child psychiatry


Child Psychiatrist: Why ‘Star Wars’ Is Good For Kids — And Nostalgic Parents

Carrie Fisher, left, and Mark Hamill star as Princess Leia and Luke Skywalker in the original 1977 “Star Wars,” later renamed “Star Wars: Episode IV – A New Hope.” (Vernon Area Public Library/Flickr)

Carrie Fisher, left, and Mark Hamill star as Princess Leia and Luke Skywalker in the original 1977 “Star Wars,” later renamed “Star Wars: Episode IV – A New Hope.” (Vernon Area Public Library/Flickr)

By Dr. Steve Schlozman

Like lots of people, I can remember the first time I saw “Star Wars.”

It was my first summer at sleep-away camp; I was 11 years old, and suffering from homesickness bad as a fever. I think I had about three weeks to go in an eight-week session that was hardly, in retrospect, torture. Still, when you’re 11, there are some things that never stop being terrifying. For instance, walking across the cold Minnesota dirt to the morning group shower was a daily tribulation. I was ready to go home.

Then, inexplicably, the camp director announced one morning during breakfast that the normal activities of the day would be cancelled. There would be no canoeing, fishing or riflery. He had a special treat, he told us, and we were to clear our trays and head out to the parking lot, where a bunch of school buses would be waiting to take us on a surprise field trip.

The parking lot was, to me, a lot like a landing pad. Five weeks earlier we had all been deposited there by these same buses, and since that time, while it had not been entirely off-limits, its hallowed ground was rarely frequented — lest we risk revisiting the fact that we would not be talking to our parents except through written letters for the next two months. (“Dear Mom and Dad. How are you? Today I caught a fish and cooked it. It tried to bite my finger off.”)

“Star” Wars is fundamentally about nostalgia. And nostalgia, remember, is a good thing.

We boarded those buses, and drove through the small town that harbored our camp, pulling into the parking lot of the only movie theater in town. It was a small town, so the theater itself was not that big; it couldn’t possibly accommodate all of the gangly legs and arms that emerged from the three big yellow buses, so we were divided into waves. I was in Wave 1 — I entered the theater near the front of the pack, while many of my fellow campers were left to while away the time at a local park until the next movie began.

And the movie we were to see was, of course, “Star Wars.”

Remember that this was during what some have called the golden age of summer camps. By definition, there was no contact with the outside world. We had no access to phones, or Internet, or even newspapers. There was certainly no television. I had no idea what “Star Wars” was all about; I hadn’t even heard of it. For me, it was enough to be sitting in the air-conditioning. But then, those words started scrolling across the screen:

“A long time ago, in a galaxy far, far away…”

And I’ll be damned if that movie wasn’t about a boy who willingly travels far away from his own home.

We burst out of the theater at the end of the movie ready to take on whatever foes blocked our inextricable march toward justice. Continue reading


Am I Safe? Psychiatrist’s Tips For Talking To Kids About The Paris Attacks

A victim outside the Bataclan theater in Paris (Jerome Delay/AP)

A victim outside the Bataclan theater in Paris (Jerome Delay/AP)

Advice columnist Steve Almond has a typically provocative piece on WBUR’s Cognoscenti today: “Why I’m Not Talking To My Kids About The Paris Attacks.” He and his wife decided, he writes, that “we have absolutely no interest in exposing our kids to the sort of panic-stricken coverage whose central aim is the profitable stoking of anxiety.”

But for parents whose children have been exposed to the news from Paris, here are some extensive and sage tips, broken down by age group, from child psychiatrist Gene Beresin, director of The Clay Center for Young Healthy Minds at Massachusetts General Hospital, re-posted with permission from The Clay Center’s website.

By Dr. Gene Beresin

Our hearts go out to the families of those who lost their lives or were injured in the recent terrorist acts in Paris.

At times like these, amid our shock, grief and fear, we need to be particularly attuned to the impact such events have on our children. Kids of all ages have questions and various emotional reactions — compounded all the more by the footage and commentary they may be seeing and experiencing. It is abundantly clear from sound research that children and teens can develop significant stress responses to what they are exposed to in the media.

While we want to shield our kids from the horrific images and stories of the terrorist attacks, it is increasingly hard to create an impervious shield. Full protection is impossible, and we should instead be prepared to help them in the wake of yet another mass killing.

While the world may feel to us increasingly unsafe, it’s our obligations as parents and caregivers to provide comfort, reassurance and guidance to our kids.

Here are some tips for all of us as we navigate this tragic time.

For Parents And Caregivers

Let’s face it: We’re all scared. These terrorist acts leave us feeling afraid, angry and insecure. However, we as adults need to find our own way of coping; after all, the more secure we feel, the better we are able to help our kids.

• We need, in times like these, to engage with others. Adults as well as kids require a sense of community to help us feel connected and protected. So, don’t worry alone; talk about what you are feeling with your partner, spouse and friends. It’s our relationships that hold us safely in this world.

• Make time for self-care through relaxing activities such as reading, listening to music or exercising.

• Pace yourself in terms of the amount of information you choose to consume. Sometimes, it’s best to just disconnect completely.

• If you have specific questions about your kids, call your pediatrician, primary care provider or mental health professional for advice.

Universal Impact On Children Of All Ages

Children need answers to three fundamental questions:

• Am I safe?

• Are you, the people who take care of me, safe?

• How will these events affect my daily life?

Parents should expect to answer these questions over and over again. For those with toddlers and preschool children who may not yet be able to express their concerns in words, it’s still important to reassure them that everyone is safe, and that life will continue in a normal fashion. Continue reading


Majority Of Young People With Depression Don’t Get Treatment, Report Finds

A new national snapshot of the state of mental health across America is, frankly, a little discouraging, especially when it comes to young people.

