Precision Medicine Market Sets 2025 Economic Growth Target with Higher Percent, a Post-COVID 19 Plan

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According to the 2020 Market Research Future Survey, the analysts saw 12.48% of business growth in the Global Precision Medicine Market 2020 is expected to register. Five months later, in May 2020, as the COVID-19 pandemic spread worldwide, there was less possibility that business was having a favorable impact on a broader note. The analysts further studied that the market can reach a valuation of USD 126.14 Billion by 2025. The entire growth scenario is predicted to take place during the years 2014-2022.

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Precision Medicine–Boomers & Decliners

The field of precision medicine has made extensive progress with prime discoveries such as microarray/ biochips and single nucleotide polymorphism. These advancements in healthcare have been beneficial for patients to the core of the pharmaceutical industry as well as society. The advent of precision medicine has made researchers understand the method of patients clinical profiles. Human genome research is the future of precision medicine as it owes maximum potential to modify medical treatments for individual patients through the understanding of molecular profiles, genetics, and clinical characteristics in determining the treatment. These factors have made the precision medicine market more robust and stable during the COVID 19 pandemic period.

MRFR’s report presents the factor rising prevalence of cancer to be projected as a booster for personalized cancer diagnostics and therapeutics demands that will leave a positive impact on theprecision medicine market growth. As per a recently published article, in 2018, in the U.S., roughly 1.7 million cases were diagnosed with cancer alone. Apart from this, more factors propelling the growth of this market are escalating online collaborative forums, rising efforts to characterize genes and advancements in cancer biology.

Furthermore, precision medicine applications are chiefly directed toward better treatment against oncological diseases, with an estimated 30% and above market leadership over other segments. According to the data reported in, the United States and a few European countries are the foremost hubs for conducting and recruiting patient pool for precision medicine applications in oncology globally. The elevated support from the government through funding and rapid growth of genomic analysis might boost the development of the precision medicine market at a fast velocity in the forecast period.

Precision Medicine Market Segment Review

The global precision medicine market has been studied under ecosystem players, sub-markets, and therapeutics.

By the segment of ecosystem players, the global precision medicine market has included diagnostic companies, pharmaceuticals and biotechnology companies, clinical laboratories, and healthcare IT specialists/big data companies. The diagnostic tool companies segment grabbed a market value of USD 16.27 million back in 2017.

By the segment of sub-markets, the market has included molecular diagnostics, companion diagnostics, biomarker-based tests, targeted therapeutics, pharmacogenomics (PGX), and others.

By the segment of therapeutics, the market has included cardiovascular disease (CVD), cancer/oncology, infectious diseases, central nervous system, and others.

Precision Medicine Market Regional Aspect

North America presently

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Will-Kankakee Coronavirus Positivity Rate Reaches 10.5 Percent

JOLIET, IL — Coronavirus positivity rates and the number of new hospitalizations of people with symptoms of COVID-19 rose sharply across nearly every region of Illinois during the final week in October. All but one of the state’s 11 mitigation regions now have restrictions on indoor service at bars and restaurants and gatherings of more than 25 people.

In Region 7 — Will and Kankakee counties — indoor dining was again halted after the region’s seven-day rolling average positivity rate remained above 8 percent for three days last week.

For the week ending Tuesday, the percentage of specimens tested that came back positive for the virus rose by 1.3 percentage points to 10.5 percent in the two-county region — a new record for the region since state public health officials began reporting the data in June. The next day, the seven-day rolling average rose again to 10.8 percent, setting another record.

New hospitalizations in the south suburban region also rose during the week, according to the rounded seven-day rolling average of daily hospital admissions of patients with what state public health officials classify as “COVID-like illnesses,” or CLI.

The rate has more than tripled since the start of October. As of Tuesday, an average of 21 people were newly hospitalized with symptoms of the virus every day, up from 16 a week earlier.

Dr. Ngozi Ezike, director of the Illinois Department of Public Health, said the state needs everyone to do their part to change the trend.

“We are on the precipice of the entire state entering into mitigation,” Ezike said Friday, announcing the new mitigation measures for Region 6 in East Central Illinois.

