As I was in the middle of making dinner on Sunday night, I started getting several messages regarding an incredibly exciting video message posted by the Duchess of Cambridge in support of the United Kingdom’s first Children’s Mental Health Week. The Duchess’ patronage, Place2Be, has launched Children’s Mental Health Week, which runs from February 16 – 22, 2015 with the hope of raising awareness of children’s mental health issues and encouraging children and their families to seek treatment for any mental health concerns.
There are a variety of mental health concerns that children can experience. Children can experience such mental health issues as depression, anxiety, and post-traumatic stress disorder just as adults do. It is worth noting, however, that the symptoms and presentation of these issues can manifest in a different manner in children than they do in adults. For example, adults with depression often experience fatigue and lethargy, a sense of hopelessness, and feelings of excessive guilt or worry, among other symptoms. Children, on the other hand, are more likely to demonstrate changes in appetite, anger outbursts, social isolation, and somatic symptoms such as stomachaches or headaches. As a society, our awareness of depressive symptoms in adults has greatly increased over the past decade, but the different presentation of depression in children can make it harder to spot – and harder to treat.
Certain mental health concerns usually first identified in children have recently risen to prominence in the media and national conversation. The Center for Disease Control currently estimates that one in 68 children have a form of Autistic Spectrum Disorder (also known as autism), a mental disorder characterized by marked social deficits and repetitive and restrictive behavior patterns. Autistic children require substantial support to function in social settings, and such support often needs to be lifelong. The CDC also estimates that approximately 10% of children between the ages of three and 17 have been diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD), which presents with symptoms of inattention and/or hyperactivity and can appear as an inability to follow directions or irritability. There is much debate as to whether or not autism and ADHD are over-diagnosed in children. After all, most young children are notoriously poor at following directions and often have tantrums, so it can be challenging to determine what is normal or abnormal behavior. Children with autism and those with ADHD both need treatment and support so that they can function at their optimal level at home and at school.
In addition to being aware of the mental health symptoms experienced by children, we should also spend some time investigating the stressors and precipitating factors in children’s lives that lead to these symptoms. For some adults and children, mental health concerns are the direct result of certain medical issues or genetic traits. For example, approximately 80% of the risk of schizophrenia is inherited from direct family members, which speaks to the genetic nature of this disorder. Certain other genetic syndromes that are most often diagnosed in childhood also present with mental health symptoms. In children with Williams Syndrome (in which someone is missing a specific gene on chromosome 7), we often see the hyperactivity, impulsivity, and lack of concentration that is diagnosed as ADHD. Fragile X Syndrome (due to the mutation of a certain gene on the X chromosome) is the most common known cause of autism, due to the presence of hand-flapping behaviors, social, and emotional problems, and frequent tantrums seen in these children.
Life stressors also can be a root cause of children’s mental health issues. Unlike adults, children lack control in their upbringing and home life. They are at the mercy of their caregivers and their school environment and this can have significant impact on children’s mental health. Financial and environmental poverty, drug and/or alcohol addiction, and any kind of loss (death, divorce, moving) can all lead to mental health issues. Children who are victims of any form of abuse or bullying also can experience mental health symptoms. Finally, children who experience any form of trauma are also at risk of developing mental health concerns.
One of the most important messages conveyed by the Duchess of Cambridge in her video message is that treatment for mental health issues merits the same amount of support as does treatment for medical concerns. Mental health treatment for children is complex. As Place2Be advocates, counselors (or therapists) are a great way to start. Counselors can work with children through various mediums (talk therapy, art therapy, even play therapy) to explore a child’s feelings or experiences. Sometimes group therapy is also recommended, which can help children speak to peers in a safe setting about their experiences and can also help them realize that they are not alone in those experiences. One of the most complicated parts of mental health treatment in children is the need to include parents and guardians in the treatment process. As I mentioned above, children don’t have control over their environments – this is the province of their caregivers – but those environments have profound effects on children. Treatment for children must be in collaboration with parents and guardians, both to encourage parents to support their child’s treatment and help make changes in the home that will help the child.
Treatment for children can also involve a range of disciplines beyond that of a counselor. Medical professionals often need to be a part of the conversation, as many mental health concerns are first identified by pediatricians and because medical issues can sometimes be the root cause of the mental health symptoms and must be addressed. It is also necessary to find support within a child’s school. The school nurse sometimes needs to be aware of what is going on in order to supply any needed medication or on-site medical support. Further, schools are required by law under the Americans with Disabilities Act to provide educational and social support to mentally ill children, through individualized education programs, resource rooms, peer support, and even one-on-one teacher aides. Certain mental health concerns also manifest with speech issues or motor difficulties, and these can be addressed through speech therapy and occupational therapy. Finally, sometimes medication is needed and the services of a psychiatrist are vital in identifying the correct course of medication management and maintenance.
Children do experience mental health concerns and they need help in identifying and treating these issues. Most importantly, they need the support and love of family and friends during these difficult and challenging times. Children’s Mental Health Week provides a wonderful opportunity to raise awareness about mental health issues and to start a conversation about the importance of treatment.
Twitter hashtag: #ChildrensMHW
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