One startling finding from the annual report produced by the nonprofit Mental Health America: “[S]ixty-four percent of youth with depression do not receive any treatment.”

In addition, the report found:

Even among those with severe depression, 63 percent do not receive any outpatient services. Only 22 percent of youth with severe depression receive any kind of consistent outpatient treatment (7-25+ visits in a year).

I asked one of our frequent contributors, child psychiatrist Dr. Eugene Beresin, executive director of the Massachusetts General Hospital Clay Center for Young Healthy Minds and professor of psychiatry at Harvard Medical School, for his thoughts on the report.

Here, lightly edited, is his response:

First, I am not surprised. There are a number of issues not emphasized by this summary:

1. There is a huge shortage of child and adolescent psychiatrists in the U.S. Currently there are about about 7,000.

So while many parents seek help, the access to care is severely limited. Primary care pediatricians are inadequately trained in psychiatry and this has been addressed by the American Academy of Pediatrics. Their graduate training requires only two months in developmental behavioral pediatrics and few have any significant training in psychiatry. They are desperate to make referrals and often are at a loss to find qualified clinicians. Some states such as Massachusetts and New York have statewide efforts to assist them through consultation and education in psychiatry, but this only scratches the surface. Continue reading

Opinion: It’s Time To Screen Teenagers At School For Risky Substance Use

By Dr. Eugene Beresin
Guest Contributor

Hearings are being held in the Massachusetts State House on a bill that would enable public school nurses to screen teens for the risk of substance use. This practice is strongly supported by the Children’s Mental Health Campaign and the Addiction Free Future Project, and part of a mission in five states to promote screening for teenagers at risk of substance use problems.

We favor broad screening as a way to reduce death and disability due to substance use that typically starts in the teen years. We understand that this screening will be totally confidential — like all substance use screening and discussions between teens and health care providers. However, parents are free to oppose the screening of their children just as they may prevent their children from receiving vaccinations.

The downside to screening raised by some is that it will bring additional costs to the state, including extra time for training and to administer the tests. In addition, some kids may feel discomfort being asked sensitive questions. However, the overall reduced costs of treatment are great. And most kids really are open to talking about substance use in a confidential setting.

There are certainly some people who do not feel school is a place for screening of any kind. But after looking at research on substance use disorder prevention, professionals at The MGH Clay Center for Young Healthy Minds, The MGH Recovery Research Institute and the Massachusetts Children’s Mental Health Campaign feel that the benefits of early screening far outweigh the financial cost and time factors involved. The risks of excessive substance use in teenage years is very dangerous to brain development and social functioning.

A new blog post by screening advocates John F. Kelly, Ph.D., founder and director of the Recovery Research Institute and associate director of the Center for Addiction Medicine at Massachusetts General Hospital, and Courtney Chelo, behavioral health project manager at the Massachusetts Society for the Prevention of Cruelty to Children (MSPCC) lays out the details: Continue reading


Psychiatrists: Lessons For Parents From Horrific Cleveland Kidnappings

Ariel Castro appears in Cleveland Municipal court on Thursday. Castro was charged with four counts of kidnapping and three counts of rape after three women missing for about a decade and one of their young daughters were found alive at his home earlier in the week. (Tony Dejak/AP)

Ariel Castro appears in Cleveland Municipal court on Thursday. Castro was charged with four counts of kidnapping and three counts of rape after three women missing for about a decade and one of their young daughters were found alive at his home earlier in the week. (Tony Dejak/AP)

The news out of Cleveland this week of three young women held captive for a decade of physical, sexual and psychic abuse horrified the world. For parents, the news provoked perhaps a more targeted kind of fear, and raised one of the most fraught questions in parenting: How can we instill in our kids street smarts and an instinct to detect danger without leaving them terrified and fearful of the world? For some answers, we paged child psychiatrists Gene Beresin and Steven Schlozman, both at Massachusetts General Hospital and Harvard Medical School. Here is their professional response:

Every parent has said it: “Now, kids…don’t talk to strangers.”

It’s good advice. However, given the recent horrific events in Cleveland, some parents might very appropriately worry that this particular bit of wisdom is due for re-evaluation. After all, it appears all three young women kidnapped and held hostage for the past decade got into a car with their tormenter. He was known in the neighborhood, after all, and his own daughter was friends with one of the victims.

This is, of course, an extreme example of a particular narrative that we hear repeatedly these days. “We can’t let our kids play outside like we used to — the world has changed too much.”

But where does that leave us? What do we say to our children as we struggle to maintain the shaky balance between ensuring safety and also teaching independence and reasonable trust in the world and in our communities?

This is among the most vexing questions of modern parenthood. We certainly don’t want our kids to see a trusted uncle or coach as a potential villain – that would create an emotionally untenable world where all individuals, no matter how well known, are deemed potentially dangerous.

And yet, the alleged perpetrator in Cleveland was the father of one of the prisoner’s close friends. How do we deal with this dilemma?

There is of course no perfect or straightforward answer. Events like those in Cleveland are indeed extremely rare. Understandable media attention can create the impression that the world is in fact far worse than it actually is. At the same time, though, we have to find a way to increase awareness among our children of the potential dangers inherent in our world.

Know Your Child

So, for children of all ages, what can we do to?

Remember that every child is different; the way you present your words of safety needs therefore to be tailored to your individual child. So, the first principle is to know your child. Parents are good at this. In most cases, no one knows a kid better than the kid’s parents. There are 8-year-olds who will not be particularly bothered that even a well-known neighbor might have somewhat sketchy “issues.” And there are 12-year-olds who will freak out, have nightmares and feel that he or she can never trust anyone ever again. Continue reading