Young Families INSIGHTS
October 2000
Linda Swann, Young Families Program Coordinator, Editor
Linda Buzard, Layout Manager

CHILDREN AND MENTAL HEALTH: THE SURGEON GENERAL'S REPORT

Dr. David Satcher, Surgeon General of the United States, released a lengthy report last year on Mental Health. He included an entire chapter on children's mental health. Dr. Satcher covers many child-related topics, including theories of development, risk factors and prevention, mental disorders in children, treatment strategies, service interventions, family support, and service delivery.

The report offers a basic breakdown, by disorder, of children ages 9 to 17 whose mental disorders are severe enough to cause impairment. The prevalent disorders are anxiety disorders (13 percent); mood disorders, such as depression (6.2 percent); disruptive disorders, such as conduct disorder (10.3 percent); and substance use (2 percent).

Some warning signs that a child may need help are: outbursts of aggression, difficulty paying attention, fearfulness, shyness, distress when habitual behaviors are interrupted, difficulty understanding language, food fads, hurting animals, destroying property, abusing substances, talking about hearing voices or seeing things that are not there, drastic or sudden changes in habits, mood, or eating patterns.

• The range of what is considered "normal" in children is wide but children and adolescents can and do develop mental disorders that are severe and greatly impair their ability to function. Therefore, it is critical to evaluate their mental health in the context of family, social, and cultural expectations about what is age-appropriate behavior, thinking, and emotions.

• Approximately one in five children and adolescents experience the signs and symptoms of a DSM-IV disorder in the course of a year, but only about 5 percent fall into the category that providers call "extreme functional impairment."

• Most children who need mental health services do not get them.

• Mental disorders and mental health problems affect families in all social classes and backgrounds. Yet some children are at greater risk, perhaps due to poverty or the mental illness of a parent. Preventive interventions, like educational programs for young children, can be effective in reducing this risk.

• There is a range of treatments that work.

• Primary care facilities and schools are the main places for screening children and adolescents for these disorders but trained staff are limited.

• A "systems" approach is the most effective way to address the problems children and their families experience as a result of these disorders.

• Cultural differences make access to services more difficult for children of different ethnic/racial backgrounds.

• Families are partners in the treatment of children for mental disorders.

You can access the entire Surgeon General's report on mental health by signing onto NAMI's home page, www.nami.org.

 

BUDGET AND LEGISLATIVE SEMINARS

The Covenant with North Carolina's Children is partnering with the NC Budget and Tax Center to sponsor a series of free seminars across the state. The seminars will focus on state budget and tax policy issues, the fiscal outlook for next year, and the state of child advocacy in North Carolina. This is a great opportunity to learn more about the legislative process and advocacy for children. The speakers are both very knowledgeable and entertaining! You will be glad you went!

Here are the remaining dates and locations:

Tuesday, Oct. 24
9:00 a.m. - 12:00 noon - Southeastern Regional Agricultural Center, Lumberton Wednesday, Oct. 25
9:00 a.m. - 12:00 noon - Cumberland County Social Services offices, Fayetteville Monday, October 30
2:00 p.m. - 5:00 p.m. - University of North Carolina-Asheville, Humanities Lecture Hall, Asheville

Tuesday, October 31
2:00 p.m. - 5:00 p.m. - NCAE Center, Auditorium, 700 S. Salisbury Street, Raleigh,

• Parents should sit in the middle of the group, not at the end. Sit with a relaxed posture, attempting to maintain a relaxed facial expression.

• Parents are wise to avoid excessive or unrelated hand or body movements. Use humor at times to get their point across, but avoid nervous laughter and joking.

• It is best for parents to present their comments in a firm but simple, positive manner, speaking so everyone can easily hear them.

• Parents are there to provide facts and reasons, but not long-winded explanations, excuses, or apologetic behavior.

Like-minded Methods Educators Can Use

• Teachers should sit next to the parents, in a relaxed posture. It is helpful for teachers to look directly at the parents and include them as they address the other professionals present.

• When feasible, teachers should support the parents' point of view.

• To check the parents' intent, teachers can restate in a simple, positive manner statements made by the parents.

