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Treating children with mental illness
The phrase "mental illness" often conjures up a host
of negative images perpetuated by Hollywood films using disabilities as
fodder for scripts. There's "The Bad Seed," a 1956 film with Patty
McCormack as a 6-year-old murderous psychopath; "Me, Myself & Irene"
(2000) with Jim Carrey as a police officer with a multiple personality
disorder; and "Girl, Interrupted" (1999) with Winona Ryder as a
depressed and promiscuous young woman who checks herself into a mental
hospital where she is befriended by an inmate played by Angelina Jolie,
to name but a few. Some film depictions are fragmented. Others are
distorted. A few are accurate.
Julie Golkowski, director of Child, Adolescent and
Family Services at the Seacoast Mental Health Center in Portsmouth and
Exeter says labeling and stereotyping young adolescents with mental
health challenges persists, hampering recovery efforts. "There continues
to be stigmatized attitudes about disorders," Golkowski says. "I think
the more we talk and educate we erase stigma."
Golkowski says as young adolescents face transitions
and stressors associated with entering adulthood, they encounter a host
of potholes during the trek. Some will find the road again; others may
have trouble getting out of a ditch. "It becomes a disorder when it
impacts your daily living," Golkowski says. "That may mean you're too
anxious to go to school." Golkowski says her agency encourages families
to seek early-intervention assistance.
According to the 1999 Mental Health: A Report of the
Surgeon General, at least 20 percent of children and adolescents have a
mental health disorder. Some conditions such as sadness after the death
of a pet ebb with time. Other conditions, ranging from severe depression
to anxiety, often last for prolonged periods, disrupting a child's life.
"Mental and behavioral disorders and serious emotional
disturbances in children and adolescents can lead to school failure,
alcohol or drug use, violence, or suicide," reads a Web site excerpt
from the Healthy New Hampshire 2010 Leadership Council and New Hampshire
Department of Health and Human Services. Golkowski stresses that early
treatment reduces these risk factors.
Golkowski and Anita McCarthy, a licensed parent and
child therapist and child development specialist based in Portsmouth,
say mental health roadblocks result from biological, social and
psychological factors. While both women say adults can take proactive
steps to lessen the negative impact of some stressors, parents shouldn't
shrink in shame and blame. "We certainly don't want them to get the
impression that it's all their fault," Golkowski says. "You really have
to look at the whole picture."
McCarthy says part of the picture relates to
understanding the cognitive and psychosocial development stages preteens
face, as outlined by psychologists Jean Piaget and Erik Erikson. For
instance, Piaget asserts that at about 11 years, a child enters the
formal operational stage and develops concerns about social and identity
issues.
Meanwhile, Erikson posits a child between 6 and 12
years approaches the industry versus inferiority stage and faces demands
to learn new skills to avoid a sense of incompetence or failure. For
instance, a student exiting elementary school and entering middle school
grapples with learning locker combinations, taking notes in class, and
accepting the role of being the youngest and smallest.
Golkowski says, "Things as adults we forget."
Meanwhile, unhealthy images from television programs and magazine
advertisements bombard young adolescents with unrealistic expectations.
"The media portrays body images that are unobtainable," Golkowski says.
As a result, young viewers feel inadequate.
McCarthy says other transitions induce stress for
children. Contending with the divorce of parents, death of a relative,
news of a learning disability, or move to a new town requires young
adolescents to adjust. However, sometimes the youngster's adaptability
battery is drained of power and their mental motor begins to mutter and
sputter. Golkowski and McCarthy cite a host of warning signs, indicating
a child needs help with refueling. Injuries to self, expressions of
helplessness, swings in moods, changes in eating habits, difficulties
sleeping, fluctuations in grades and use of alcohol and drugs are a few
on their lists.
McCarthy says a behavior problem, such as yelling or
interrupting in a classroom, is often one of the first signs a child is
experiencing difficulty coping with stressors. She recommends looking
for patterns. "Then, it's about putting the pieces of the pie together,"
McCarthy says.