RELATED: Coronavirus Indoor Dining Ban Imposed On Lake, McHenry Counties

Restrictions were added to 10 of Illinois' 11 COVID-19 resurgence mitigation regions in October after coronavirus metrics triggered fail-safe measures established over the summer by state public health officials. (Illinois Department of Public Health)
Restrictions were added to 10 of Illinois’ 11 COVID-19 resurgence mitigation regions in October after coronavirus metrics triggered fail-safe measures established over the summer by state public health officials. (Illinois Department of Public Health)

RELATED: Illinois Restaurant Association To Vote On Indoor Dining Ban Suit

“These last few regions have seen rapid increases in test positivity, one right after another, because of increasing disease spread throughout our communities,” Ezike said. “We need all people to adhere to both the community mitigation measures and well as personal and family measures so we can swiftly turn our entire state around.”

As of Friday, there were 49 counties across the state, including several in the Chicago area, that are considered to be at the “orange” warning level, which means two or more countywide risk indicators suggest a heightened risk of the virus.

They include: Adams, Alexander, Bond, Boone, Clark, Clay, Clinton, Coles, Crawford, Cumberland, DeKalb, Douglas, DuPage, Effingham, Ford, Franklin, Greene, Grundy, Hamilton, Henderson, Jackson, Jo Daviess, Johnson, Kane, Kendall, Knox, Lee, Macon, Marion, McHenry, Mercer, Morgan, Ogle, Perry, Pike, Randolph, Rock Island, Saline, Sangamon, Shelby, Stephenson, Wabash, Warren, Washington, Wayne, Whiteside, Will, Williamson and Winnebago counties.

RELATED: Pritzker Defends Coronavirus Data Used To Ban Indoor Dining

On Friday, public health officials announced 6,943 new confirmed cases

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Coronavirus Positivity Rises To 9.4 Percent In Region 8

WHEATON, IL — The coronavirus positivity rate in Region 8, made up of Kane and DuPage counties, this week reached its highest level since state public health officials began publishing the data.

In the third week of October, positivity rates continued rising across all but one of the state’s 11 COVID-19 resurgence mitigation regions. As of Friday, four of the regions are subject to state-ordered mitigation measures restricting indoor dining and other activities, including DuPage, Kane, Kankakee and Will counties.

In Region 8 of Gov. J.B. Pritzker’s mitigation plan, the positivity rate reached 9.4 percent Tuesday, the most recent day where the seven-day rolling average is available from the Illinois Department of Public Health. The two-county region had seen nine days of increases in the previous 10.

The average number of new daily hospitalizations in the region also continued to rise. The rounded, rolling seven-day average of admissions to hospitals with “COVID-like illnesses,” or CLI, rose to 23 people a day Tuesday, up from 18 a week earlier — and twice the region’s hospitalization rate from a month earlier.

Meanwhile, the number of counties considered to be at a warning level for COVID-19, meaning two or more county-level risk indicators show an increasing risk of the virus’ spread.

Half Illinois counties are now at the “orange” warning level: Adams, Bond, Boone, Carroll, Cass, Christian, Clay, Clinton, Crawford, DeKalb, Douglas, Edwards, Fayette, Ford, Franklin, Gallatin, Greene, Hamilton, Henderson, Jersey, Jo Daviess, Johnson, Kane, Kendall, Knox, LaSalle, Lee, Macon, Macoupin, McDonough, McHenry, Mercer, Morgan, Moultrie, Ogle, Perry, Pike, Pulaski, Rock Island, Saline, Shelby, Stephenson, Union, Vermilion, Wabash, Warren, Wayne, Whiteside, Will, Williamson and Winnebago.

RELATED: Coronavirus Mitigations In Region 8 Start Friday

(Illinois Department of Public Health)
(Illinois Department of Public Health)

Public health officials said some businesses continue to disregard social distancing and face covering requirements, noting in a statement that “mayors, local law enforcement, state’s attorneys, and other community leaders can be influential in ensuring citizens and businesses follow best practices.”

On Friday, the state public health agency reported and 3,874 new confirmed cases of the coronavirus, including 31 deaths.

As of Thursday night, there were 2,498 people in Illinois reported to be hospitalized with COVID-19, up by 482 from a week earlier and 38 percent more people than were hospitalized with the virus two weeks ago.

Of those currently in the state’s hospitals, there were 511 patients in intensive care units, 111 more people in the ICU than a week earlier. There were 197 COVID-19 patients on ventilators, 46 more than a week earlier.