• Professionals should repeat their views in a calm manner and outline their descriptions, as in "There are three factors to consider. First..."

• Focus on the child's strengths.

• Use clear instructions in a highly structured learning environment.

• Use short sentences, simple vocabulary when giving instructions and lecturing.

• Be flexible with classroom procedures. For example, let the child use a tape recorder when he has a problem with written language.

• Incorporate "self-correcting" methods when possible. This allows for immediate feedback and "saves face."

• Plan for opportunities for achievement that increase the student's self-esteem.

• Make use of computers for practice drills.

• Use positive reinforcement for proper social skill development.

• Be aware that students with learning disabilities can experience much success given the time to grow and learn.

 

Here’s to the kids who are different,
The kids who don’t always get A’s,
The ones who have ears
Twice the size of their peers,
And noses that go on for days.

Here’s to the kids who are different,
The ones they call crazy or dumb,
The kids who don’t fit
With the guts and the grit,
Who dance to a different drum.

Here’s to the kids who are different,
The ones with the mischievous streak,
For when they have grown
As history has shown,
It’s their difference that makes them unique.

By Digby Wolfe

"I …
am bored
am at loose ends
need some one-on-one
need time to be alone
need time to get over being mad
need time to play by myself
need this day to be over
need something really wonderful to put me in a better mood
need some personal space
need a break from my best friend without losing my best friend
want to be far, far away from those weird, annoying sounds
want to be somewhere else – if only I could
want to be a bigger kid
want to be a little kid again
want to be able to do everything other kids can do
want to be a ‘normal’ kid
want to be myself and not get in trouble for it
want to hate some of the things you make me do
want to feel real mad inside and not feel guilty about it
want to feel jealous of silly, little things even though I know better."

(Source: BDINews: An electronic newsletter about the ‘high maintenance child" by Kate Andersen, M. Ed.)

1. Learn more about children and youth with special mental, emotional, and behavior needs. To the extent that you are better informed, you will be able to evaluate and resist the inaccurate negative stereotypes and labeling that exists.

2. Listen to children, youth, and families experiencing these challenges. These individuals can describe what hurts, what they find stigmatizing, how stigma affects their lives, what they would like others to know about having special mental, emotional, and behavior needs, and how they would like to be viewed and treated.

3. Watch your language. Most of us use terms and expressions that perpetuate stigma, like "nuts," "crazy," "stupid," violent," "unmotivated," uncontrollable." We also depersonalize children and youth by referring to them generically by a diagnosis they have been given. We need to remember they are so much more than just their emotional or behavior problem.

4. Monitor media and report stigmatizing material. Organizations like the National Stigma Clearinghouse, NAMI, and the Mental Health Association protest such material by contacting the people responsible for it.

5. Respond to stigmatizing material in the media. Write, call, e-mail those who are responsible. Express your concerns and provide them with more accurate information to use.

6. Speak up about stigma. When someone you know misuses a term or diagnosis, let him/her know and educate them about the correct meaning. If someone disparages a child or youth with mental, emotional, or behavior problems or makes disrespectful comments, let them know you find such comments offensive or unacceptable,

7. Talk openly. Don’t be afraid to let others know of the challenges you or your child faces. The more hidden it remains, the more people continue to believe that it is a shameful thing that needs to be concealed. Talking about it can also be empowering and help relieve "internalized stigma."

8. Demand change from your elected officials. Policies that perpetuate stigma – from poorer health insurance coverage for mental health than for other physical health conditions – to limited funding for research to inadequate budgets for mental health services – can be changed if enough people let their representatives know what they want changed

9. Provide support for organizations that fight stigma. Join, volunteer, or make a monetary donation. The influence and effectiveness of organizations fighting stigma depend on some extent on size of membership and adequacy of finances.

10. Contribute to research related to children’s mental health and stigma. To the extent our children’s mental, emotional, and behavior problems can be understood and treated, stigma will be reduced. When we can be confident that our children’s special needs can be treated quickly and effectively, it will be less frightening. Contributing to research is a way to bring understanding and awareness of what is working, what is not, and what is still needed.