We Need to Pay Attention to Children’s Mental Health

[ 0 ] May 9, 2013 |

mentalhealthdayToday is National Children’s Mental Health Awareness Day, a time to raise awareness about the importance of children’s mental health and that positive mental health is essential to a child’s healthy development from birth. President Obama has proclaimed May as National Mental Health Awareness Month.

We reached out to Dr. Joseph Shrand, an instructor of psychiatry at Harvard Medical School and author of Outsmarting Anger: 7 Strategies for Defusing Our Most Dangerous Emotion, to get his insight as to the biggest mental health challenges to kids today – and what we can do to help them. Dr. Shrand is also an Assistant Child Psychiatrist on the medical staff of Massachusetts General Hospital, and the Medical Director of CASTLE (Clean and Sober Teens Living Empowered), an intervention unit for at-risk teens which is part of the highly respected High Point Treatment Center in Brockton, Mass. Here’s what he said…

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First off, Dr. Shrand stressed that “we don’t have a bunch of sick kids in the United States,” and that just because some children and teens are on medication for certain mental-health issues such as depression or Attention Deficit Disorder (ADD), does not mean they are “broken.” “It’s very important to dispel all of that,” he said. Medications, in fact, act as a tool to help those affected by certain mental health issues to thrive in school and at home.

“It doesn’t define them as broken any more than if you were trying to climb a mountain … you’d need the right equipment,” Shrand said, whether it be parents, family, medication, etc… Medications “are simply a piece of the equipment. Technology does not define the kid.”

Shrand said it’s imperative our health system facilitate better connections between family practitioners and pediatricians and psychiatrists, so that psychiatrists are readily on hand when a pediatrician suspects a patient may need care more focused on mental health than physical. It’s also vital to have better communication between psychiatrists and the pediatricians who may be authorizing use of certain medications.

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“It takes a child psychiatrist to really be able to treat all these kids,” Dr. Shrand said.

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Dr. Joseph Shrand

But there aren’t nearly enough psychiatrists to take care of all of the kids who need their services. And those services that are available are maldistributed, with rural areas suffering from lack of services the most. There are “millions of kids who are going to need care,” Shrand said. “Part of child mental health … is a system where a child psychiatrist can support a large number of people who are going to be directing these kids.”

Psychiatrists need to be able to offer support for conditions like ADD or ADHD at not only pediatricians’ offices, but also in schools, since these disorders will come to the attention of them first. Pediatricians and school staff can then refer cases to on-hand psychiatrists to confirm certain conditions.

“Just like I would send some of my psychiatric kids to a cardiologist if I were worried about their heart,” Shrand said. “These are real conditions and they need expert help. A large number of them need support in the background from a child psychiatrist.”

If every pediatric practice in the U.S. had a psychiatrist on call, for example, “that would be enormous for children’s mental health.”

One huge problem that also needs to be addressed as it relates to mental health is one that resonates with too many kids in this day and age: bullying.

“This is a major, major risk factor in adolescents” and their mental health, Shrand said. “I think we need to be more aware.”

“We need to really understand what bullying not only does to the victim but does to the witness. Within the witness we’re really going to be able to change bullying,” he added. We need to empower people to stop it when they see it.

“However, we cannot leave the bully out of the bully … you have to be able to work with kids who are bullies, draw out why they’re doing it without them feeling persecuted or bullied themselves. It’s really, stopbullyingreally an important part of where we’re going to be headed in terms of treating bullies, the bullied victims, and the witness.”

Consider this: when a kid is bullied, they initially will feel stress, and cortisol levels spike. Under chronic bullying conditions, cortisol levels actually get blunted, which means victims feel so hopeless and powerless, they don’t bother to do anything about it. “That’s really sad,” Shrand said. This leads to them feeling alone, depressed – some even start to identify with aggressor and become bullies themselves, and later feel bad about it. Suicide rate among bully victims is high.

“We all can be witnesses to do something about it in a very positive and constructive way without trying to bully the bully out of the bully,” he said.

College students are another population that needs to be closely watched she it comes to mental health. collegekidsAll of a sudden, they are on their own, facing stresses like academics and the availability of drugs and alcohol, at a time when their brain is just beginning to function in ways that anticipates consequences of actions.

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“They are really one foot out of the nest and one foot in the nest. And sometime when you straddle that far, you can get hurt,” Dr. Shrand said. 

Too much mental stress can lead to substance abuse and cause life-long dependencies and addictions, he added.

In sum, Dr. Shrand said, “we have an amazing group of kids in this country – amazing talent – they are remarkable and all we can hope to do is give them the support they need to remember how valuable they are.”

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Category: Health, Mind Body Connections, Stress Management, Views on the News

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About Dr. Joseph Shrand: Dr. Joseph Shrand is an Instructor of Psychiatry at Harvard Medical School, an Assistant Child Psychiatrist on the medical staff of Massachusetts General Hospital, and the Medical Director of CASTLE (Clean and Sober Teens Living [...]
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