I Wish I’d Said That

By March 8, 2013Blog

Every so often, I read something or hear someone speak and all I can think is “I really wish I’d said that”! It’s one of those ‘aha’ moments when what was conveyed is so in line with my passion and beliefs, yet it completely eluded my brain’s ability to formulate, let alone articulate.

Such was the case this week when I read an article in the American Psychiatric Association’s newspaper ‘Psychiatric News’ by the APA president, Dilip Jeste, MD, entitled “We Must Do Better for the Children”. The bulk of the article is a compelling case laid out by Paramjit Joshi, MD, the president elect of AACAP (the American Academy of Child and Adolescent Psychiatry). Dr. Joshi speaks from the perspective not just of a child and adolescent psychiatrist, but also from that of a pediatrician.

As new parents, most of us are/were fastidious about taking our babies to the doctor for their weekly, monthly and annual well baby check-ups.  As our children grow they are screened in school for everything from scoliosis to vision to head lice. However, at the same time, despite the fact that 1 in 5 children suffer from a medical condition that affects mental health, only 20 percent ever receive treatment! And of those 20 percent, it takes an average of 8 to 10 years between the onset of symptoms and when treatment begins.  To me, any one of these statistics leaves not a shred of doubt that as a society we have to make children’s mental health a top priority. It shouldn’t be that hard. Dr. Joshi succinctly identifies key next steps which include:

1. Adapting a proactive approach. Clinicians need to anticipate and intervene before a disease begins rather than diagnosing after the fact. Early intervention saves lives.

2. Treating the child, not the diagnosis. In children, the same diagnosis can manifest very differently. The diagnosis is a starting point, not an end. The treatment needs to take into account environmental, social and developmental factors. Tell THAT to the DSM-V committee and the insurance companies.

3. Ensuring access to care. The best treatments in the world will fail if they are not made available to the 1 in 5 children who have a mental illness.  Legislators and voters, this one’s directed to you.

Dr. Joshi writes “The nation has a social and moral imperative to support the 1 in 5 children who need access to care. But it also has a practical imperative. Physically and mentally healthy children are more likely to become physically and mentally healthy adults. These children will grow up and enter our armed forces, our intelligence communities, our workforces, and our governments. Strengthening early access to mental health care strengthens communities and promotes stability and enables a free society.”

For those of us who ‘get’ the realities of mental illness in children, these points may seem glaringly obvious and simple. Yet we also know that turning these steps into reality seems at times to be insurmountable. Thankfully, we have people like Dr. Jeste and Dr. Joshi who articulate and publicize not only the urgency of children’s mental health, but what needs to be done. We, in turn, need to keep the conversation going, expanding, permeating until these facts and these steps are embraced as widely and naturally as those well baby check-ups. Society deserves this. Our children deserve this. And, as the article states, we MUST do better for the children.

Nanci Schiman is a licensed social worker with a Master’s degree from the University of Wisconsin-Madison.  She has over 10 years’ professional experience in child and adolescent mental health, family support, advocacy, writing, public speaking and collaborating with local and national mental health organizations. On a personal level Nanci and her husband are parents of three daughters ages 16, 18 and 20.  The oldest and youngest were diagnosed with bipolar disorder at ages 9 and 10 respectively.

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