children’s mental health

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Parents: Kids Spurn Emotional Help For Fear ‘They Might Think I’m The Next Shooter’

Candles spelling UCC -- for Umpqua Community College -- are displayed at a candlelight vigil for those killed during a fatal shooting at the school, Thursday in Roseburg, Oregon. (Rich Pedroncelli/AP)

Candles spelling UCC — for Umpqua Community College — are displayed at a candlelight vigil for those killed during a fatal shooting at the school in Roseburg, Oregon. (Rich Pedroncelli/AP)

By Lisa Lambert
Guest contributor

Lisa Lambert is the executive director of the Parent/Professional Advocacy League, which is subtitled “The Massachusetts Family Voice For Children’s Mental Health.”

“He doesn’t want to take the risk and have someone think he could be a shooter,” one mother said, “just because he has a mental health diagnosis.”

I was at a meeting with other parents whose children have mental health needs. This mother told us her son was reluctant to leave his high school classroom for an important evaluation, which included psychological testing.

Like much of America, we were talking about the recent and not-so-recent shootings on campuses and in communities across the country. For this mother, as with many parents whose children have mental health issues, the conversation is far more personal and troubling than for most.

Some parents said that in response to recent shooting incidents, their children are dropping out of services or refusing school supports so they won’t risk their peers or teachers finding out why they get treatment.

As a parent, this breaks my heart. Young adults shouldn’t have to choose between the safety found in avoiding treatment and the healing found in seeking it.

Lisa Lambert (courtesy)

Lisa Lambert (courtesy)

During our discussion, another mother reported that her son was in his first year of college and struggling to complete all his coursework. Freshman year is a stressful time for many students and even more so for students with depression. Because her son had had special education services in high school, he could access supports there to help him manage his academic and emotional stress.

She encouraged him to go to the college student services office to get help. He responded, “I’d rather drop the classes I am most behind in. If I go there, the professors and other students will know I have mental health problems. They might think I could be the next shooter.”

Often, as a news channel covers the latest shooting, the speculation immediately jumps to mental illness. Continue reading

Mass. Parents Report Early Logjam In Care For Mentally Ill Kids

LisaLambert-140x140

Lisa Lambert of PPAL (Courtesy)

It usually happens in spring, the annual back-up of mentally ill kids who need beds in Massachusetts psychiatric hospitals or residential care centers.

But Lisa Lambert, executive director of the Parent/Professional Advocacy League, which works on behalf of mentally ill children and their families, reports that already this fall, the waits are unusually long and the resulting crises severe. (Imagine: a child in severe emotional distress, stuck in an Emergency Room for days. Or stuck in a hospital far from home, because there are no local beds.)

What’s happening? It’s not exactly clear. Might it be that state social service agencies are putting kids into residential care more than usual in the wake of the Jeremiah Oliver case? Is it a longer-term effect of having more community-based treatment for kids? Community care is widely considered a good thing, but it could mean that because children in crisis stay at home longer, their needs are more acute when they’re brought in for care. Lambert writes that the bottom line is that no one seems to be taking responsibility for alleviating the back-up, and the situation is getting dire:

At my office, the phone and emails are nonstop. Often, they spill over to the weekend. A few days ago, we heard from a mom whose 14 year old son had swallowed a bottle of Tylenol. This was his third suicide attempt. She rushed him to the emergency room and got medical treatment right away. But once that was completed, he needed inpatient mental health care. “You have to wait, his mother was told twice a day. “There are no beds.” She’s a smart and proactive parent and was trying every avenue to budge a system that told her there was nowhere to admit her son for treatment. When she called us he’d been waiting for four days and counting.

We are hearing a new term this year: boarding at home.

We are not the only state grappling with this issue. Last summer, the Sacramento Bee reported that hospitalizations for California children and teens had spiked 38% between 2007 and 2012. Nationally, hospitalizations have also increased but at a slower pace than California. Connecticut also reports an increase in children and teens coming to emergency rooms in psychiatric crisis. Data from the state’s behavioral health partnership shows that the number of children and teens stuck in emergency rooms rose by 20 percent from 2012 to 2013. Continue reading

School Lockdown Calculus: The Line Between Preparedness And Trauma

(Cory Doctorow/flickr)

(Cory Doctorow/flickr)

By Dr. Steven Schlozman
Guest Contributor

“If there’s a lockdown and they tell me to go under the table, and there’s a window open next to my desk, I’m going out that window. There’s no way I’m sticking around.”

That’s what a 14-year-old boy recently told me after he was reminded again that with the start of the school year comes as well the now increasingly familiar “lockdown” drill protocols.

Not very long ago, you’d probably have to ask kids what “lockdown drill” meant. Now, however, most kids recognize the term as routine. There’s recess, lunch-time, fire drills and lockdowns. Since the beginning of this school year alone, there have been more than 10 actual school lockdowns across our nation. One, as recently as this week, in New York. Importantly, none of these incidents featured the horrible images that come to mind when we picture nightmares like Sandy Hook or Columbine. A child might think she’s seen a gun in the school, or neighbors nearby might brandish shotguns in the midst of suburban altercations.

