The Mental Health Crisis: A Growing Epidemic

– By Dr. Dana Harris

 

Keeping children safe from harm and providing them with a loving, stable and healthy environment is at the heart of everything parents strive to achieve. If we have been lucky enough to grow up with skillful parents, then we have probably acquired a good sense about what great parents do.  Raising children is perhaps one of the most important endeavors we undertake as humans. Children remind us of what’s most important: joy, laughter, happiness, and honest human connections. There is no training required of us to help us do to it to the best of our ability and like almost everything else we do in life, parenting is a skill with a wide body of research out there that can help us do it more skillfully—with greater confidence, less stress, and better results. Along with the benefits of parenting, however, come challenges. Let’s face it, our kids and teens are constantly changing. They are growing up quickly and before you know it, your giggly, energetic toddler is now a teenager who sleeps until noon, keeps his/her cell phone with them 24/7 and expects you to knock on their bedroom door before you enter.  But with all these changes going on, how can we tell which changes are normal?  At what point should we start worrying that our child’s tantrums or teenager’s mood swings are more than just ‘growing pains’?  It can be hard to tell. The truth is, for many kids, these sudden changes aren’t just a part of growing up, they are symptoms of something more serious. Even in the most ideal situations, the task of raising a child is monumental.  But what happens when your child has mental health issues?

There is a ‘mental health care crisis’ in the United States. We are dealing with an epidemic where at one end of the scale we’ve got four-year old’s being tested while at the other end of the scale we’ve got teenagers leaving school and facing the prospect of leaving their university with record amounts of debt.  The stakes for children with mental health issues are high, and the responsibility for acting falls on the parents, making what was already a tough job that much tougher. Worst yet, the crisis in children’s mental health has become more alarming than most people might suspect. For some, this statement is an accurate one, but for others, it may be difficult to accept or maybe you just don’t want to believe it to be true. Nevertheless, whether you agree that there is a health crisis or not, you cannot ignore the fact that it is having an enormous impact on the world today at an alarming pace. The statistics are staggering. 1 in 5 young people suffer from a mental, emotional or behavioral disorder, but only 4 percent of the total health care budget is spent on mental health. Worldwide, it is estimated that 10-20% of children and young people (aged 5-16) have clinically diagnosable mental health problems, yet 70% of those individuals have yet to have appropriate intervention at a sufficiently early age. They remain underdiagnosed and untreated.

Signs of poor mental health can be overlooked for several reasons, such as a lack of knowledge or awareness about mental health among health workers, or stigma preventing them from seeking help. Having good mental health is key to the healthy development and well-being of every child.  Kids need good mental health – not only to be able to deal with challenges and adapt to change, but so they can feel good about themselves, build healthy relationships with others and enjoy life.  Childhood behavioral disorders are the sixth leading cause of disease burden among adolescents. Adolescence can be a time where rules, limits and boundaries are tested. It can furthermore be influenced by a myriad of other things, life family circumstances, school life and life altering events.  About half of all serious mental health issues begin before a child reaches 14 years of age. Therefore, it is critically important to be able to recognize if there is cause for concern.  Everyone feels sad, angry or upset sometimes, including children.  But if a kid feels like this most of the time, it’s a sign they may need help.

Globally, depression is the ninth leading cause of illness and disability among all adolescents; anxiety is the eight-leading cause. It is estimated that 62,000 adolescents died in 2017 as a result of self-harm. Suicide is the third leading cause of death in older adolescents (15-19). Suicide attempts can be impulsive or associated with feelings of hopelessness or loneliness.  Even if these thoughts are not acted upon, these are clearly indicative that a child is unhappy and in need of support.  These suicidal feelings are often triggered by other things such as being bullied, having low self-worth or living with mental illness. Risk factors for suicide are multifaceted, including harmful use of alcohol, abuse in childhood, stigma against help-seeking, barriers to accessing care, and access to means. Communication through digital media about suicidal behavior is also an emerging concern for this age group. Children are struggling with their identity and the numbers are self-harming.  Pressure to fit in are making children unhappy – from how they look, to their sexuality, to how boys and girls must behave.

Having a mental illness is not a choice or moral failing.  Quite to the contrary, mental illnesses can occur at similar rates around the world, in every culture and in all socioeconomic groups.  The statistics are staggering.  Child anxiety rates are the highest they have ever been in American history.  Child suicide rates are the highest they have been in American history and they have been rising sharply over the past 10 years.  There have been more school shootings in the last 18 years than there were in all the 20th century. In any given year 20% of American children will be diagnosed with a mental illness. If these facts do not leave you deeply concerned, they should, especially if you are a parent or educator. To date, most research on mental illness have centered on adults.  However, the mental health community have now begun to focus on mental health illness in children.  Researchers are currently looking at childhood development in terms of what is normal and abnormal, trying to understand how factors affecting development can have an impact on mental health.  The over-arching goal is to try to predict, and ultimately prevent, developmental problems that could lead to mental illness.  A key part of this research is the identification of risk factors that increase a child’s chances of developing a mental illness. 

