A Crisis in Child Mental Health – Early Intervention Can Make a Difference

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The United States is facing a child mental health emergency and the public’s lack of awareness of the problem is a chief cause of it, according to Bela Sood, M.D., professor and chair of child and adolescent psychiatry at the Virginia Commonwealth University School of Medicine, and a nationally recognized expert in children and adolescents with mental health problems.

May 1 to 7 marks National Children’s Mental Health Awareness Week, an effort to raise awareness and change attitudes toward mental illness affecting children and adolescents.

For most children, growing up is a carefree time filled with play and laughter, but some are plagued with emotional problems that impair their day-to-day functioning and quality of life. While these children require immediate attention, there is often a delay in identifying a child in crisis and getting them the necessary care or intervention.

Much of this can be attributed to the overall lack of awareness of mental health issues among children and the stigma associated with mental disorders, Sood said.

Sood stresses that early intervention can lead to a positive and significant improvement for children who are able to get the right help up front.

“This country is in the grips of a major crisis as far as child mental health issues are concerned because of poor recognition of these illnesses within families, schools and then a lack of a trained workforce that can intervene adequately,” she said.

“Early intervention has immense impact on the outcome for these young children … but the first step is awareness of these mental health issues. Once treated using well-tested treatment strategies, the outcome as far as school functioning, quality of friendships and overall adjustment in children with mental illness is startlingly good,” said Sood, who has worked with children with attention deficit/hyperactivity disorder, or ADHD, depression and bi-polar disorder for the past 25 years.

In her practice, she estimates approximately 80 percent of the children who have received early intervention care and counseling have experienced improved functioning in terms of academic success, social interactions and social relationships.

Sood said that without early intervention, secondary problems may arise. These may vary between a child not functioning well in school because they are unable to concentrate, or they develop depression and lack the energy to carry out activities that affect their ability to lead a healthy life. In very extreme circumstances, secondary problems could lead to suicidal behavior or threats to harm others, as well as substance abuse.

Stigma and social awareness

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According to Sood, many people still associate mental illness with “being crazy.” It stands to reason that when the brain or the mind is not functioning well it becomes equated with personal weakness. However, in recent years, scientific knowledge has demonstrated that behavior stems from the way people are wired, and not what they will upon themselves.

The growing knowledge of the neurobiological and genetic basis of behavior puts mental illness on par with physical illness, said Sood. Abnormalities in neurotransmitter levels in the brain correlate with abnormalities in emotional regulation. Once these abnormalities are corrected the intervention holds the promise to reverse the mental illness.

In the United States, approximately 15 million children suffer from mental illness, and only 20 percent receive treatment. Mental illnesses include attention deficit/hyperactivity disorder, depression or bi-polar disorder, or fear and anxiety disorders resulting from trauma in their lives.

Other challenges include a limited capacity to deliver care and a lack of professionals trained in children’s mental health - only 20 percent of the 20 percent of children who receive help are treated by somebody who is trained in child mental health. Additionally, Sood said that the economic impact of ill children transitioning into adulthood secondary to lack of recognition of illness is enormous.

Ultimately, Sood would like to see mental illness considered the way society views physical illnesses such as cancer. Fifty years ago, cancer was a stigmatizing term that no one wanted to talk about. Today, there are cancer survivors, people talk about the dreaded illness openly, fundraise for treatment and research and it’s no longer a bad word, she said.

“As a community, we all need to come together and understand that when a person has a mental illness, they did not will it upon themselves. It has come to them because of neurobiological reasons and we need to understand that,” she said. Mental illness could be transmitted from a family member or because of a devastating response to some type of traumatizing incident.

“If we understand that we will begin to treat mental illness just like physical illness and appreciate the multi-factorial reasons of why people suffer from mental illness. From this awareness will come expanded efforts to fund research, bring authentic parity to fund services and attract the brightest minds to the field of mental health. This is even more important for the most vulnerable population which holds the most promise to become productive citizens of our nation: the children,” Sood said.


 About Bela Sood, M.D.:

Aradhana Bela Sood, M.D., professor and chair of the Division of Child and Adolescent Psychiatry in the VCU School of Medicine, and a nationally recognized expert in children and adolescents with mental health problems is frequently quoted by national media for her views on the use of medication in such disorders.

Sood, medical director of the Virginia Treatment Center for Children at VCU, served on the panel reviewing the Virginia Tech shootings as a mental health expert. She is a dedicated teacher and lecturer and has taught a wide range of courses in pediatric psychopharmacology. Her current research examines the psychopharmacology of mood disorders in children and adolescents.