Like an ocean people mix and mingle, flow along current and crash onto the shore, in the way we behave and compete. But we are more complex than h2o. Nor does our function in society require the kind of uniformity that is desirable in the military.
When we can appreciate how we are different as unique beings we can live in a way that is responsible to ourselves and others. We have so much potential that is not utilized as a result of not appreciating unique perspectives.
In the process of building our culture we can recognize the ingenuity that brings the most value to quality of life. Illness inherently draws our attention away from the regular rhythm of life. IMO the creeping malaise is the wasted potential of people living now with competition overriding understanding.
Instead everybody listens to the same bad music and they are content with it.
When we can appreciate how we are different as unique beings we can live in a way that is responsible to ourselves and others. We have so much potential that is not utilized as a result of not appreciating unique perspectives.
In the process of building our culture we can recognize the ingenuity that brings the most value to quality of life. Illness inherently draws our attention away from the regular rhythm of life. IMO the creeping malaise is the wasted potential of people living now with competition overriding understanding.
Instead everybody listens to the same bad music and they are content with it.
3
Well, that thing called the Cold War drove us Boomers crazy. why do you think people are voting for the current batch of Republicans?
2
This is an interesting article with many informed comments but my 2 cents is... "Let's Get Smarter About Preventing Developmental-Behavioral Problems" http://thehill.com/blogs/congress-blog/healthcare/233131-lets-get-smarte...
Isolated research studies such as this make good copy, but we shouldn't be too quick to accord them validity. Validity comes from replication and the data withstanding the test of time. Self-report scales are of less reliability than actual complete evaluations. They are simply screening tests. Before leaping ahead to conclusions about the explanations for this alleged phenomenon, we should await confirmation from other scientific data. Reporting on isolated studies such as these tends to seed the imagination but it helps to blur the already messy boundaries between truly worthy scientific discoveries, and those which are interesting but lack scientific confirmation.
6
"One is that the current generation of parents is doing something right,..." -- another is that they are not paying enough attention to their kids to notice problems. Pollyanna ought to determine independently whether or not this is the case before drawing pleasant conclusions.
2
Parents have become more aware that the drugs for treating these conditions are dangerous and otherwise questionable. So where there is doubt, they are more hesitant to have their kids' behavior problems treated as major mental health problems. Some find alternative, non-medical treatment effective. As a result, their kids are not classified as mentally ill. It's not that instances of major behavior problems have decreased, but that fewer kids are being taken to psychiatrists to be treated medically.
3
First step involving any medical study nowadays is to follow the money. Sad to say, my first skepticism arises from the journal it's published in: "The drug industry's preferred journal is The New England Journal of Medicine." (Peter C Gotzsche's Deadly Medicines.) Percent of a journal's income that comes from sales of "reprints", usually paid for by pharma, is a good sign of reliability or lack thereof. And the percentage can be amazingly large!
It's probably unfair to ask that the authors of a study have no ties to Big Pharma: it's difficult nowadays to find non-conflicted authors. I want to have high hopes, so let's hope that the doctors and institutions mentioned have received no money from drug companies. A reporter could, of course, research this. Answers are less reliable now that everyone knows about it ahead of time, but what doctors got how much money from Big Pharma is available at Pro Publica's Dollars for Doctors.
I have no idea in this case: I want to start out being extra optimistic, since less mental illness would seem to indicate less need for medication. But will there be another shoe dropping that attributes all this decrease in illness to the massive medication of our children? If that's the case, hey, we better prescribe more drugs.
PS Prescription drugs are the third leading cause of death in the US.
You could find one example by googling "statin myopathy".
It's probably unfair to ask that the authors of a study have no ties to Big Pharma: it's difficult nowadays to find non-conflicted authors. I want to have high hopes, so let's hope that the doctors and institutions mentioned have received no money from drug companies. A reporter could, of course, research this. Answers are less reliable now that everyone knows about it ahead of time, but what doctors got how much money from Big Pharma is available at Pro Publica's Dollars for Doctors.
I have no idea in this case: I want to start out being extra optimistic, since less mental illness would seem to indicate less need for medication. But will there be another shoe dropping that attributes all this decrease in illness to the massive medication of our children? If that's the case, hey, we better prescribe more drugs.
PS Prescription drugs are the third leading cause of death in the US.
You could find one example by googling "statin myopathy".
4
It's remarkable that so few comments are willing to entertain the study author's suggestion that increased diagnosis and treatment of childhood mental illness may be accomplishing its goal of preventing/reducing severe impairment.
