Child and Teen Mental Health Care in York, PA: Ages 8 to 17 with Zainab Koroma

Zainab Koroma, PMHNP-BC, FNP-C sees patients ages 8 and up — in-person at our York office and via telehealth in PA and MD. Abu Koroma, PMHNP-BC, CRNA sees patients ages 12 and up via telehealth in PA, MD, and VA.

For children younger than 8, we recommend starting with your child's pediatrician for initial assessment, who can make appropriate referrals to pediatric psychology or child psychiatry as needed.

Yes. After a thorough evaluation that includes Vanderbilt rating scales (parent and teacher versions), we prescribe FDA-approved ADHD medications when indicated. Stimulants (methylphenidate, amphetamine formulations) are first-line per the 2019 AAP Clinical Practice Guideline for school-age children and adolescents. Non-stimulants (atomoxetine, guanfacine ER, clonidine ER) are alternatives when stimulants aren't appropriate or aren't well-tolerated.

Initial titration typically requires visits every 2–4 weeks to find the right medication and dose. We coordinate with the pediatrician for baseline cardiovascular screening and growth monitoring. Full ADHD details.

SSRIs carry an FDA black box warning for patients under 25 indicating a small but real increased risk of suicidal thoughts in the first weeks of treatment. The absolute risk is low — in clinical trials, about 4% of adolescents on antidepressants reported new suicidal thoughts versus 2% on placebo — and no completed suicides occurred in the original trials. The warning is to ensure close monitoring, not to discourage treatment.

Untreated adolescent depression is itself a major risk factor for suicide. The TADS trial showed that combination fluoxetine + CBT was the most effective treatment, with lower suicidality than either fluoxetine alone or placebo. Fluoxetine (FDA-approved age 8+) and escitalopram (FDA-approved age 12+) are the two SSRIs with FDA pediatric depression approval. We discuss the warning thoroughly with parents and the patient before starting, and monitor weekly for the first month.

Yes — parents are involved as developmentally appropriate. For children ages 8–11, parents are typically present for most or all of the visit. For adolescents 12–17, the structure varies: parents are present for the initial intake and decision-making conversations, but adolescents often have private time with the provider for clinical content. This balances parental involvement with the developmentally important task of teens learning to advocate for their own health.

Confidentiality: routine clinical content with adolescents is kept between provider and patient. Safety concerns — suicidal ideation, self-harm, substance use that puts the teen at risk — are shared with parents. We're transparent with the teen about what gets shared and why.

Yes — with appropriate releases of information signed by parents (and the adolescent for ages 14+). We can communicate with school counselors, teachers, and IEP/504 teams about accommodations and support; coordinate with the pediatrician on medication response, side effects, and physical health monitoring; and coordinate with existing therapists on integrated care plans.

For ADHD specifically, we collect Vanderbilt rating scales from teachers as part of the evaluation. For school refusal or significant academic decline, we provide letters supporting accommodations or 504/IEP requests.

Common, and worth working through. Some practical approaches: frame it as a one-time evaluation, not "therapy"; offer telehealth (lower friction, more privacy); let the teen choose between Zainab and Abu; emphasize that the first visit is mostly information-gathering, not "you have to talk about feelings." Many teens who resist initially engage well once they meet the provider and realize it's a real conversation, not an interrogation.

If your teen is in active crisis — expressing suicidal thoughts, self-harming, or refusing all engagement — that's a safety situation that needs more immediate help. Call 988 (Suicide & Crisis Lifeline) for guidance, contact your pediatrician's after-hours line, or go to your nearest emergency room. We can take over outpatient follow-up after stabilization.

Both can evaluate, diagnose, and prescribe medications for child and adolescent mental health conditions. Psychiatric Mental Health Nurse Practitioners (PMHNP-BC) are licensed in Pennsylvania to provide pediatric psychiatric care, including controlled substances within scope, working under Pennsylvania's collaborative-practice requirements for nurse practitioners. Child psychiatrists (MD or DO) have additional fellowship training specifically in child psychiatry — they're often consulted for complex cases (early-onset bipolar, autism with severe behavioral concerns, treatment-resistant cases).

For the majority of common pediatric mental health conditions — ADHD, anxiety, depression, behavior concerns — a PMHNP-BC provides comparable care to a child psychiatrist with typically shorter wait times. National pediatric psychiatrist shortages mean PMHNPs play an increasingly important role in providing access to care. We refer to child psychiatrists for complex cases that fall outside our scope.

Yes — mental health care is covered under federal mental health parity laws. We accept all major insurances. Call today to confirm your insurance. (717) 202-2285. Most patients pay only their plan's specialist copay (typically $20–60).

Self-pay rates are $249 for an initial evaluation and $99 for medication management follow-ups; therapy begun within your child's visit is not billed separately. HSA, FSA, cash, credit card, and check accepted.

Yes. The patient must be physically located in a state where the provider is licensed at the time of the visit.

For minors, a parent or guardian must be present at the visit and consent to treatment. We use HIPAA-compliant video and a secure patient portal. Most parents prefer an in-person first visit for younger children, with telehealth for medication management follow-ups once the child is established.

New patient appointments at Optimal Health York are typically available within one week. Initial evaluations for children and adolescents are 60-minute visits, allowing time for both parent and child input; follow-ups are 30 minutes. Saturday appointments (ages 12+), are available. Call (717) 202-2285 or book online 24/7.

If your child or teen is in crisis — expressing suicidal thoughts, self-harming, or showing severe distress: call or text 988 (Suicide & Crisis Lifeline), available 24/7. Crisis Text Line: text HOME to 741741. Contact your pediatrician's after-hours line for guidance, or go to your nearest emergency room. If there are firearms in the home, secure them with a gun lock and store ammunition separately — means restriction is one of the strongest evidence-based suicide prevention measures, particularly important for adolescents in crisis.