Less than 83,000 tests were reported in the previous 24 hours. The statewide preliminary seven-day average positivity rate, as a percentage of total tests, is 5.6 percent for the week ending Thursday, up by 0.5 percentage points from a week earlier.

Illinois Coronavirus Update Oct. 23: More Than Half Of Illinois Counties Now At ‘Warning Level’ — Don’t miss updates about precautions in the Chicago area as they are announced — Sign up for Patch news alerts and

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Moderna’s coronavirus vaccine trial is fully enrolled, 37 percent of participants are minorities

“I think that we have done quite well — I think the demographics of the Moderna trial have markedly changed,” Larry Corey, a virologist at Fred Hutchinson Cancer Research Center said in an interview last week. Corey is heading up the clinical trials under Operation Warp Speed, the federal effort to speed vaccine development.

“We hope that we continue to improve upon that, this is the first trial,” Corey said. ‘There are two others in the field, and two more scheduled to go — so our journey in covid-19 vaccines is just starting.”

Pharmaceutical giant Pfizer’s coronavirus vaccine trial is also nearing completion. Pfizer’s trial, which is not part of Operation Warp Speed, has enrolled 39,862 of its planned 44,000 participants. Of those, 34,601 have received their second, booster dose.

Half the participants in both trials receive the study vaccine and half receive a placebo, and more than 25,000 of Moderna’s participants have already received their second dose.

More than half of the volunteers in Moderna’s trial are healthy and not at high risk of severe covid-19, the disease caused by coronavirus. But 25 percent are at elevated risk due to age and 17 percent are younger, but have conditions such as diabetes or obesity that put them in a high risk group.

Moderna has projected having early data in the next month that may show whether its vaccine is effective. The company will determine whether that data is sufficient to apply for regulatory authorization once it has accumulated two months of safety follow-up on half the study participants, a milestone anticipated slightly before Thanksgiving.

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Parents of Boy with Brain Disorder That’s ‘100 Percent Fatal’ Raise Money for Gene Therapy Clinical Trial

gofundme Connor

The parents of a boy with a rare, fatal brain disorder are raising money so he can participate in a gene therapy trial that has potential to stop the disease.

Marisa DiChiacchio and Mike Dobbyn’s 12-year-old son Connor has Sanfilippo Syndrome Type C, which is a rare degenerative brain disorder that is “like Alzheimer’s, but in children,” according to a GoFundMe campaign created earlier this month.

According to the campaign, the syndrome is “100 percent fatal” and has no cure.

“As the degeneration rapidly progresses, Connor will stop walking, stop talking, stop being able to feed himself,” the GoFundMe campaign says. “He’ll develop movement disorders and seizures, suffer severe dementia, endure a lot of pain and suffering, and then he’ll die.”

But Connor’s family is raising money for the Cure Sanfilippo Foundation and a gene therapy clinical trial that needs funding at UT Southwestern in Dallas, Texas.

gofundme Marisa DiChiacchio, Mike Dobbyn and their sons Keenan and Connor

RELATED: Louisiana Couple Welcomes Second Set of Identical Twins: ‘God Has a Real Funny Sense of Humor’

“Research for this gene therapy has shown in pre-clinical models that it can stop the disease,” the campaign says. “This clinical trial is the crucial step of determining whether earlier research is able to show the same therapeutic benefits in children.”

“It was like a bomb was dropped on us in the geneticist office,” Connor’s dad told CBS Philadelphia of the moment they learned of his diagnosis. “I just remember it was a life-shortening condition, the geneticist actually told us at the time, ‘Don’t Google this yet because we don’t have a 100 percent conviction on this diagnosis yet.’ “

gofundme Marisa DiChiacchio, Mike Dobbyn, Connor

RELATED: Casey Goode Opens Up About the Hardest Part of Son’s COVID Treatment and His ‘Emotional’ Homecoming

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“We knew Connor obviously was special and loved and adored by so many people, but sometimes you just don’t realize until something devastating like this comes out,” Connor’s mother added. “And just everybody comes out of the woodwork trying to help and wanting to help. So he’s like our local community rock star.”

As of Wednesday, the campaign had raised $172,210 of its $3,000,000 goal. 