This is the simplest and most likely answer, and it's a good news answer for a profession that is constantly maligned for overreach.
This is the simplest and most likely answer, and it's a good news answer for a profession that is constantly maligned for overreach.
2
And it is remarkable and regrettable that so many of the comments, however well intentioned, are based on speculations and preconceptions even weaker than the report itself. And that these comments come from a readership much more educated than the general population. Sigh...
The metrics of the studies mentioned here are all rather dicey, Perhaps, if they in fact turn out to be comparable, the comments about lead, pollution, and contraception may have some validity. But I'm with you regarding the power of increased awareness and early intervention.
What really matters is that, even if things are improving, most kids with serious problems still do not get help of any sort, not even unproven therapies or unneeded drugs from under-trained providers.
The metrics of the studies mentioned here are all rather dicey, Perhaps, if they in fact turn out to be comparable, the comments about lead, pollution, and contraception may have some validity. But I'm with you regarding the power of increased awareness and early intervention.
What really matters is that, even if things are improving, most kids with serious problems still do not get help of any sort, not even unproven therapies or unneeded drugs from under-trained providers.
2
What "author" said that?
The profession is maligned for over-medication, not "overreach".
The profession is maligned for over-medication, not "overreach".
2
Strange measurement of mental health disorders. My son is diagnosed with autism but from measurements this study uses, the autism may not be detected. For example: Is he“Feeling unhappy or sad?” - no. “Having fun?” Yes. “Getting along with other kids?” Kind of? “Feeling nervous or afraid?” Sometimes? Makes me very doubtful of the conclusions of this study.
4
I think many parents are responsible for emotional problems of their children because they raise the children like race horses, for achievement and performance under constant pressure. Soccer parents are are in that class. When the child falls behind the expectation he/she naturally being depressed and sick. Some children, like Mozart and Beethoven finally succeed but they are bound, like Beethoven, to have rather a miserable life.
I was very sad and depressed during the first three months when I was sent to a boarding school when I was twelve years old. I wrote desperate letters to my parents to take me out without any result. The depression went away however during the following months and I spent the best years of my life among the wonderful friends I found in this school and now I am grateful that my parents did not listen to me. This was 80 years ago. Would this situation occur nowadays I would probably be brought back to home, drop from the school, taking medicines and miss the happy years I spent in this school. I think weaning from your immediate family, one way or another, is the cause of most emotional problems for children. It is painful but it is healthy thing to enjoy the rest of your life.
3
Children need stability, and parents who are grounded and loving enough to provide consistent guidance and consistency in values and environment. The younger the child, the more susceptible to trauma due to domestic and community violence. Many of our kids with ADD are actually hyperalert due to exposure to violence. These children need safety, and treatment. The irony is that medication does help with treatment. The tragedy is that many kids only get the drugs.
4
Its worth looking at diet patterns in this generation. What changed in the young, or more importantly in the diets of the parents of the young, that may have contributed to a drop in severe mental issues. Were more vitamins and micronutrients emphasized, was more healthy eating encouraged, were less preservatives and additives consumed, were more balanced meals promoted and became affordable, was less meat consumed, cleaner meat with less hormones, less antibiotics treatment? Etc etc. As a public health nutritionist, these would be interesting to study and learn lessons for future trends in population demographics.
8
Sorry Pete. No more meaningless epidemiological studies- which is oxymoronic. ALL epidemiological studies are meaningless. But I agree, nice work if you can get it.
1
This article makes me think of common sayings that may apply to one degree or another to this subject area and where we are at with the science of it all.
The blind leading the blind.
Monkey see, monkey do.
All the kings horses and all the kings men couldn't put Humpty together again.
The mind is its own place.
We have a long way yet to go to understand the workings of this awesome creation of nature that we call the human mind.
The blind leading the blind.
Monkey see, monkey do.
All the kings horses and all the kings men couldn't put Humpty together again.
The mind is its own place.
We have a long way yet to go to understand the workings of this awesome creation of nature that we call the human mind.
2
One wonders if the reduction in air pollution, lead, carcinogens, tobacco smoke, etc. for the past 40 years or other environmental factors in the womb or during childhood, helped in some way?
or, another way to look at it is, 40+ years ago, we lived in a much more polluted environment with little pre or post natal care.
or, another way to look at it is, 40+ years ago, we lived in a much more polluted environment with little pre or post natal care.
3
The truth is in the very last paragraph of this story. Parents' perceptions are not an accurate indicator of their children's mental health problems. This research study is basically useless since its methodology is flawed.
