Meeting the Mental Health Needs of Children and Adolescents
Children’s and Adolescents’ Mental Health
“Mental
health is how we think, feel, and act as we face life’s situations. It is how
we look at ourselves, our lives, and the people in our lives. It is how we
evaluate options and make choices. Mental health includes how we handle stress,
relate to others, and make decisions.” American Psychiatric Association
Some of the Most Commonly
Known Psychiatric Disorders...
Mental Health
Problems for Children
Anxiety Disorders
Major Depression
Bipolar Disorder
Attention-deficit/hyperactivity disorder
Learning Disorders
Conduct Disorders
Eating Disorders
Autism
Schizophrenia
Asperger’s Disorder
ADVOCATING FOR CHILDREN
Advocating for Children and
Adolescents
School Problems
Frequent fighting
Trouble Sleeping
Feeling sad
Thoughts about suicide or running away
Stealing or lying
Mood swings
Setting fires
Obsessive thoughts
Excessive weight loss or gain
Disturbing thoughts
Use of drugs and alcohol
Withdrawal or isolation
Killing animals
Self-destructive behavior
Anxiety
Mental Health
Problems for Children
Phobia - unrealistic and overwhelming fear of some object or
situation
Generalized Anxiety Disorder - a pattern of excessive,
unrealistic worry not
attributable to any
recent experience
Panic Disorder - Terrifying panic attacks with physical
symptoms such as rapid
heartbeat
The Anxious
Child
Constant thoughts and fears about safety of self and parents
Refusing to go to school
Frequent stomachaches and other physical complaints
Extreme worries about
sleeping away from home
Overly clingy behavior at home
Panic or tantrums at times of separation from parents
Mental Health Problems for Children
Obsessive-compulsive disorder - being trapped in a pattern of repeated
thoughts and behaviors
Post-traumatic stress disorder - a pattern of flashbacks and others
symptoms from
experiencing psychological
distressing events such as physical or sexual abuse, witnessing
death or violence, bombing or
hurricane
Separation anxiety - intense anxiety to the point of panic as a result
of being separated from a
love one
Mental Health Problems for
Children
Miss school or don’t finish school
Impaired relations with peers
Low self esteem
Alcohol or other drug use
Problems adjusting to work situation
Mental Health Problems for Children
Experience extreme, unrealistic worry
Very self-conscious
Feel tense
Strong need for reassurance
Somatic complaints
Mental Health Problems for Children
Studies show that up to 6 out of every 100 children may have depression.
The disorder is marked by changes in:
emotion - the child feels sad, cries, looks tearful,
feels worthless;
motivation - schoolwork declines, the child shows no
interest in play;
The Depressed Child
Frequent sadness, tearfulness, crying
Hopelessness
Inability to enjoy previously favorite activities
Persistent boredom; low energy
Social isolation, poor communication
Low self-esteem and guilt
Extreme sensitivity to rejection or failure
Increased irritability, anger and hostility
Major change in eating and/or sleeping patterns
Mental Health Problems for Children
Physical well-being - there may be changes in
appetite or sleep patterns and vague physical
complaints;
and
Thoughts - the child believes that he or she is ugly,
that he or she is unable to do anything
right, or
that the world or life is hopeless
Mental Health Problems for Children
Bipolar disorder - is marked by exaggerated mood swings between extreme
lows (depression) and highs (excitedness or manic phases). The child may talk nonstop,
need very little sleep, and show unusually poor judgment.
Bipolar Disorder
The manic symptoms include:
Severe changes in mood-either unusually happy or silly, or very
irritable, angry or aggressive
Unrealistic highs in self-esteem
Great increase in energy with no sleep for days without feeling tired
Talks too much, too fast, changes topic quickly and can’t be interrupted
High-risk behavior-alcohol, drugs, reckless driving, or
sexual promiscuity Bipolar Disorder
Bipolar
Disorder
Depressive symptoms
include:
irritability, depressed mood, persistent sadness, frequent crying
thoughts of death or suicide
loss of enjoyment in favorite activities
low energy level, fatigue, poor concentration, complaints of boredom
major change in eating or sleeping patterns
Mental Health
Problems for Children
ADHD: Affects three to 10 percent of all children in America; ten times
more common in boys than
girls; most often diagnosed when
the child is between ages eight and 10.
The child:
has difficulty finishing any activity that requires concentration at
home, school, or play;
shifts from one activity to another;
doesn’t seem to listen to anything said to him or her
Mental Health
Problems for Children
Acts before thinking, is excessively active and runs or climbs nearly
all the time, often is
very restless even during sleep;
Requires close and constant supervision, frequently calls out in class,
and has serious
difficulty waiting his or her
turn in games or groups
A Child presenting ADHD
symptoms
A child with ADHD may have other psychiatric disorders such as conduct
disorder, anxiety disorder, depressive disorder, or manic-depressive disorder.
Treatment approaches may include cognitive-behavioral therapy, social
skills training, parent education, and modifications to the child’s educational
program.
Mental Health
Problems for Children
Conduct disorders occur in nine percent of boys and two percent of girls
under the age of 18. Symptoms are socially unacceptable, violent or criminal
behavior such as:
Steals without confrontation such as
forgery
Uses physical force as in muggings, armed robbery, purse-snatching or
extortion
Deliberately sets fires
Mental Health
Problems for Children
Is often truant from school
Has broken into someone’s home, office, or car
Deliberately destroys the property of others
Has been physically cruel to animals and/or humans
Has forced someone into sexual activity with him or her
Often start fights
Mental Health Problems for Children
Aggression to people and animals
Bullies, threatens or intimidates others
Is physically cruel to people and animals
Forces someone into sexual activity
Destruction of Property
Deliberately engaged in fire setting
Deceitfulness, lying, or stealing
Serious violation of rules: runs away, stays out all night, truant from
school
Mental Health Problems of Children
Many children with conduct disorder may have coexisting condition such
as mood disorders, anxiety, PTSD, substance abuse, ADHD, learning problems or
thought disorders.
