.