7
Isn't it possible that because parents and educators put a lot more effort now into training kids to make eye contact, use their words, etc. plus into anti bullying policies that they are actually succeeding in moving kids who might have been diagnosed as mentally ill without treatment into the normal range as adults? Isn't a kid who is fidgety or distracted / afraid more likely to be lonely and victimized and therefore angry and therefore diagnosed as mentally ill?
2
Just three days ago, there was another article published in the NYTimes that said, "Rise in suicide among black children." It seems rather important for the researchers of both studies to connect, analyze, and explain their statistics to the public in hopes of preventing the tragedies of childhood suicides.
10
In the study, researchers analyzed mental disability in 53,622 youngsters aged 6 to 17, based on ratings provided by parents. The parents scored their children on a so-called impairment scale.
If this study were entered in a court of law, it would be immediately objected to and thrown out as hearsay evidence. but i guess the CDC knows better...
If this study were entered in a court of law, it would be immediately objected to and thrown out as hearsay evidence. but i guess the CDC knows better...
6
Exactly Tess... And it didn't even take a court of law when I was reading the article. The moment I read that the findings were based on reported ratings by the parents, I discounted the whole thing.
We're parents of a child with autism and also one typically developing child, so we are very in-tune with almost every aspect of their development and lives in general... If you put us in separate rooms and gave us a list of questions about our kids, most of the answers would probably be generally in line with each other. But I'm sure many would be slightly different -- What a parent sees and reports is not always the reality... Among other factors, a lot of emotional stuff can cloud a parent's view. So basing a scientific study on anecdotal info from the parents is probably not going to be very accurate.
We're parents of a child with autism and also one typically developing child, so we are very in-tune with almost every aspect of their development and lives in general... If you put us in separate rooms and gave us a list of questions about our kids, most of the answers would probably be generally in line with each other. But I'm sure many would be slightly different -- What a parent sees and reports is not always the reality... Among other factors, a lot of emotional stuff can cloud a parent's view. So basing a scientific study on anecdotal info from the parents is probably not going to be very accurate.
Mental illness is not black and white but a continuum. A small dose of "disorders" like psychosis or mania can be helpful, while too much becomes a burden. Discussions like this relate to where to draw the line between who is healthy and who is sick. In fact there is no easily defined point.
We go through evolution as a population following the rules of population genetics, but experience our minds and bodies as unique and separate individuals. This tension between the many and the one is at the core of this discussion. Mental illness most impacts the lives of the small fraction of individuals who have the bad luck to be born with a propensity for too much of something that benefits the rest of their family and humanity in general. They suffer for our benefit.
An enlightened society realizes that brain and mental illness is a necessary evil. A compassionate one will try its best to help the few people who suffer involuntarily for the greater good of humanity as a whole, rather than "culling" the sicker members of our tribe, or leaving it to environment and evolution to do it for us through our indifference. This unfair distribution of pain and suffering means that there will never be a perfect solution, but we are obligated to help reduce their suffering.
We go through evolution as a population following the rules of population genetics, but experience our minds and bodies as unique and separate individuals. This tension between the many and the one is at the core of this discussion. Mental illness most impacts the lives of the small fraction of individuals who have the bad luck to be born with a propensity for too much of something that benefits the rest of their family and humanity in general. They suffer for our benefit.
An enlightened society realizes that brain and mental illness is a necessary evil. A compassionate one will try its best to help the few people who suffer involuntarily for the greater good of humanity as a whole, rather than "culling" the sicker members of our tribe, or leaving it to environment and evolution to do it for us through our indifference. This unfair distribution of pain and suffering means that there will never be a perfect solution, but we are obligated to help reduce their suffering.
3
I've heard a theory that ADD is correlated with creativity.
Have you read "the Hypomanic Edge?" Great book and explains a lot about countries like ours with high rates of immigration and their corresponding high rates of mental illness.
1
It is important that in many cases the cure is worse than the disease. Diagnosing children with mild deviations from the normal, which is perhaps a character trait than a disease, benefits health care providers and pharmacological industry rather than the child. Well educated parents and respect for children certainly are the best answer for children's problems.
8
My concern with this study is that some people who really struggle mentally are well-behaved over-achievers as kids, however much they may suffer internally. It has been a revelation to me in adulthood to discover how much unhappiness lurks behind a facade of 'fine!'
