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Treating children with mental illness

 Treating children with mental illness con’t
10-7-2006 — Mental Health experts urge parents to be alert to signs of depression in young children as early intervention can make a positive difference during treatment.
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.

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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.


SOURCE:-McClatchy Newspapers
Copyright 1999 – 2004 Seacoast Newspapers, a division of Ottaway Newspapers Inc., all rights reserved.

Reviewed by  Lindsay May 2010

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