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“Mom, I’m gonna kill myself. I can’t take it anymore. I just want to die. I want to go to the woods and kill myself. Can you just leave me on the road somewhere?’
Gianni, nearly five years old boy, said this an hour after being prescribed an untested antidepressant by a doctor, who did not know exactly what was wrong with him.
“You’re so desperate you’re willing to take anything as a diagnosis,” Gianni’s mother recalls that episode in a 2011 CNN report. Is Gianni bad, disturbed, or ill? What can be done to help youngsters like him?
Neuropsychiatric disorders in children could swell by 50 percent by 2020, putting them among the five leading causes of childhood illness, disability and death, according to the World Health Organization (WHO).
Many experts admit inability to explain precisely why mental issues among children are rising rapidly. Is it related to increased stress in children, families, “social disintegration” or a remarkable level of insecurity among young people?
Wanted: Early intervention
Complex psychological symptoms, abnormal behaviors, impaired functioning, or any combination of these often characterize mental disorders. This is what experts mainly agree on: Early interventions prevent or mitigate onset of mental disorder.
Early intervention means early assessment; missing the early warning signs or aberrations during childhood or adolescence means losing the intervention opportunity and could lead to more serious mental disorder later in adulthood.
Half of all mental health disorders show first signs before the age of 14, and three quarters of mental issues begin before age 24. Despite state and private insurance programs, less than 20 percent of mental health problems receive needed treatment.
Chronic childhood adversity, now recognized as far more prevalent than researchers had imagined, could lead to mental issues. These childhood experiences include an incarcerated family member, an unexpected or untimely death in the family, depression, violence, abuse or drug use in the home, or periods of homelessness.
Unfortunately, the education system often responds bluntly to children manifesting mental challenges. Many academic personnel resort to traditional disciplinary measures from yelling and “timeouts” to detentions and suspensions. These only enhance stress, are ineffective and make things worse for many students.
Barriers, solutions
The US Surgeon General reported, “One in five Americans experiences a mental disorder in any given year. Unfortunately, half of those with severe mental illness do not seek treatment.”
There are subtle barriers to accessing mental treatment: stigma or embarrassment is associated with mental illness; shortage of providers, long seen as significant problem in the U.S.; lack of information; parents themselves burdened with mental issues, are among others.
Reforms to help reduce crime, incarceration and homelessness have been proposed as solutions. Newer concepts are also emerging.
Providing care through patient-centered medical homes into which many community clinics are now morphing is one. These facilities integrate mental, medical, vision and dental care so patients can seek treatment for a range of disorders under one roof. This integration resolves an array of barriers, thus optimizing each service.
“Screening students” and “teaching emotion” in school are also proposed. These, however, are not without controversies flaring up among parents, providers and school administrators.
Screening in schools
“Mental health screening can save lives,” contended advocacy-group Mental Health America (MHA) in 2013. “Thanks to the results of research and technology, our mental health can be measured much like other vital signs in our body, such as heart rate or blood sugar, stated, Wayne W. Lindstrom, Ph.D., president and CEO of MHA.
“Screenings for mental health are just as important as school and sport physicals,” according to Laurie Glynn, executive director of the TeenScreen National Center for Mental Health Checkup at Columbia University.
Early widespread screening in the middle school to identify struggling children has been proposed. A bill first introduced in 2007 (H.R. 1211: Mental Health in Schools Act of 2015) went to congressional committee in March 2015.
Teach ‘emotion‘ in classroom
“Every classroom in America, starting as early as kindergarten, should begin each morning by placing magnetized name tags next to a ‘How I Am Feeling’ chart — a pledge of personal allegiance that tells teachers, fellow students, and parents that it’s okay to be sad, angry, and happy,” suggested columnist Clark Young.
“Teachers should then record that daily information in a personal, morning journal to discover patterns of expression that may result in the need for further understanding alongside parents, principals, and social workers. In this day and age, an email or text titled ‘Today, your child says he/she is feeling…’ could be sent to parents by 9:10 a.m.,” he said further.
The goal is for children to understand their own anger, frustration, and sadness or what emotion they have for the day. In the immediate sense, red flags will become more accessible, and feelings easier to discuss. Relationships will develop. The rub is, some school districts have a social worker to student ratio of 1:400.
Mental illness is a critical public health problem that must be addressed immediately. Besides expanding services and creating full service schools there is a need for comprehensive, multi-faceted approaches that help make schools caring and supportive places that maximize learning and wellbeing and strengthen students, families, schools, and neighborhoods.
Advocacy or a crusade on mental health should begin at the doorsteps of the academes.
Dr. Aggie Carson-Arenas is a Clinical Psychology and a Behavior Analyst specialist in Nevada (NPI 1972927598), an educator, researcher, and a published author.