8
There is a strong possibility that parents have changed their criteria for judging their children. Conforming to gender expectations is less of an issue and peer group opinions among those aged 30 and lower tend to be less rigid. And the method of world interaction for younger people has changed from one that was more physical and out in the world to one that revolves around small screens and electronic devices. Just think how a psychiatrist from 1960 would react to a world where adults spend their time seemingly talking to themselves, fixated on pushing buttons on a small object while walking down the middle of the street. Or, how they might respond to the thousands of 'friends' a patient might brag about that 'liked them.'
4
When I was a child divorce, though common, still held social stigma in many circles. Also, the church opposed it, causing many unhappy families. Children that acted with 'confused' sexual preference were treated either with total denial and persecution by their parents, and taunting by their peers, or chose the path of hypocrisy and denial themselves. A married man had fulfilled his 'obligation' and could be as gay as he pleased, discretely. Children had their perceptions of reality challenged all the time by the magic realism embraced by their parents and society. If they insisted on the truth it was a sign of mental instability, unhappiness, and depression. Not much different for my friends in the U.S. from what I've heard.
In addition it's far more profitable for drug companies to sell drugs for treating 'conditions' than allowing for a system that elicits feedback for what is really bothering children. No one really cares to know anyway. Better to treat their 'bi-polar' disorder.
In addition it's far more profitable for drug companies to sell drugs for treating 'conditions' than allowing for a system that elicits feedback for what is really bothering children. No one really cares to know anyway. Better to treat their 'bi-polar' disorder.
7
In my 25 years in community mental Heath I often thought that the Psychiatric community was too quick to diagnose severe M.I. in young children. Also too quick to throw drugs at them. We had a Psychiatrist who did nothing but ADHD and used nothing but drugs. His clinic was the busiest of them all.
8
Watch what A cup of None Sugared Cup Coffee can do to a true ADHD Child----same effect as Ritalin!
I certainly hope you aren't recommending that as a legitimate medical treatment, because the last thing that addiction-prone people with ADHD need is being nurtured on two addictive substances.
Organic causes should always be considered first. The near-elimination of lead from the environment in the US since 1980 has removed what was the largest single cause of brain damage and mental impairment. For one example of the scale of this effect see
http://www.edf.org/blog/2013/07/10/surprising-connection-between-polluti...
http://www.edf.org/blog/2013/07/10/surprising-connection-between-polluti...
7
Since lead exposure has decreased for a generation, you'd think that mental illnesses caused by lead exposure would also decrease.
We've also seen a large world wide decrease in crime, another trend attributed to decreased lead exposure.
We've also seen a large world wide decrease in crime, another trend attributed to decreased lead exposure.
3
If this statistic proves to be largely accurate, it will be a result of our society finally easing up on its Hitlerian sensibilities with regard to the social and societal enforcement of gender conformity. Also our profession has grown to recognized that drug use is not necessarily a gross psychological disorder.
In the 50s and 60s parents who learned their children were experimenting with drugs often responded by having their children committed to the care of various mental health facilities.
Thanks to the "War on Drugs" our society has criminalized experimental behavior of this nature and as a result an industry of programs and 'special schools' have sprouted into existence as an 'alternative track' for the wealthy. Jail and youthful offender horror shows await those of lower incomes.
Historically a not surprisingly high number of patients were referred to me because they were 'acting out' were 'acting out' various family dramas that revolved around infidelities, incest, and sadistic tendencies on the part of either parent. A great deal of my profession, arguably since Freud, has derived an income from helping to launder such soiled linen. There is the additional pressure that medical insurers have been increasingly reluctant to cover mental health issues that might be treated in a non-linear, not drug, therapy centered manner. In short - the bar for judging 'mental health has been moved. Not necessarily a 'bad thing.'
In the 50s and 60s parents who learned their children were experimenting with drugs often responded by having their children committed to the care of various mental health facilities.
Thanks to the "War on Drugs" our society has criminalized experimental behavior of this nature and as a result an industry of programs and 'special schools' have sprouted into existence as an 'alternative track' for the wealthy. Jail and youthful offender horror shows await those of lower incomes.
Historically a not surprisingly high number of patients were referred to me because they were 'acting out' were 'acting out' various family dramas that revolved around infidelities, incest, and sadistic tendencies on the part of either parent. A great deal of my profession, arguably since Freud, has derived an income from helping to launder such soiled linen. There is the additional pressure that medical insurers have been increasingly reluctant to cover mental health issues that might be treated in a non-linear, not drug, therapy centered manner. In short - the bar for judging 'mental health has been moved. Not necessarily a 'bad thing.'
3
Hmmmm... Could the rise of detecting Autism in very young children - along with early intervention - have anything to do with a decrease in the emergence of mental illness at later points in childhood?