Mental Health Problems for Children
Autism is the most severe of psychiatric disorders that appears within
the first 3 years of life.
Autistic children:
Don’t cuddle and may stiffen and resist affection
Fail to develop normal relationships with anyone - even their parents
Exhibit very repetitive behaviors (e.g., rocking,
head banging)
Mental Health Problems of Children and Adolescents
Asperge’s disorder is a pervasive developmental disorder characterized
by problems in the development of social skills, have difficulty interacting
with peers, and may display eccentric behaviors like spend hours each day
preoccupied with counting cars or watching only the weather channel on
television
Mental Health Problems for Children
Anorexia Nervosa - cannot be persuaded to maintain a minimal normal
weight
Bulimia Nervosa - compelled to binge (eat huge amounts of food at a
time) and purge to
prevent weight gain by vomiting,
abusing laxatives, or exercising obsessively.
Mental Health Problems for Children
Young people with schizophrenia can have a devastating mental disorder
characterized by psychotic periods when they may hallucinations, withdraw from
others, and lose contact with reality.
The Causes of Mental Health Problems are Complicated
Biological Causes:
Genetics
Chemical imbalances in the body
Damage to the central nervous system
Fetal alcohol syndrome
Mental retardation
The Causes of Mental Health Problems are Complicated
Environmental:
exposure to environmental toxins (e.g., lead);
exposure to violence (abuse, victim, disasters);
stress related to chronic poverty, discrimination or
other hard ships;
loss of
primary care giver through death, divorce, or broken relationships
Some Warning Signs: Pay Attention If a Child or
Adolescent
Really sad and hopeless without good reason;
Very angry most of the time, cries or overreacts to
things;
Worthless or guilty;
Anxious or worried more than other young people
Unable to
get over a loss or death of someone important
Some
Warning Signs: Pay Attention if a Child or Adolescent
Extremely
fearful - has unexplained fear or more fears than most children;
Constantly
concerned about physical problems or physical appearance;
Frightened
that his or her mind is controlled or is out of control
Some
Warning Signs: Experiences Big Changes,
school performance deteriorates;
loses interest in things usually enjoyed;
has unexplained changes in sleeping or eating;
avoids friends or family and wants to be alone all
the time;
daydreams too much and can’t get things done;
feels life too hard to handle or is suicidal;
hears voices that cannot be explained
Some Warning Signs
poor concentration; can’t think clearly or make up
his or her mind;
inability to sit still or focus attention;
worry about being harmed, hurting others, or about
doing something “bad;”
needs to wash, clean things, or perform certain
routines in excess in order to avoid danger
thoughts that race - almost too fast to follow;
persistent nightmares
Some
Warning Signs: Behaves in Ways That Cause Problems,
uses alcohol or other
drugs;
eats large amounts of foods than purges using
laxatives, etc.;
continues to diet and/or exercise obsessively
although bone-thin;
constantly violates the rights of others or breaks
the law without regard for others;
does things that can be life threatening
Meeting
Mental Health Needs
case management
community-based in patient psychiatric care
counseling
crisis residential care
crisis outreach teams
day treatment
special education services
family support
intensive family-based counseling (in the home)
psychiatric consultation
self-help or support groups
therapeutic foster care
protection and advocacy
Twenty percent of all
children from birth through 17 years of age suffer from a diagnosable mental,
emotional, or behavioral disorder, and nine percent - 13 percent of all youth
ages nine to 17- have a serious emotional disturbance (SED)
Questions to ask about psychiatric medications for children
and adolescence
Children and adolescents should be included in the discussion about
medications, using words they understand. Keys questions to ask:
How will
the medication help my child and when will I see an improvement?
What are
any side effects?
Is the
medication addictive? Can it be abused?
How will
progress be checked and by whom?
Psychiatric
Medication
With ongoing evaluation and in most cases, psychotherapy. When
prescribed appropriately by an experienced physician, medication may help
children and adolescents with psychiatric disorders feel restored to their
normal selves.
Psychiatric Medication for
Children and Adolescents
Bedwetting
Anxiety
ADHD
Obsessive-compulsive disorder
Depressive disorder
Eating disorder
Bipolar disorder
Psychosis
Autism
Severe aggression
11 Questions to Ask
1. Why is psychiatric treatment
recommended and how will it help our child?
2. What
are the other treatment alternatives to hospital treatment?
3. Is
a child/adolescent psychiatrist admitting our child to the hospital?
4. What
does the inpatient treatment include?
5. What are
the responsibilities of members of the treatment team?
6. How
long will our child be hospitalized and costs?
7. What
will happen if we can no longer afford hospitalization?
8. Is the
hospital accredited by the Joint Commission for the Accreditation Healthcare
Organizations?
9. How
will we as parents be involved in our child’s treatment?
10. How are the decisions made to discharge our child from the hospital?
11. Once discharged, what are the plans for follow-up treatment?
Important Messages About Children’s and Adolescents’ Mental
Health
Every
child’s mental health is important.
Many
children have mental health problems.
These
problems are real and painful and can be severe.
Mental
health problems can be recognized and treated.
Caring
families and communities working together can help.