Warren Washington Association for Mental Health

Table of Contents

Mending the Safety Net
By Karen Padowicz, Director of Development

Education is a priority of the new national administration. To emphasize this point President Bush proclaimed during the 2001 Address to Congress that “In the end, every child in a bad situation must be given a better choice because, when it comes to our children, failure is simply not an option.”

Nevertheless, sadly absent from this directive was the connection between a child’s academic performance and his or her mental health. Many of the kids dropping out of school began as youngsters with untreated mental health problems. Even with remedial help, some children will struggle—and fail—to reach Mr. Bush's goal of literacy by third grade. Coming to terms with this awareness is critical for the future because it will shape how the various systems which touch the lives of children proceed.

When thinking about mental health as an issue it is important to understand its history. It is a topic that has yet to be discussed truthfully and openly in our culture and these distortions impede the very awareness that is needed to truly care for each child. “Mental illness is the last health issue our society persists on stigmatizing,” emphasized Peter Groff, AMH CEO. “This needs to change for mental health to become more visible—and acceptable– to our community.”

One of the myths of mental illness is that a person is somehow responsible for their illness. This misinformation reinforces the “blame game” which results in guilt and shame which, in turn, closes the door to asking for help. Following the March 6th school shooting in California, President Bush stated that our country will be better off when America teaches their children right from wrong.

“I don’t know anyone who would disagree with this statement,” explained Groff, “but this tragedy involved much, much more than an error in judgment committed by a child not having learned right from wrong. It has to do with children’s mental health and our society’s ability to recognize and accept mental health as any other health issue and make efforts to educate and treat it.” The answer is not found in metal detectors and security personnel. Even the concept that people with mental illnesses are more prone to violence is a deterrent to progress. Statistics show that the majority of people struggling with a psychiatric disorder are more often victims of violence than perpetrators of violence and if a harmful act occurs it is more often directed towards self than others.

Unmet Needs
Take the most extreme form of self-victimization—suicide. A survey by the Center for Disease Control showed that 7 percent of high school students have tried to kill themselves and that 20 percent have considered it. It is a fact that suicide among youth has risen over the past decade. It is also a fact that drug and alcohol use is accelerating and according to Cliff Green, Dual Recovery Coordinator at AMH, 90% of adolescent abuse problems begin with mental illness. And the tragedy of unmet mental health needs is that criminal justice systems are now new homes and “therapy” sites for kids. The lost lives of these children are a direct result of society’s dysfunctional awareness which often misinterprets the root causes of behaviors.

The author In a Connect for Kids article illustrates the devastating impact of untended mental health needs by citing the rate of youth suicide in Pierre, South Dakota, a city of 13,000 with no mental health providers, 11 young people killed themselves in the last three years.

The reporter asks, “Could Pierre and other similar tragedies have been prevented? Were there signs that these children needed help? Signs that teachers trained to recognize depression could have caught, or greater awareness among family and community members, places of worship, coaches and other adults could have yielded an early intervention and broken the cycle of despair?” The answer is a conditional “yes”.

In Pierre, the most basic condition of adding mental health services might have provided a minimal safety net for a few of the eleven youth. But this rudimentary condition has been met in numerous communities across the nation and youth continue to suffer. Questioning why and finding deterrents has become a top priority in many American communities.

Complex barriers to care
Among mental health advocates and government agencies, the goal is to create a new safety net for kids by coordinating efforts in every system where children are found—families, educational entities, justice systems, social services and primary care offices. Researchers are now busy testing models for optimum community-based programs but funding has always been just one of the many barriers to research. A total of $24 per patient is spent on research for schizophrenia and major depressive disorder whereas cancer research is funded at $203 per patient. Barriers are found in schools, too, where mental health is still not a part of many health curriculums. And although some schools now have a greater support staff of guidance counselors, social workers and, in some instances, psychologists, the student-to-counselor ratio and cumbersome administrative tasks seriously limit the quality and quantity of contact. And even in an ideal school setting which could recognize and assist all students with their mental health needs, referrals to community programs are often hindered by long waiting lists, the lack of insurance coverage, transportation problems and the lack of support by some parents. Stigma, the underlying and pervasive assumptions about mental and emotional disorders, hurts and many parents still cringe at the negative effects of labeling their child “special ed” or in need of mental health counseling. Stigma is part of their perceptions, too, and creates barriers to understanding why their child is having trouble.