Just a thought. But worth investigating. Could be possible, for a number of reasons.
Just a thought. But worth investigating. Could be possible, for a number of reasons.
2
The scientific research into finding a blood test for all mental illnesses looks promising. See Sadine Bahn schizdx blood test project and eu51. biomarker blood test.
We can add a mysteriously lower rate in serious mental disease to the previously discovered mysteriously low rate of violent crime committed by this same generation.
Yes, let the investigations continue into the search for a cause.
And, that search should include determining whether the removal of lead from motor fuels and paint are a significant factor.
We know with certainty that that lead in gasoline and paints created the largest for-profit mass poisoning in human history. We should continue to investigate the intriguing and plausible idea that lead -- and proven neurological damage it does to young brains -- was a cause of the surge of criminal violence and mental disease in the 20th century, and that its banning has led to as-yet unexplained significant reductions in both in the 21st.
Yes, let the investigations continue into the search for a cause.
And, that search should include determining whether the removal of lead from motor fuels and paint are a significant factor.
We know with certainty that that lead in gasoline and paints created the largest for-profit mass poisoning in human history. We should continue to investigate the intriguing and plausible idea that lead -- and proven neurological damage it does to young brains -- was a cause of the surge of criminal violence and mental disease in the 20th century, and that its banning has led to as-yet unexplained significant reductions in both in the 21st.
2
If these shrinks claim that the rise in prevalence of Autism is not real, they need their heads examined. Anecdotally, I did not know a single kid with autism while growing up. Now I know several friends with autistic children. These are severely impaired children who will need care for life, not a figment of their parents imagination. Autism prevalence seems to mirror the rise of other autoimmune diseases like Crohns, Rheumatoid Arthritis, Lupus etc. where higher your socioeconomic status, the more likely you will get these diseases. CDC is rightly picking up these trends. This is a silent epidemic that will overwhelm the nation.
3
All supposed to be preventable by playing outside, maybe by pets. Also, by eating home grown produce such as grapes on the vine while standing outside.
My mother and I were both raised on peanut butter and banana whole wheat bread sandwiches. Almost every day we both ate this. Now my mother is 85 and does not have any autoimmune diseases and neither do I.
My mother and I were both raised on peanut butter and banana whole wheat bread sandwiches. Almost every day we both ate this. Now my mother is 85 and does not have any autoimmune diseases and neither do I.
1
True Autistic Kids have Self Simulation ticks says active finger eye Twicks rocking---not many of those diagnosed today have them----is it possible that Mom dropped them off at day care when they were quite young and that they are actually suffering from an ATTACHMENT DISORDER Instead. Some of the same behaviors that over time and with caring more attentive parents many may overcome!
BTW: Attachment Disorder kids whereby the parents toss them out---hand them over to Foster Care or worse and Break that bond with their child in the 1st 3-5 years of life without concern for the Child usually end up as sociopaths!
BTW: Attachment Disorder kids whereby the parents toss them out---hand them over to Foster Care or worse and Break that bond with their child in the 1st 3-5 years of life without concern for the Child usually end up as sociopaths!
1
Study participants could achieve a total score of up to 52 points (0-4 for each of 13 questions). A score of 16 or higher was considered "Severely Impaired". That's barely over scoring a "1" for each question.
I have to wonder what a baseline score of "0" equates to... maybe all kids start somewhat impaired?
I have to wonder what a baseline score of "0" equates to... maybe all kids start somewhat impaired?
1
Problems that are a problem in the classroom are the ones that are a concern. Teachers are enlisted to assess children. Once children are given a diagnosis, psychologist have very little influence over the schools. I was told, "The schools don't like these kids."
Schools may be filled with bad programs (race to the top), bullying and lack of training; leaving fragile children to drift. Often small classrooms are unpopular teachers handling a rainbow of problems (other teachers refused to attend planning sessions with my son's special ed teacher). I felt my fragile son was a football.
I believe there is a great deal of potential for improvements in schools and the treatment of special needs children. Its important because all children will be a citizen. Don't confuse statistics with the science or process. Public school tends to be self-accessing, exclusive and have very few external controls beyond statistics. I went to three lawyers to file a civil suit and each one claim conflict of interest. Progress for these kids could work if anyone wanted it to.
Schools may be filled with bad programs (race to the top), bullying and lack of training; leaving fragile children to drift. Often small classrooms are unpopular teachers handling a rainbow of problems (other teachers refused to attend planning sessions with my son's special ed teacher). I felt my fragile son was a football.