New research suggests that mental health problems amongst children have hit a ‘crisis point.’  Early diagnosis and appropriate services for children and their families can make a significant difference in the lives of children with mental disorders.  Access to providers who can offer services, including screenings, referrals, and treatment opportunities is the first step to address this issue. CDC is working to learn more about access to behavioral health services and supports for children and their families.  Untreated mental health problems can disrupt children’s functioning at home, school and in the community.  Without treatment, children with mental health issues are at a greater increased risk of school failure, contact with the criminal justice system, dependence on social services and even suicide. The impact is more than in statistics and factoids, it’s in feelings and emotions.  It’s in our families, with our friends and in our communities. No child should have to reach a crisis point to get help with their mental health issues.

Our public schools are struggling daily and face huge challenges in dealing with mental health issues in their students, and teachers are on the front line.  With more than 50 million public school students in the US, as many as 1 in 5 show signs of a mental health disorder.  In schools, mental health should be everybody’s job.  Too often, it ends up being no ones.  As a retired educator with more than three decades of professional service in the field, I have witnessed firsthand and far too many times the devasting impact of pressures such as test anxiety, bullying, and family problems.  The consequences of these problems are serious, often life-threatening, and teachers are desperate to help. Yet at a times when the need for preventative, early intervention and specialist services are soaring, schools are finding it increasingly difficult to provide the help their pupils need.  There’s an urgent need for better support mechanisms in schools, as well as decent funding for the range of mental health services children and young people need.

The National Education Union (NEU) surveyed more than 8,000 school leaders and support staff in various states and found the number of young people with mental ill health have ‘increased significantly’ since 2017. When asked if they had noticed a change in the number of pupil mental health problems in the past two years, 83% said there has been an increase – and just 7% said they hadn’t noticed any change.  One teacher said, “We are at a crisis point with mental health,” and another in the survey commented, “SAT pressure and general expectations are taking their toll on more vulnerable pupils.  We have 9-year-olds talking about suicide.” Another teacher said there had been three suicides in three years in her school alone. The NEU asked teachers whether they felt they had the right provisions for supporting pupils with mental health issues.  While most teachers (59%) reported they had learning support assistance, less than 50% reported a school counselor. Only 30% had external specialist support and less than 30% had a school nurse.  Because of this, the burden of support falls on the shoulders of teachers.  I can vividly recall one of my former teachers confessing to me that she spent over 40% of her lunchtime nurturing children experiencing a range of mental health issues.

When parents suspect that their child may be facing mental health issues, the most important first step is to get a proper evaluation.  The quality and accuracy of the evaluation will determine the course of treatment, which will in turn have a direct effect on the outcome. On the other hand, parents and caregivers may have mixed feelings about getting their child help for the mental illness. They may worry about being blamed for their child’s change in behavior, or they worry what treatments may be tried.  Mental illnesses can be frightening, and many people worry what others will think if they talk about their experiences.  The good news is that mental illnesses can be treated successfully, and early treatment can help reduce the impact of a mental illness on your child’s life. It is highly recommended that if you suspect something terribly wrong, talk to your doctor to learn more about the different options. Consider seeking family counseling or the help of support groups.  It’s important for you and your loved ones to understand your child’s illness and his or her feelings, as well as what all of you can do to help your child. When deciding on treatment, it’s important to think through exactly how the plan is going to play out in real-time, and how it’s going to work in the day-to-day life of the family.  Treatment should be family-centered, based on the strengths of the child, have clear goals and objectives and most importantly, include steps to modify the plan based on the evaluation criteria. Don’t avoid getting help for your child out of shame or fear.  Your child’s teachers, doctors, school personnel, social services and all involved family members should be part of the process.

There is undeniably a growing health care crisis in our schools and society. The policies on education and the lack of school funding are contributing significantly to a terrible and destructive workforce. Schools can’t solve this alone and government underfunding of public services is damaging the next generation from an early age. We all want what is best for kids – that is unquestionable.  With greater awareness of the factors affecting kids’ mental health, we are all better prepared to help our kids develop healthy senses of self that can ultimately lead them living much more fulfilled and happier lives. Children’s mental health problems are real, common and treatable.  Although one in five children has a diagnosable mental health problem, nearly two-thirds of them get little or no help.  The cost of ignoring these numbers are far too high.  We are living in a society full of broken systems – the health system, the justice system, the child welfare system, the legal system, the political system . . . I can go on. There is however one broken system that we cannot continue to ignore:  the children’s mental health system.  Failure to access services in a timely manner can often be fatal. We must work together to improve the lives of children and youth with mental health disorders and begin to create a system with far fewer cracks. After all, our kids deserve nothing less.

This article appears in the June/July 2019 issue of Augusta Family Magazine.
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