It is easy to empathize with suffering we can see: a child who lost hair in chemotherapy, for instance. The suffering of a child with psychiatric issues is far less obvious. Many children and teens with emotional problems keep their pain secret. Others express their feelings in risky or offensive ways. Due largely to stigma--fear, shame and misunderstanding about mental health disorders--the majority never receive clinical care.
Debunking myths about child mental health is critical to getting more children the help and understanding they deserve.
MYTH 1: A child with a psychiatric disorder is damaged for life.
A mental health condition is by no means an indication of a child's potential for future happiness and fulfillment. The most important thing to remember here is that early intervention can be very effective at preventing chronic, debilitating conditions. If parents and teachers recognize the early signs of a psychiatric disorder -- whether it's ADHD or depression or anxiety -- and get a child treatment, she has a much better chance of eliminating, or effectively managing, symptoms that would otherwise interfere with relationships and her ability to succeed at school and at work.
MYTH 2: Psychiatric problems result from personal weakness.
It can be difficult to separate the symptoms of a child's psychiatric disorder -- impulsive behavior, aggressiveness or extreme shyness, for example -- from a child's character. But a mental health disorder is an illness, just like diabetes or leukemia is not a personality type. By way of example, anorexic girls are often blamed for starving themselves, but the obsessive fears and distorted body image that drive their behavior have genetic and biological bases. We can't expect children and teens to have the tools to overcome anorexia (or any other psychiatric disorder) on their own, but they can absolutely recover with the help of their parents, clinicians and a carefully individualized treatment plan.
MYTH 3: Psychiatric disorders result from bad parenting.
While a child's home environment and relationships with his parents can exacerbate a psychiatric disorder, these things don't cause a disorder. Anxiety, depression and learning disorders -- indeed, the full range of mental health conditions -- often have biological causes. Parenting isn't to blame. But parents play a central role in a child's recovery. They provide support and care that is crucial to their child's treatment plan and future development.
MYTH 4: A child can manage a psychiatric disorder through willpower.
The key word here is disorder. A disorder is not mild anxiety or a dip in mood. It is severe distress and dysfunction that can affect all areas of a child's life. A heartbreaking number of parents resist mental health services for their children because they fear the stigma attached to diagnoses or see psychiatrists as pill-pushers. This is incredibly sad because kids don't have the skills and life experience to manage a condition as overwhelming as depression, anxiety or ADHD. They can benefit profoundly from the right treatment plan, which usually includes a type of behavioral therapy, and have their health and happiness restored.
MYTH 5: Therapy for kids is a waste of time.
Treatment for child mental health disorders isn't old-fashioned talk therapy. Today's best evidence-based treatment programs for children and teens use a cognitive-behavioral model: therapy that focuses on changing thoughts, feeling and behaviors that are causing them serious problems. This is solution-driven therapy, and it's a key component of some of the most exciting and innovative new treatments plans for kids. Research has shown that there's a "window of opportunity" -- the first few years during which symptoms of mental health disorders appear -- when treatment interventions are most successful. This means that early identification followed by therapeutic interventions can give kids the tools they need to decrease, or effectively manage, their symptoms before they experience the stigma and negative effects of a fully developed psychiatric disorder.
MYTH 6: Children are overmedicated.
Since so many public voices (many without authority or clinical experience) have questioned or decried the use of medications in the treatment of childhood psychiatric disorders, many people believe that psychiatrists simply prescribe medication to every child they see. The truth, however, is that good psychiatrists use enormous care when deciding whether and how to start a child on a treatment plan that includes medication -- usually along with behavioral therapy. Medication is not the norm. Approximately 20 percent of children and teens in America have psychiatric issues at any one time; only five percent of them take medication. We never doubt whether a child with diabetes or a seizure disorder should get medication; we should take psychiatric illness just as seriously. The larger problem is that millions of children who suffer from serious psychiatric problems never receive any help.
MYTH 7: Children grow out of mental health problems.
Children are less likely to "grow out" of psychiatric disorders than they are to "grow into" more debilitating conditions. Most mental health problems left untreated in childhood become more difficult to treat in adulthood. Since we know that most psychiatric disorders emerge before a child's 14th birthday, we should have huge incentive to screen young people for emotional and behavioral problems. We can then coordinate interventions while a child's brain is most responsive to change, and treatment is more likely to be successful. Left untreated, disorders often lead to substance abuse, difficulties with relationships and work, and brushes with the law.
Harold S. Koplewicz, M.D.
President, The Child Mind Institute
Director, Nathan S. Kline Institute for Psychiatric Research
The opinions expressed herein are solely my own as a child and adolescent psychiatrist and public health advocate.