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VA Coronavirus Positive Test Rate Drops Below 5 Percent Again

VIRGINIA — The Virginia Department of Health reported 926 new cases of the coronavirus and 28 new deaths of people with COVID-19 on Tuesday. The new cases bring the cumulative total to 167,754 since the start of the pandemic. Across the state, 3,485 people have died from the disease.

The seven-day positive rate of PCR tests is 4.8 percent as of Oct. 16, down from 5 percent the previous day. There have been 2,411,940 PCR tests completed to date, a 12,829 increase from Monday. Positive averages of tests by region include 4.1 percent in the northern and northwest regions, 4.5 percent in the central region, 4.6 percent in the eastern region, and 7.1 percent in the southwest.

By region, Tuesday’s 926 new cases included 308 in the southwest region, 193 in the northern region, 155 in the central region, 149 in the eastern region, and 121 in the northwest region.

The VDH reported 937 hospitalizations on Tuesday, down from 972 on Monday. The regional breakdown is 228 in the central region, 202 in the northern region, 202 in the southwest region, 174 in the eastern region, 131 in the northwest region.

Across the state, 19,170 COVID-19 patients have been discharged to date, as reported by the Virginia Hospital & Healthcare Association. No hospitals reported difficulty Tuesday obtaining personal protective equipment or other medical supplies in the next 72 hours.

There are 98 current COVID-19 patients on ventilators, up from 81 reported on Monday, according to the Virginia Hospital & Healthcare Association. Ventilator use among all Virginia hospital patients is at 23 percent, the association said.

ICU patients across Virginia totaled 194 on Tuesday, down from 210 the day before. ICU occupancy among all hospital patients stands at 79 percent, 12 percent higher than the 2019 average.

Here are the latest coronavirus data updates for our coverage area between Monday and Tuesday:

  • Alexandria: 4,133 cases, 324 hospitalizations, 75 deaths; increase of 10 cases and one hospitalization

  • Arlington County: 4,399 cases, 520 hospitalizations, 152 deaths; increase of 15 cases and one hospitalization

  • Fairfax County: 22,769 cases, 2,213 hospitalizations, 602 deaths; increase of 82 cases

  • Fairfax City: 155 cases, 13 hospitalizations, eight deaths; increase of one case

  • Falls Church: 75 cases, 13 hospitalizations, seven deaths; no changes

  • Loudoun County: 7,599 cases, 470 hospitalizations, 130 deaths; increase of 23 cases, two hospitalizations and one death

  • Manassas: 2,013 cases, 132 hospitalizations, 27 deaths; one case removed; increase of one death

  • Manassas Park: 632 cases, 57 hospitalizations, eight deaths; increase of one case

  • Prince William County: 13,674 cases, 977 hospitalizations, 221 deaths; increase of 62 cases, nine hospitalizations and three deaths

  • Fredericksburg: 573 cases, 51 hospitalizations, five deaths; increase of one hospitalization

  • Spotsylvania County: 2,343 cases, 150 hospitalizations, 47 deaths; increase of 16 cases and two hospitalizations

  • Stafford County: 2,279 cases, 168 hospitalizations, 19 deaths; increase of 12 cases


This article originally appeared on the Fairfax City Patch

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Montco Had 4 Percent Of PA’s Protection From Abuse Orders In 2019

MONTGOMERY COUNTY, PA — Montgomery County had one of the largest percentages of protection from abuse orders granted in Pennsylvania in 2019.

That’s according to newly released statistics from the Administrative Office of Pennsylvania Courts, which analyzed nearly 40,000 different petitions. PFAs are civil orders issued by the state to protect victims or potential victims of domestic violence, usually from a partner or family member.

>>Domestic Violence Rises In Montco: Where To Turn If You Need Help

Montgomery County trailed only Philadelphia (22 percent), Allegheny (9 percent), and Delaware (5 percent) in the largest share of PFAs issued in 2019.

The latest statistics come as Montgomery County sees a rise in domestic violence cases in 2020 since the beginning of the coronavirus pandemic. Isolation and quarantine have exacerbated underlying issues and caused increased stress in many cases, officials say. In the early months of the outbreak, cases of reported domestic violence increased by 9 percent in the county.

There’s also been a rise in relationship-related homicides in the county in 2020. They account for nine of 2020’s 14 homicides, per the District Attorney’s Office.