On the other hand, the parents that do acknowledge the possibility of an emotional or behavioral disorder run up against stigma also. In the study conducted by the National Alliance for the Mentally Ill, “Families on the Brink: The Impact of Ignoring Children with Serious Mental Illness”, parents often felt “blamed, frustrated and unsupported by family, friends, professionals and schools.” To counter this, they called for greater educational efforts which would expose others to the latest scientific research which clarifies the mind/body connection and identifies harmful stressors in a child’s life.

Stigma negatively invades a child’s psyche. “School settings are not always tolerant or understanding of children with emotional disturbances,” explained Ingrid Aldous, youth services case manager for the AMH Integrated Services Program. “The kids we see have little or no social skills, are often economically deprived and they don’t often fit in.” Another case manager, Eileen Tarantino, adds “A lot of these kids are worrying about their next meal and can’t find that quiet corner to do their homework.” but according to case manager Angela Tracy the biggest problem she encounters is “getting people to accept help.”

Helping kids cope
Youth Services staff sees kids who were traumatized. They have all learned to protect themselves through various defense mechanisms. Some are the “tough” kids who readily anger and act out; others internalize their pain and have a diagnosis of depression. Some are defined as SED (Seriously Emotionally Disturbed), but there are many others that are adrift in the system. “Funding inhibits defining all the kids in need of help,” said Tarantino, “and they just don’t get the special attention they need to cope with their traumas.” And for some drugs, alcohol, risky and anti-social behaviors become their coping mechanism. Besides compromising the future of these kids, the consequences have an impact on everyone.

The Office of Juvenile Justice and Delinquency Prevention projects a continuous rise in violent crimes by juveniles. Unmet mental health needs, substance abuse, multiple environmental and biological risk factors, low self-esteem, a lack of coping skills, firearm availability and a culture defined, in part, by the media contribute too. Three major national studies have shown that excessive exposure to televised violence significantly impacts the violence in our culture.

Fear is the driving force behind some discussions about anti-social, destructive actions of our youth, but fear can foster counter-productive, punitive systems which react to symptoms, not causes. The scurry to implement violence prevention programs in schools look more to breaking the code of student silence rather than breaking into the conditions which bring a young person to such hopelessness. Instead of passing insurance parity legislation that could help families afford mental health guidance, all but a few legislators are looking at ways to increase penalties for violent crimes committed on school grounds. Certainly, these ideas and efforts compose a few pieces of this troubling puzzle, but until children’s mental health needs are met, communities may feel that the problems are still boiling under the guise of safety programs.

Knowledge is key Shattering the pervasive stigma attached to every facet of mental health is needed. The Surgeon General and numerous others now formally recognize the importance of mental health and are looking for new investment strategies for a child’s well-being. Strategies call for earlier interventions, better screenings and assessments, information exchange between research and practice, an increase in the coordination and integration of mental health care for families with mental health needs and substantive educational campaigns which, in part, teach people that it is all right—in fact, it is much healthier and stronger—for people of all ages, abilities and incomes to recognize when their mental health is fragile and reach out for help.

“In order for kids to be successful in schools they have to overcome barriers to successful learning.”
~ Dr. Steve Adelsheim, New Mexico School Mental Health Initiative

HOW IMPORTANT IS EARLY DETECTION?

74% of 21 year olds with mental disorders
had prior problems.

“Patterns of behavior established in childhood and early adolescence not only wreak havoc, but are the foundation for lifelong patterns manifested in adulthood.”
~ American Psychological Association