In all cases, schools aren’t taking any chances. The lockdown is quickly enacted and, school officials are quick to note, no one gets hurt.

But at what cost? Is there a psychological risk to what has now become routine practice? It’s time that we examine the lockdown and all its potential repercussions.

As a child psychiatrist, I worry a lot about these drills. Schools regularly ask for advice from mental health professionals on these matters, and parents often reach out and ask, understandably, what we ought to do in the setting of the still enormously rare and, at the same time, increasing and enormously traumatic spate of school shootings. The implementation of the mandatory lock down drill at our nation’s schools represents an awful lot of energy and resources and a potentially significant threat to the psychological well-being of our students in preparation for something that still thankfully hardly every happens.

Here are the facts:

•School shootings are horrific.

•School shootings are extremely rare.

•School shootings are increasing (at least according to this FBI analysis).

•Given how rare these events are, one can accurately say that school shootings are in fact increasing at a steady clip.

In other words, if we go hypothetically from one event to four events per year, that’s a fourfold increase even though the overall number of schools without incidents still massively dwarfs the schools that have had to endure a shooter.

•Every parent and every teacher worries about these events.

•Kids, it turns out, seems to worry less about these shootings than do adults.

•Some kids, however, are significantly frightened by these drills. Continue reading

Fallen Idols: Therapist On Talking To Kids About Doping Athletes

By Steven Schlozman, M.D
Guest Contributor

Lance Armstrong. Sammy Sosa. Mark McGwire. And now Ryan Braun.

/flickr

Andy Miah/flickr

These athletes share an awful lot in common. They’re all celebrated professional sports stars. They are now — and always have been — amazing athletes. And, they all fell hard from the exalted pedestals on which we seem intent on placing them.

Armstrong, Sosa, McGwire and Braun all used performance enhancing drugs. How do you tell your kids that their sports heroes are no longer heroes? Do the stars stop being heroes to your kids? How do you tell an eight-year-old that the homeruns Sammy Sosa hit are somehow not real? They sure looked real when the made their way out of the park…

A common and more general question thus rears its head for fans and, even more importantly, for the parents of young fans. What do we tell our kids when their idols fall from perceived grace?

We can use the ongoing issue of performance enhancing substances as a primer for these discussions. In fact, this is a more complicated issue than at first might appear. After all, we tend as a culture to have a binary view of our athletes. Spend five minutes on Sports Radio, and you’ll get that message. Athletes are either gods or they’re bums. There isn’t a whole lot in between.

In fact, developmentally, we tend to view the professional athletes in our world with the cognitive level of an eight-year-old. Continue reading

Judge In Famous ‘Rosie D’ Case Reflects: ‘What Are People For?’

“Rosie D” is famous. A landmark Massachusetts lawsuit bears her name, a suit that continues to reverberate through the state’s mental health system. “Rosie D” was the lead plaintiff in a class-action suit brought against the state, arguing that it was not doing right by its children with serious mental illness on Medicaid. Many could not get the services they needed at home, where they wanted to be.

In 2006, a federal judge, Michael A. Ponsor, ruled that yes, the state had to do better by its poor, mentally ill children. That decision has continued to play out in the years since, as the state carries out a plan to try to fix the system and offer more care to children at home. (An FAQ on ‘Rosie D’ is here.)

Today, Judge Ponsor spoke in Boston to the second Children’s Mental Health Summit, a major meeting aimed at assessing the current state of the children’s mental health system — progress made and challenges remaining. He kindly agreed to provide the text of his remarks as prepared; nearly the full text follows. Judges don’t usually get to editorialize freely from the bench; here, Judge Ponsor uses his public-podium time to pay personal homage to all the dedicated people who work in the challenging — and often under-appreciated — field of children’s mental health. 

A few weeks back Kate Dulit asked me for a title for these few remarks,and, on an impulse, I pinched the title from an essay by the naturalist Wendell Barry — the question “What Are People For?” I think I was drawn to the question because I wanted to try stepping back, to take a long view of the challenges faced by the people sitting in this room – advocates, clinicians, agency staff and others – and to applaud the incredibly hard, incredibly important work you do. As I tried to assemble what I was going to say, I began to fear that the title struck too grandiose a pose for my fifteen minutes of modest observations. I’ve had a tendency to make this kind of mistake in the past…

‘A solid majority of the adults who come before me in federal court as criminal defendants suffer from mental health disorders that can be easily traced to childhood.’

With that humiliating background, let me turn to my possibly over-blown question: What are people for? It seems to me that, while there may be some debate about many other justifications for human existence, one vital and obvious task we all bear, that we share with all living things, is to protect, nurture, and cherish the next generation – our own offspring as well as others’ children – and to give them the best start we can in their lives. By doing this we help to insure the continuation of our own species, and we give those who will succeed us the tools to build on what we’ve created, and, one selfishly hopes, the generosity to nurture us as we decline.

The evidence is strong that in the United States we are not doing this work very well, especially recently. Continue reading