The county kept the courts working through the pandemic so that residents could continue to file PFAs.

PFAs can require that a domestic abuser have no contact with the victim or children. They can also order the abuser to leave the home where the abuse is taking place, or pay fines related to the abuse.

Statewide, the total number of PFAs filed increased to 39,132 in 2019. It’s a number that’s trickled steadily upwards since 2015, when 37,563 orders were filed.

There are numerous other resources available for victims in Montgomery County:

Laurel House

  • Open 24/7

  • Provides immediate, safe shelter for victims and children of victims

  • Provides counseling via Telehealth

  • Call 800-642-3150

  • Website

Women’s Center of Montgomery County

  • Open 24/7

  • Partners with law enforcement to provide counseling, relocation assistance, help with protection from abuse orders, and other advocacy to victims

  • Call 800-773-2424

  • Website

Victim Services Center

  • Open 24/7

  • Offers crisis counseling, medical exam support, help with protection from abuse orders, and more

  • Provides counseling via Telehealth

  • Call 888-521-0983

  • Website

Mission Kids Child Advocacy Center

  • Mental health treatment, resource referrals, medical care

  • Trauma therapy offered through Telehealth

  • Open Monday through Friday, 8:30 a.m. to 4:30 p.m.

  • Call 484-687-2990

  • Website

This article originally appeared on the Norristown Patch

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My dentist recommended this top-rated Waterpik flosser that’s 43 percent off

Our team is dedicated to finding and telling you more about the products and deals we love. If you love them too and decide to purchase through the links below, we may receive a commission. Pricing and availability are subject to change. 

If you’re extra careful when it comes to your dental hygiene, you likely already have an electric toothbrush, whitening toothpaste and maybe even coconut floss in your teeth-brushing arsenal. But you just might be missing out on one small-but-mighty tool.

While I floss on a daily basis, I have a permanent retailer on my bottom teeth to preserve the position of my pearly whites from my braces days. But this makes flossing extra tricky.

At my most recent teeth cleaning, my dentist recommended I invest in a Waterpik electric water flosser to ensure I’m always cleaning those hard-to-reach areas of my mouth — and behind my retainer.

It’s not every day your dentist pulls up the Amazon app and shows you exactly which product to buy. But mine dentist did that day, and now I’m forever grateful.

But not only my dentist recommends this dental device. The Waterpik flosser has a big fan base, with 35,000 five-star reviews. And right now during Prime Day, you can buy it for a whopping 40 percent off!

Shop: Waterpik Electric Countertop Water Flosser, $39.93 (Orig. $69.99)


If you have enough space on your bathroom counter, you can leave the Waterpik plugged in, making it ready for daily use. And if you have a permanent retainer, braces, implants or other dental work, the Waterpik is 99.9 percent effective at removing plaque on hard-to-reach spots. Plus, as the product description states, it’s 50 percent more effective than actual floss for improving gum health.

With its range of settings and 1,400 water pulses per minute, you can use the Waterpik in two different modes, including a massage mode to stimulate your gums. Not only that, but you can use the 10 pressure settings to get a range of gentle to firm cleanings. Plus, with the built-in timer, you don’t need to guess about cleaning time. You only have to use it one minute per day!

You receive seven different tip types with the Waterpik, designed for braces, crowns, implants, treating periodontal pockets and more, if you have any of those extra dental needs.

While I use the Waterpik daily in place of floss, it admittedly does have a learning curve. Your gums might be a little sensitive afterward, and you’ll definitely have water spraying around at first. Just be sure to use it over the sink.

After a few months of use, I’m a Waterpik fan and have said goodbye to traditional flossing. While Waterpik offers a cordless version, the company’s countertop electric flosser is discounted until Prime Day deals end Oct. 14 at 11:59 p.m. PST.

Not an Amazon Prime member? Sign up here.

If you liked this story, read about all the best Amazon Prime Day 2020 deals

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Key coronavirus model predicts nearly 80 percent rise in deaths by February

A key model foresees approximately 171,000 more coronavirus related deaths by February 2021, a number that would represent a spike of 78 percent.

The model from the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine suggests there will be roughly 389,087 deaths by Feb. 1.

If all Americans use face masks, the model’s best-case scenario projects 314,000 deaths by that date. The model, however, foresees more than 477,000 deaths if mask mandates are eased.

