"Mental Health Care in America's Youths" (AJN Reports, June) reveals a taboo topic in pediatric health care. As a nurse of 15 years, specializing in neonatal care and pediatrics, I have seen many patients in whom mental health care was lacking.

In my experience, three common problems prevent pediatric patients with mental health issues from being diagnosed: (1) their parents don't think anything is wrong, or they refuse to accept a diagnosis; (2) physicians and nurses fail to perform a mental health assessment; or (3) physicians are concerned about "labeling" a child.

Jerri Wolfford, BSN, RN, CPN

Beaumont, TX