One part of the pie is related to how a child uses
spare time. While Golkowski and McCarthy don't use the technologies of
the Digital Age as a scapegoat for youth problems, they agree electronic
devices in a household, ranging from computers to televisions, can
splinter family time. In 2006, Nielsen Media Research estimated average
American homes have their televisions on eight hours daily or 55 hours
weekly. "I think it's difficult to say, No television. No video games,'"
McCarthy says.
However, she says, parents need to develop
opportunities for uninterrupted conversations with their children to
share experiences, tackle problems, and take a break. Golkowski adds,
"It's a lot about relationships. I think it's nurturance." Golkowski
talks about the benefits of reviving a fading ritual -- gathering for
dinner. However, she realizes for adults and children finding family
time is a formidable feat. "That may be hard be for some folks," she
says.
In 2005, the Families and Work Institute released
statistics from its study Overwork in America: When the Way We Work
Becomes Too Much, indicating about 33 percent of employees are
repetitively overworked. Meanwhile, 54 percent feel overwhelmed.
McCarthy says parents and guardians need to nurture
themselves to have the fortitude to nurture others. "Certainly a huge
piece of putting the pie together is the stress level of the parent,"
she says. "We need to take care of ourselves too." It's difficult to
recharge a young adolescent's mental battery when the caregiver's own
battery is depleted.
In 2006, the National Association of Health Education
Centers shared findings from its Kids Health/Kids Poll study, revealing
41 percent of the questioned adolescents between 9 and 13 said they felt
stress from too many scheduled tasks. Seventy-seven percent of the
survey sample said they need more free time.
With relaxation time becoming a cultural fossil,
Golkowski and McCarthy recommend seeking assistance from members of the
child's community. Big Brothers Big Sisters of the Greater Seacoast in
Dover and New Heights in Portsmouth are two of a host of Granite State
youth organizations offering programs and mentors for children and
teens.
Thus, when Mom or Dad are juggling two jobs or
tackling household responsibilities, a child is connecting with peers
and adults in a supervised setting. Golkowski says it's critical for
parents to find healthy relationships for their children, as discussed
in "The Second Family: Reckoning with Adolescent Power," by Ron Taffel
and Melinda Blau.
In addition, McCarthy says simple activities stimulate
the imagination, provide an outlet for stress and operate without
electricity. "I think play is a great opportunity for kids," she says.
"When I think of play, I used expressive mediums."
McCarthy refers to organizations -- the Association
for Play Therapy and Sandplay Therapists of America -- as resources for
parents and mental health professionals. Some credit mental health
professionals Dora Kalff and Margaret Lowenfeld for developing the
concept of sandplay, which provides children a protected, safe space to
act out emotions and cope with difficult situations.
While Golkowski and McCarthy talk about the power of
play and family time, they realize situations are unique and
multi-faceted. Learning to play chess or enjoying a plate of homemade
macaroni and cheese with family members will not treat all mental health
issues.
Golkowski and McCarthy recommend that families begin
an ongoing dialogue with mental health professionals, pediatricians,
teachers, community groups, peers and other parents to assess a child's
needs. Some mental health situations may require medication, counseling,
and hospitalization. New Hampshire Hospital's Anna Philbrook Center in
Concord and Hampstead Hospital work with children and adolescents
grappling with severe psychiatric and behavior disorders.
Golkowski reiterates the importance of early
intervention to mitigate serious conditions. Constant monitoring is akin
to caring for a car; frequent tune-ups prevent a young adolescent's
mental engine from conking out or igniting on a busy highway. However,
she says a detour sign remains in the road, as expressed in a quote from
Donna Shalala, former U.S. Secretary of Health and Human Services:
"Mental illnesses are just as real as other illnesses, and they are like
other illnesses in most ways. Yet fear and stigma persist, resulting in
lost opportunities for individuals to seek treatment and improve or
recover."
Golkowski says shifting away from this culturally
embedded and stigmatized attitude will prompt more people to seek help
when it's needed."You wouldn't be ashamed to say you have diabetes,"
Golkowski says.
Colleen Lent
5 October 2006
http://www.seacoastonline.com/news/10052006/health-f-o5-adolescents.html
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