“We expect deaths to stop declining and begin increasing in the next one to two weeks,” researchers said, according to CNN. “The winter surge appears to have begun somewhat later than the surge in Europe. Daily deaths will reach over 2,000 a day in January even with many states reimposing mandates before the end of the year.”

As of Thursday morning, the United States is now averaging approximately 52,345 new daily cases, an increase of 16 percent from the previous week. 

An analysis of COVID-19 data from Johns Hopkins University reveals that 21 states are recording a peak of weekly averages of new cases since the onset of the pandemic, CNN reported

The states seeing record increases in new cases include Alaska, Colorado, Idaho, Illinois, Indiana, Kansas, Kentucky, Minnesota, Missouri, Montana, Nebraska, New Mexico, North Dakota, Ohio, Oklahoma, Oregon, South Dakota, Utah, West Virginia, Wisconsin and Wyoming.

Public health experts are warning that rising cases will continue to spike as the weather cools and people move indoors. 

Anthony FauciAnthony FauciTrump fields questions on coronavirus, conspiracy theories in combative town hall Chris Christie says he ‘was wrong’ not to wear face mask at White House Overnight Health Care: Georgia gets Trump approval for Medicaid work requirements, partial expansion | McConnell shoots down .8 trillion coronavirus deal MORE, the government’s top infectious disease expert, on Thursday warned that American families should “evaluate the risk-benefit” of having a Thanksgiving gathering with regard to spreading coronavirus. 

“We really have to be careful this time, and each individual family evaluate the risk-benefit of doing that, particularly when you have people coming in from out of town who may have been on airplanes, in airports,” Fauci said.

He called the current situation in the U.S. “quite concerning [and] we’ve really got to double down on the fundamental public health measures that we talk about every single day because they can make a difference.”

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50 Percent US Kids With Mental Health Conditions Remain Untreated, Claims Study

Half of the children in the United States suffering from any kind of mental disorder remain untreated, revealed a recently published study. The researchers analyzed data gathered from the 2016 National Survey of Children's Health, a nationwide survey administered to the parents of young adolescents.

The findings revealed that out of the 46.6 million youngsters in the age group of 6 to 18 years, whose parents filled the survey, around 7.7 million teens were suffering from at least one type of mental health issue like anxiety, depression, or attention-deficit / hyperactivity disorder (ADHD). Also, a year before this survey was conducted, only half of these children received counseling or any kind of treatment offered by a mental health provider.

The survey further showed that the percentage of young teens diagnosed with a mental health disorder and not receiving any treatment from a provider fluctuated extensively between 72.2 percent in North Carolina and 29.5 percent in the District of Columbia. The findings featured in the journal JAMA Pediatrics in February 2019.

What do child and adolescent psychiatrists have to say?

Co-author Mark Peterson, an associate professor at the Michigan University (Medicine) said that he pondered upon the conditions affecting children at a young age in a comprehensive manner. But he was shocked to see such a high percentage of young teens not receiving mental health treatment in the US

However, child psychiatrists did not seem too surprised with the results. Dr. Barbara Robles-Ramamurthy, an adolescent and child psychiatrist at the Long School of Medicine at the University of Texas (UT) Health Science Center, San Antonio, said that unfortunately, this was not news to her. In fact, she was well-versed with the fact that the percentage of young teens with mental illness who remained untreated in the US was quite high.

Explaining further, Dr. Jennifer Mautone, a consulting psychiatrist at the Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, said that the families and the children with mental illness face a number of challenges when it came to accessing mental health treatment services, thus pursuing to the high rates of not receiving treatment.

Extreme Dearest of Mental Health Providers

The American Academy of Child and Adolescent Psychiatry (AACAP) revealed that the United States was facing an extreme dearth of practicing child and adolescent psychiatrists. According to the available data, there were fewer than 17 health care providers per 100,000 teenagers.

This indicates that a lot of families needed to wait long to receive treatment, which deteriorated the primary mental health condition of the affected child. Also the qualified providers available faced significant challenges while interacting with other existing systems responsible for the care of these children. Some of these systems included the health care, education, child care, and the adolescent judicial system. All these systems were supposed to take care of the child, but none of them interacted with each other, resulting in half-hearted care.

A ray of hope

A lot of pediatric health systems have started …

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