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Why Treatment Is Critical for Youth With Mental Illness

Childhood is supposed to be a time of curiosity, learning and growth. But children and teens with serious emotional or behavioral problems often miss out on these normal developmental phases.
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There are moments, seemingly ordinary at the time, that later have the power to alter your entire life course. For me, one of those moments occurred more than 13 years ago while working as a journalist in Portland, Ore. On a Sunday afternoon, a fax landed on my desk. It was a letter from a desperate father, begging for help with his troubled son, Christopher. The father said he had exhausted all avenues trying to get help for his son, and it was tearing his family apart.

Childhood is supposed to be a time of curiosity, learning and growth. But children and teens with serious emotional or behavioral problems often miss out on these normal developmental phases. That was the case with Christopher. Despite his father's best efforts to find him care, the boy who'd suffered from the symptoms of mental illness since early grade school eventually wound up in a juvenile detention center at age 14 for minor and seemingly-preventable crimes. Christopher spent the remaining days of his childhood locked behind bars. My series of stories that appeared in The Oregonian sparked widespread outrage and was headlined "Losing Christopher," because that's what had happened. This boy and his full potential had been lost -- to his family, to himself, to all of us.

The facts are indisputable: Kids who are not treated for their mental illnesses, or who do not receive the appropriate treatment, are at a much higher risk for school failure, problems at home, trouble with peers, substance abuse and, like Christopher, entrance into the juvenile justice system.

Early treatment is critical for the one in 10 American children and teenagers estimated to have a mental illness serious enough to impair their functioning in some way. But research shows that only one in five of these kids will get the kind of intervention they need to live happier, healthier lives.

Christopher's story, and dozens of other sadly-similar narratives I wrote about childhood mental illness over the years, mobilized me to want to help in a more direct way. Soon after leaving daily newspaper journalism in 2009 to pursue advanced degrees in clinical mental health counseling, I received the unique opportunity to learn about and contribute to a solution that could help millions of kids like Christopher.

Dr. Peter Jensen, a giant in the child psychiatry field, founded and is president and CEO of the New York City-based Resource for Advancing Children's Health Institute -- The REACH Institute. He asked me to join the organization's board to help support the goal of identifying and adapting the best childhood mental health interventions and making them accessible to millions more children.

Jensen, who also serves as a professor of psychiatry and Vice-Chair for Research in the Department of Psychiatry and Psychology at the Mayo Clinic, understood that powerful, new, evidence-based techniques to help these children existed, but these new methods were 15 to 18 years away from being disseminated and applied in everyday practice.

A big part of the problem is America's crisis-level shortage of child psychiatrists. According to the American Academy of Child and Adolescent Psychiatry (AACAP), there are only about 7,400 practicing child psychiatrists in our country today. There are a few ways to do that math, and each is fairly grim. The issue is even worse in rural areas.

Because of this shortage, many pediatricians and family doctors have been stepping in to fill the void, though their training is far less thorough. When confronted with these "problem children," they often don't feel empowered or trained to help them.

Jensen and his team want to empower them. With the right kind of training and consultation, pediatricians and family physicians can initiate mental health interventions for children with behavioral problems and common mental health disorders. Now in its sixth year, REACH crisscrosses the country teaching psychiatrists, family physicians, pediatricians and nurse practitioners how to conduct proper assessment, treatment, and appropriate use of medication if indicated for childhood depression, anxiety, ADHD, bipolar disorder and aggression.

Dr. Joan Flender, a pediatrician in rural, upstate Dansville, N.Y., has received REACH's training and says she is now much more confident in her ability to help patients with mental health problems. Most children and adolescents who receive mental health treatment do so by their primary care physicians.

"Our patients trust us and share their emotional pain just as they share their ear pain," says Flender. "Their mental illness is not marginalized by physician denial or by our refusal to treat this aspect of the human body. We are helping our youth stay healthy in all realms as they move towards becoming caring, competent adults."

Additionally, REACH trains social workers, psychologists, juvenile justice workers and other mental health professionals in the latest proven psychotherapy interventions for children dealing with anxiety, depression, post-traumatic stress and other disruptive behavior disorders. The organization also teaches parents how to advocate for the best treatment for their children, a resource I wish had been available for Christopher's family.

I don't know where Christopher is today. His family kept in touch for several years, so I know that he was eventually released from juvenile prison. But their letters finally stopped. Christopher would be 27 now. Internet searches to find him have been unsuccessful.

If I could find him, I'd tell him how much his story stayed with me, and how the chance intersection of our lives inspired me to take a new career path. I'd tell him that the stigma of mental illness is finally beginning to lift. I'd tell him that people are working hard to make sure what happened to him doesn't keep happening to others. I'd tell him he's part of the reason why.

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