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Advocate, National Alliance on Mental Illness

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Half of teens with mental illness don't get treatment. It gets worse at age 18. How do we identify & treat teens with mental Illness?

As part of the response to the tragedy in Newtown and the Vice President's task force that resulted, President Obama has proposed to spend $235 million on mental health screenings for children in schools. This plan has been met with some skepticism as to its potential effectiveness and potential bias against children of lower incomes or of color.

But NAMI and NIMH statistics have shown that more than 50% of adults with serious mental illness - Bipolar Disorder and Schizophrenia - showed their first symptoms before the age of 14, and that teens and young adults (>25) have an average of six YEARS between onset of first symptoms and first treatment.

Due to HIPAA laws, parents of children over age 18 cannot get mental health treatment for their adult children without the child's consent. But if the adult child is manic or psychotic, it's highly unlikely consent will be given.

So how do we do a better job of identifying children with mental illness and providing them treatment before they become legal adults?

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  • Jan 3 2014: We do need to improve and invest in early identification and treatment of children with mental illness and start early mental health education to reduce the stigma. We want families to be confident about seeking help and where to find it in the community.
  • Jan 6 2014: How many kids are treated and drugged even though their is nothing wrong with them?
  • Jan 4 2014: Educating parents and substance abuse counselors on the subtle signs of mental illness and the importance of early treatment are so important. For us, we thought the paranoia, weird behaviors, inability to focus in school, etc. were just weird teenage behavior. And the substance abuse counselors who should have intervened and gotten him the help he needed failed us.I wish we had known then what we known now.
    • Jan 4 2014: How can we educate them?

      My son and I participated in training of Cook County social workers last year, specifically in the signs of mental illness in children and teens. I was shocked at how I informed licensed, clinical social workers were about mental illness if our professionals don't know, how can we educate non-professionals?
  • Jan 3 2014: Another important issue with violent or aggressive teens is the failure of the most frequently used psychotropic medications in reducing outbursts. More benign, more effective medications are working for some kids and are rarely considered as they are not in the cross hairs of big pharma. We recently interviewed Dr Ankerman author of Hope For The Violently aggressive child and discussed the importance of the hypothalamic-pituitary-adrenal axis and violence in teens. Looking for the organic basis of behaviors is key as well. For girls, endocrine issues can wreak havoc on mood, anxiety and rages. Educating parents early, unravelling the possible biological, organic and environmental causes and then applying the right type of therapy can make a huge difference. For example, talk therapy for adults going through a crisis may be very helpful but for kids with severe mental illnesses, discussing their behaviors without giving them tools to control them can cause even more anxiety and frustration which is why for some of these kids cognitive behavioral therapy can be helpful.
  • Jan 3 2014: I believe the best way of identifying children with mental illness and providing them treatment before they become legal adults is to stomp the stigma of mental illness. Until we get everyone to understand that children with mental illness are no less "ill" than a child with a serious physical illness, we will not be able to make the strides needed. Unfortunately, embarrassment and shame keep parents from seeking the help their children need which quickly escalates due to the additional pressures of school and later social interactions with peers. When we hear the words "mental illness" we need to take out the "mental" and remember "illness".

    The state of health care for children with mental illness in this country is a national disgrace. Many state funded programs are barbaric and those that offer quality care are completely unaffordable to the average family. Improving health care benefits to best assist families with children and teens suffering with severe mental illness needing residential care is sorely needed. Educating parents on their rights for cooperation and assistance from school districts to help pay not only for residential but private therapy is key as well.

    Teaching children with mental illness to self advocate and collaborate in their care and problem solve is essentially the only way to set the tone for their futures. Understanding that if they could, they would, and that no child wants to fail at school or at home is the first step in understanding defiant or mentally ill kids. It is important for these fragile kids to trust their caregivers. Instead of pushing these kids further into the abyss we need to extend our hands to pull them out as well as their beleaguered parents.