I believe there is a great deal of potential for improvements in schools and the treatment of special needs children. Its important because all children will be a citizen. Don't confuse statistics with the science or process. Public school tends to be self-accessing, exclusive and have very few external controls beyond statistics. I went to three lawyers to file a civil suit and each one claim conflict of interest. Progress for these kids could work if anyone wanted it to.
2
I think the reason for this is obvious. Children now have access to the internet, and can form relationships outside of their family. In other words, if they are in a bad family situation, they can find peace and sanity outside of it with very little effort. This is one of the great underappreciated positive aspects of the Internet age.
2
The study seems to be biased from the start - parents can not do objective assessment of their children. Parental bias will be part of the scores. Unless that bias is systematically removed, the result will reflect wrong numbers. The argument of trend vs absolute number is some what valid, but that will require more rigorous statistical analysis with higher moments.
1
i can only imagine that these resuls reflect an increased scope of whats normal for both children and adults. all in all a misleading headline.
Perhaps people who are ill suited to parenthood now have the option of abstaining thus leading to steadily declining numbers of children with hereditary psychological disorder? Just wondering.
2
Parameters change over time as to what is considered normal. 2K years ago we defined it quite differently. 2K years from I assume we will as well. What do you think they will define as crude, crazy or unacceptable in the future that we consider normal now?
People who think they have it ALL figured out need some adjustment in their thinking.
People who think they have it ALL figured out need some adjustment in their thinking.
The majority of comments today are critical of the findings of this article. My postulation: any findings that do not indicate the need for more spending of tax dollars (or complaint if there aren't more tax dollars spent) are inherently looked on as wrong or suspicious by the majority of your garden variety NYT reader.
2
This article overlooks the fact that parents control the purse strings when it comes to a child getting psychological help. My parents were adamant about not allowing me to talk to anyone outside the family about anything. I was severely depressed and suicidal while in high school. I cut myself. I was also in the top 10 in terms of grades. Therefore my parents felt that I was trying to make them look like bad parents or wanted too much attention. What was really going on was that I was starting to understand that something was wrong in our family. My parents were physically and verbally abusive with me. I was afraid to grow up because I thought that being an adult meant that others could hit or kill me. Had I received the help I needed I think I might have had a better start in life.
7
Parents no longer accept kids as kids the way they were accepted by their parents. Now parents expect their young children to behave like them, or adults.
Spankings are now replaced by drugs.
Spankings are now replaced by drugs.
6
The lead is misstated, "Confusion in Mental Health Metrics" is the take away, unless you read down and see that the "improvement" in accessing services is up to 44% from 26%. So less than half for the most serious? Hmmm, more please.
1
I read the abstract of the NEJM article this piece refers to, and nothing about the finding of a 16 percent drop in the prevalence of severe mental illness in children was even mentioned in the abstract. As a former public health science researcher, I think this points to it being unlikely that the authors of the study considered this to be the most important finding. It is strange that the NYTimes would pick up on something not in the abstract and make it the headline. I admit it is interesting that any study would find a drop in this measure over the time period in question, no matter the survey used. However, abstract-writing for an NEJM submission is exactly the time when you would make sure to at least include this, if you thought it was of high clinical or public health significance. Perhaps this finding, although robust and real, as the quote says, was not included in the abstract because there are too many potential confounders in the particular study population that could explain the finding. Many possibilities exist, like increased psychiatric drug usage in parents over that same time -- which might influence their responses about their perceptions of their kids -- or the strange but well-documented phenomenon that the placebo effect has been generally increasing over time. The latter would help reconcile, for example, the studys finding of increased drug and therapy use in children -- which the abstract DOES write about -- with the finding NYT decided to focus on.
2
One of the known preventable causes of mental illness is childhood abuse and neglect. This has become better understood both by professionals and by lay people, including parents. Our current economic environment discourages some folks from becoming parents because it's hard work with very little support from outside the family. Family planning and birth control are better understood as well. Depo Provera injections once every three months provide reliable birth control with little effort. I believe that more and more women are planning better and delaying parenthood or opting out completely. Unwanted children are unwanted for a good reason: poverty, addiction, mental or physical illness, unstable family etc etc etc. It's my hope that every child born in the U.S. will be a wanted child. This will help decrease the incidence of abuse and neglect and hopefully prevent trauma-induced mental illness. For a great discussion of this, read Bessel Van de Kolk: "The Body Keeps the Score". This new book lays out the realities of PTSD as a factor in mental illness with readable explanations of brain responses to trauma and excellent discussions of non-pharmaceutical treatments. My favorite book of the last ten years.
