Children's Issues

Reinvesting in the Community: A family guide to expanding home and community-based mental health services and supports

NAMI has released a publication titled, Reinvesting in the Community: A Family Guide to expanding Home and Community-Based Mental Services and Supports, to inform families about the importance of expanding the array of home and community-based services and supports available to children and youth with mental illness and their families.

To download a copy of the family guide, please visit NAMI’s Child and Adolescent Action Center website at www.nami.org/caac. Sections of the guide in Spanish are also available online.

Parents and Teachers as Allies

Recognizing Early-onset Mental Illness in Children and Adolescents (taken from the booklet "Parents and Teachers as Allies" by Joyce Burland Ph.D. National Director of NAMI Education).

On January 3, 2001, the Surgeon General of the United States released a report stating that 12 percent of American Children under the age of 18 have a diagnosable mental illness. Although welcome as a wake-up call to the nation, this belated recognition of children in crisis is not likely to come as news to the millions of parents and teachers who are struggling everyday to help these distressed youngsters.

The Heart of the Matter: Children Robbed of Childhood

There is now compelling evidence that brain disorders in children do occur, that untreated mental illness places at risk of developing the most debilitating forms of illness, and that the impact of untreated mental illness on their growing years is devastating. When children have neurobiological symptoms that they cannot control, childhood becomes a painful ordeal. All of the building blocks that need to prepare themselves for adulthood are kicked out from under them.

Many of their symptoms cause poor functioning in school; they fall behind, can't compete, fail. Behaviors driven by their symptoms are unpleasant and irritating; they become lightening rods for criticism, ridicule and rejection. In the starkest sense, untreated mental illness is a thief of childhood. It steals away every benefit this precious span of development confers on growing children.

When consequences this serious threaten a child's potential and effective medical and therapeutic treatments are at hand to stabilize a child's life, delaying affective remedies for any reason can compromise a child's entire future. Parents and teachers must be empowered as allies to confront any and all conventions standing in the way of early recognition and immediate treatment of childhood mental illness.

Keys to Early Recognition and Treatment

It is normal for all growing children to be reactive to stressors in their environment and to express their feelings in behavior disturbances. Many children struggle with poverty, depravation, and abuse and many must get through traumatic periods of loss or family instability. Children can have difficulties when they shift from one developmental stage to another or find that academic and social challenges are just too much for them at a given point. Parents and teachers witness a range of environmental stresses that can cause children to act out, rebel and show disturbed behavior.

However, none of those environmental events causes mental illness. Early-onset brain disorders are a biological given, and this is a case where children are handicapped by a chemical disturbance in their brain that controls their behavior and undermines their ability to deal with their world, whatever it may be. Environmental stressors can trigger the onset of mental illness and certainly make the experience worse for children; but their parents, socioeconomic status or degree of chaos in the home, for example, do not cause their brain disorders.

The problem, of course, is identifying which set of disturbances are which. Is the child spinning out of control a candidate for therapy and family counseling, or does the behavior represent symptoms of a brain disorder that will also require close psychiatric supervision and treatment? This is a call that only a qualified child psychiatrist can make. Medicating a child whose problems can be effectively remedied by therapy alone is as clinically misguided as denying medication to the child whose condition cannot improve without it.

Unhappily, because brain disorders in children are not well recognized, children with mental illness are more likely to be diverted into counseling than to medical treatment. Any child with persistent behavioral difficulties should have a psychiatric evaluation. Verifying clinical symptoms is basic, but doctors also look for a group of clinical features that have particular diagnostic significance, intensity, duration and level of distress. Children with serious mental illness suffer constant unrelieved misery. Therapy may help the child and support the family, but it has little impact on illness driven behaviors. Parents and teachers must watch for early signs of severity and disability so they can speed the referral to a qualified psychiatrist. For children with brain disorders, this step is the threshold to recovery and hope.

School Best Practices

Schools play a critical role in helping students diagnosed with mental illnesses reach their full academic and functional potential.  The academic performance and behavioral functioning of students significantly improves when their mental health needs are effectively addressed.  NAMI calls on schools to adopt the following ten best practices, download School Best Practices (pdf).

Other Resources

• Academy of Pediatrics and Child and Adolescent Psychiatry
• NAMI National Child and Adolescent Action Center
• Child & Adolescent Bipolar Foundation
• Eating Disorder Information for Students
• Reinvesting in the Community: A Family Guide to Expanding Home and Community-Based Mental Health Services and Supports
• Choosing the Right Treatment: What Families Need to Know About Evidence-Based Practices
• Crisis Intervention Team for Youth
• Utah Parent Center