    Getting an adult teen to sign a health care proxy or legal document giving parents permission to make health care decisions should they be impaired is the best 18th birthday gift a parent can give
  • Jan 3 2014: Are to many parents passing off the signs of mental illness and the odd behavior of teens? Are to many of us in denial or still fearing the stigma? Or is it just a general lack of education? The one place where we can possible set up a better system to identify teens in need would be inside our middle and high schools. Yes, we already ask far to much of our teachers, but if we could simply set up a system where our teachers could fill out one form of concern it could start the chain of events to get a teen help. These are the same people who are mandated reporters in the case that they might see signs of abuse or neglect. Not giving a child proper medical care is neglect. Not getting a child proper mental health care should also be a sign of neglect. I'm not saying we bog down DHS workers with neglect report. Simply referring the teen to a school counselor or other staff who can assist that teen and their family in accessing and maintaining mental health services would help more kids. When we learn to take mental health as serious as we do physical health, we will have far more functional members in our society.
    Many schools already have contracted services that allow an outside mental health agency to have an office inside the school. Having this system already in the school means that all we would really need is a referral form and maybe a few hours of teacher education on the early warning signs of mental illness. It would be a great goal to educate all parents, but educating our educators would be far more attainable.
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    Jan 9 2014: On the other hand, half the kids without mental illness get treatments.
    Too often, too many of these mental illness are diagnosed by observation. I understand that this can be a legitimate form but, it should be done by more then one observer. Too often children are termed with some disorder and are treated with drugs designed for other disorders. We don't always know how long term effects on developing minds of many of these drugs.
    So, if there is a confirmed disorder and known treatments are available, then by all means, treatments should be given. If HIPPA law ends treatment authority at majority, maybe a review of the HIPPA law is needed.
    But, I am concerned with the number of active young boys in school were they have eliminated gym class for budget reasons are given drugs to mellow them out in their classrooms.
  • Jan 6 2014: Keith: not many. According to NIMH, it's about 10% of children that are prescribed psychiatric meds - the same rate as kids wirh mental illness. And the rate of prescribing them has dropped off dramatically, particularly in young children: http://m.healthday.com/iphone_article.htm?CID=0B3F45B2&NFID=C&articleId=680600
  • Jan 6 2014: Exterminate the concept of "mental illness" and abolish our superstitions about the nervous system. After all, what stigma is there to getting a digestive ailment treated? The problem is superstition.
  • Jan 4 2014: Here's a twist. My son was diagnosed at age 5 with SPMI. I, his mother,ensured he remained compliant with treatment which was extremely successful. He was set to graduate from high school with a regular diploma, quite an amazing feat. BUT - six months earlier he turned 18 - the magic adult age where he made the legal decision to try life without his meds, an event none of us had planned for. And there was NOTHING anyone could do about it but sit back and watch him decompensate, dropping out of school two months before graduation & homeless. His teachers nor doctors could talk to me. I visited an attorney to question my ability to get a conservatorship over him. BUT -because he had been so successful in treatment with minimal history of hospitalizations, the attorney told me the potential for intervention was dim. So my son became paranoid/psychotic to live on the streets for two years, learning to self medicate with drugs and alcohol, becoming sicker and sicker, committing petty crimes as result of his deterioration. I followed him closely, developed a relationship with the prosecuting DA and, following his 4th arrest and tasing by police, she agreed with me that he might not survive if he did not get back on his meds. So, an agreed order was made with his attorney in court (we called it duct tape AOT since my state TN does not have an AOT law so we pieced together provisions of AOT as a mandate to returning to the community from jail where HE DID NOT BELONG). One year after AOT, he had regained insight into his illness to decide never go off meds again. That was five years ago and there have been no additional incarcerations and/or experiences with the criminal justice system. He is 100% disabled but now living independently (safely) in the community & taking classes at a community college. I tell this story to raise awareness that early intervention and treatment does not necessarily guarantee a successful transition to adulthood! Legal adults can refuse meds.
  • Jan 4 2014: Ed - while environment has been shown to trigger some mental illnesses, the majority of research shows a genetic and/or biological origin for mental illness. Parents of persons wirh mental illness have long been stigmatized, labeled as bad parents when their children are diagnosed with Bipolar Disorder or Schizophrenia. Why would you perpetuate that fallacy?
  • Jan 4 2014: Hi Chrisa,it is really a good topic for us to pay attention to teens mental illness.You know what caused teens get mental illness?Parents' caring,social environment,schools ...So it is the most important for us to do is:improving parents' quality,adults' quality,teachers' quality...in a word:focus on education,let better education come to us,let all parents keep love for their children,teachers keep love for students....every adult keeps love for all children.Only one generation to another to keep on working on better education career does help...