4
Although there is no evidence to support this conclusion, many this is due to the widespread use of vaccines. If anti-vaccine people can trash all vaccine without any real evidence, maybe pro-vaccine people can do the same. Yes, the evidence-supported finding that measles temporarily wipe out the immune system, greatly increasing a child's propensity to become ill for several years, is HUGE, and we should evidence. But we Americans are, for the most part, an evidence-free society where only individual ideologies matter.
2
The improved stats might be caused by decreased tolerance for bullying. I read that often bullying stops when a child is put into a difference school indicating that the behavior of the child who is bullied is not the cause. My child was bullied in Steamboat Springs Colorado, an awful and truly corrupt community with beautiful scenery where I was also bullied. My child was bullied by the children of people associated with the convicted felon who was the city council president. He would be attacked 3 on 1 and the principal would tell him not to tell me. Older kids brought dirty motor oil to school and poured it on his head and the administrators did nothing. If an adult were in that situation, they would have difficulty handling it too.
2
All God's chillun got a place in the choir, some sing lower, some sing higher....
Some children are shy some outgoing, some passive some active, some bookish some athletic, some impulsive some obsessive, some hetero some homo. Takes all kinds to make a world. Let's stop doping our kids to make them fit in with school classes way too large, home situations way too pathological (alcoholism, violence, neglect) and allow them to bloom as Nature designs them. And by the way teenage is by definition a really weird stage of life; ever seen Rebel Without A Cause?
Some children are shy some outgoing, some passive some active, some bookish some athletic, some impulsive some obsessive, some hetero some homo. Takes all kinds to make a world. Let's stop doping our kids to make them fit in with school classes way too large, home situations way too pathological (alcoholism, violence, neglect) and allow them to bloom as Nature designs them. And by the way teenage is by definition a really weird stage of life; ever seen Rebel Without A Cause?
3
Seriously? Would this be the same "Nature" that designs holes in children's hearts, spina bifida, cerebral palsy, epilepsy, life-threatening prematurity, etc.?
I highly doubt all parents are objective, benign, unbiased judges of their children's behaviour. If they were, there would be no need for the Primary Care Physician, or School Psychologist.
I doubt any of this means much of anything, in the long run. Mental illnesses are not like infectious diseases, with known pathogenic causes. They are part of the mysteries of the mind, arising in part due to genetic predispositions, but also triggered by external stressors in family life and society. Nobody knows who is mentally ill until after they become that way. If the younger generations go through significant social traumas in the future, we may have some sense about which of them are vulnerable. Until then, we may as well be predicting who is going to win a kewpie doll at a carnival baseball throwing booth.
2
Wisconsin has legislation introduced which will give $12,000 to a parochial voucher school for a child who needs special education services and is not accepted by another public school under "school choice."
But isn't it interesting that parochial schools do not have to provide special education services. So this child is being bought and sold to churches (the money for parochial schools does go to the church, folks) with taxpayer money - but what about the special education services that the child needs?
Gone by the wayside. because believe it or not, voucher parochial schools do not have a special ed department.
This part of the the new voucher school push. Beware. This hair brain idea, which is cruel, too, will not serve any purpose for childhood mental health. It is another Republican Christianity push - and it is using children, powerless children, in the meanwhile for churches to get taxpayer money. It sounds absurd, but it is for real, sadly. Look up Wisconsin legislation in this regard.
It is unbelievable, and as a once school nurse, I am in awe in a very sad way.
But isn't it interesting that parochial schools do not have to provide special education services. So this child is being bought and sold to churches (the money for parochial schools does go to the church, folks) with taxpayer money - but what about the special education services that the child needs?
Gone by the wayside. because believe it or not, voucher parochial schools do not have a special ed department.
This part of the the new voucher school push. Beware. This hair brain idea, which is cruel, too, will not serve any purpose for childhood mental health. It is another Republican Christianity push - and it is using children, powerless children, in the meanwhile for churches to get taxpayer money. It sounds absurd, but it is for real, sadly. Look up Wisconsin legislation in this regard.
It is unbelievable, and as a once school nurse, I am in awe in a very sad way.
3
The study is a survey of parents' opinions about how their children is doing. That's barely scientific.
"Without a good handle on baseline levels of severe pediatric mental disorders, policy makers and research-funding organizations lack a good guide to targeting their resources, these experts said."
This is a joke, because these "experts" would have no control group to compare with children with "severe pediatric mental disorders" for random double-blind placebo control (RDBPC) experiment--the gold standard for epidemiological studies.
