My
previous blog dealt with mental health crisis, but there is general information
about mental health issues that all families should know. 1 in 5 children have mental health issues,
yet only 50% get help. Half of mental
illnesses start by age 14. The highest dropout rates are for kids with mental
illness (source NAMI {National Alliance on Mental Illness.}) Here
is a summary of the Statewide Parent Advocacy Network’s mental health guide for
families (see Resources.)
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Photo
www.unitedwayaustin.org
Access
to care
Mental
Health is just as important as physical health. The Affordable Care Act
strengthened access to mental health services. One of the ten Essential Health
Benefits is coverage for “mental health and substance use disorder services,
including behavioral health treatment.”
Avoiding
Stigma
In dealing
with mental health, families must try to avoid the stigma associated with
mental illness. The NAMI likens it to any other biologically-based illness
except the organ affected just happens to be the brain, and the symptoms
manifest as behavior. Just as no one would blame someone with diabetes who
needed insulin, the same should be true for those who need treatment for mental
illness.
When
to Get Help
It could be time to talk
with your primary care provider and consider getting professional help if your
child has any of the following symptoms:
Frequent temper tantrums
Crying more than usual
Not doing things they enjoy
Waking up at night
Needing a routine or doing the same things over and over
Overeating or extreme dieting
Not being able to sit still or pay attention
Doing poorly in school
Drinking, smoking, drugs
Not dealing well with loss (such as death in the family)
Trauma (natural disaster, abuse, accident etc.)
Any behavior that
is harmful to themselves or others
Photo
www.coordinatedfamilycare.org
What to Expect
The
mental health provider will do an assessment of the child, including family
history. They may use tests to screen for certain conditions. If the assessment
shows the possibility of a disorder, the child may need a more detailed
evaluation to reach a diagnosis.
The Diagnosis
Sometimes
the “not knowing” is worse than actually having a name for the condition. Once
parents know what’s happening, they may not feel so helpless or hopeless. The child may start having questions and ask
about his/her condition. Children may ask, “Why I am I different,” or “Why is
it so much harder for me to do things?”
Photo
http://forourkids1st.blogspot.com
Medication
Medication
use is a personal decision. Families need to realize, however, that mental
illness is “biologically based.” Families may also be concerned about the
“black box warnings” on certain medications for children. The warning, although
warranted, has predictably lowered the amount of certain prescriptions;
however, there must be recognition that untreated depression is the highest
risk factor for suicide. There are some excellent guides on medication use
which should help parents, which also address this issue of balance.
Supports and
Services
SAMHSA
(Substance Abuse and Mental Health Services Administration) emphasizes a Wellness/Recovery
Model. Prevention, as well as getting better, are the key ideas. This idea of
wellness is based on “evidence-based practices” (proven to work.) The key
recovery concepts are hope, education, personal responsibility, support and
self-advocacy.
Schools and
Mental Health
Collaboration
and education on mental health in the school setting is critical. Children
spend many hours in the school environment. Schools have a responsibility to
identify children who may have emotional, behavioral, and/or mental health
challenges. When there are concerns, the child may go through a pre-referral
intervention such as the Intervention and Referral Services (I&RS) Team in
New Jersey. The team may decide that the child just needs extra supports in
school and then look at Response to Invention (RTI), which requires the school
to provide “evidence-based” interventions and then determine whether those
interventions had the desired effect. An
important piece for success at school is the use of Positive Behavioral
Interventions and Supports. Behavior is the result of the child trying to
communicate the best he/she can.
State Agencies
on Children’s Mental Health
Many
states have a Department of Children and Families which can offer assistance.
Some states have a “Children’s System of Care” which covers behavioral health.
There may also be “mobile response” available for crisis intervention which
means they would go to where the child is, including home, to try and
deescalate the crisis and stabilize the situation.
Where to Find Help in Your
Community
There are many organizations that support families of children with
challenging behaviors.
FFCMH
is a national family-run organization linking more than 120 chapters and state
organizations focused on the issues of children and youth with emotional,
behavioral, or mental health needs and their families.”
NAMI has workshops for families, a Child &
Adolescent Action Center, and a family guide on how a primary care doctor can
address mental health.
Parent-to-Parent
is a national network offering support to families. Trained volunteer parents
are matched with families of children with the same condition. These services
are free to families. Parents can get one-to-one support from another parent who’s
“been there.”
Advocacy/Self-Advocacy
Issues
There
are some issues regarding mental health that may affect children and also later
as they become self-advocates. These can include minor consent, making medical
decisions, parent’s rights, restraints, waiting in emergency rooms, and dual
diagnosis of mental illness and developmental disability.
Other good
resources for families:
There are resources for young children, helping
siblings understand, and information for teens (listed in our mental health
guide in Resources.) Family
caregivers who have children with mental illness can use this information to
make good treatment choices for their child, resulting in best outcomes.
Resources
Children’s Mental Health Services: A Family Guide
Parent Training and Information
Centers
Positive Behavioral Interventions
and Supports
Remain Hopeful,
Lauren
Lauren Agoratus is a parent/advocate
who works for the Statewide Parent Advocacy Network and serves as the NJ
Coordinator for Family Voices (www.spanadvocacy.org), a national network that works to “keep families at the center
of children’s healthcare” at www.familyvoices.org
or
FB www.facebook.com/pages/Family-Voices-Inc-National/137783182902269. She also serves as NJ representative
supporting caregivers across the lifespan for the Caregiver Action Network
(formerly National Family Caregivers Association) in a volunteer capacity at http://caregiveraction.org/
or
FB www.facebook.com/CaregiverActionNetwork.
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