And if they do a RDBPC, the study would either involved children previously medicated and/or healthy children starting medication for no reason; in which case, the former would distort the control group, and the latter start future medical problems for otherwise a would-have been healthy child.
If anything, this study might as well be a propaganda piece for vindicating psychiatry.
"Without a good handle on baseline levels of severe pediatric mental disorders, policy makers and research-funding organizations lack a good guide to targeting their resources, these experts said."
This is a joke, because these "experts" would have no control group to compare with children with "severe pediatric mental disorders" for random double-blind placebo control (RDBPC) experiment--the gold standard for epidemiological studies.
And if they do a RDBPC, the study would either involved children previously medicated and/or healthy children starting medication for no reason; in which case, the former would distort the control group, and the latter start future medical problems for otherwise a would-have been healthy child.
If anything, this study might as well be a propaganda piece for vindicating psychiatry.
1
I'd credit the parents with this development. It has been revealed that up to 75% of psychoactive medications prescribed to children have not been tested for children, including the antipsychotics which are widely prescribed to those suspected of being seriously mentally ill. Side effects of antipsychotics and antidepresants that have been widely publicized include grotesque weight gain, suicide, and fatigue. As for adderall, the main medication prescribed for ADHD, which can be very effective is better known for its wide abuse by older kids. Finally, the overdiagnosing of serious mental illness In children has been widely discussed.
The logical course for any parent with access to the internet, is to seek a diagnosis and medication only as a last resort. As an intermediate measure, I would imagine that many consult professional counselors and as long as the counselors indicate that medication is not an absolute necessity, the parents probably continue to not consult a psychiatrist.
Under this circumstances no diagnosis is made, and no medication is prescribed. That means statistics will show a decrease in serious mental illness, not because mental health has improved but because parents have grown more cautious.
The logical course for any parent with access to the internet, is to seek a diagnosis and medication only as a last resort. As an intermediate measure, I would imagine that many consult professional counselors and as long as the counselors indicate that medication is not an absolute necessity, the parents probably continue to not consult a psychiatrist.
Under this circumstances no diagnosis is made, and no medication is prescribed. That means statistics will show a decrease in serious mental illness, not because mental health has improved but because parents have grown more cautious.
2
The problem is that youngsters who could benefit from treatment too often do not get it?
Let's call things by their names: this is Obamacare, baby.
Let's call things by their names: this is Obamacare, baby.
1
No it's not. It's been that way far longer than "Obamacare" has been around.
Autism is a serious mental illness. Yes, people can live with it, but that doesn't make it NOT a serious mental illness, even if it is only mild impairment. Maybe psychiatrists should stop playing politics when their job is science.
A good study would involve parents, teachers and mental health professionals. The view from any one angle might be skewed but if you have it from the standpoint of the major adults in the child's life, you might get a truer picture. I didn't recognize my child's depression in high school or her attention deficit because she made straight As in top level classes but she struggled to keep her mind focused. Because she was old enough to study on her own and actually never needed help on schoolwork I didn't realize how long it took to complete an assignment. Her teachers didn't notice because she was a model student. It wasn't until she would burst into tears without any provocation that I realized something was wrong. I was a teacher with an advanced degree and I didn't see it in my own child even though I could recognize signs in other children. I believe this study is flawed.
19
This study was a survey of parents. Perhaps, the real finding is that more parents are either blind or in denial regarding their children's difficulties.
1
Without any insights into the data -- i am just wondering if it can be that schools are set up to identify and handle learning disabilities at an earlier age -- building confidence and heading off severe behavioral issues. There has been a rapid acceleration of educators being educated to see early signs of learning issues over the past 15 years. If there is any connection, this would be yet another boon to early education funding.
I wonder why the article doesn't mention whether a reduction of environmental lead levels might be responsible for the decline. Environmental lead with corresponding higher serum/tissue lead levels are correlated with lower reading scores and behavioral problems in children. This is a bigger issue than is generally realized but is well documented in the toxicology literature.
5
You are right - lead was once a huge problem, and has largely been eliminated.
In our school ADD was not a problem.
We had nuns.
We had nuns.
6
Let's also remember that rates of physical abuse and sexual abuse are down nationwide. This could certainly contribute to fewer children showing extreme pschiatric symptoms.
7
A good deal has been done to reduce lead exposure since 1971. As an observer it does imply this reduction in lead, done for good reasons, has had good results.
At least I would say it was a factor in reducing mental difficulties.
At least I would say it was a factor in reducing mental difficulties.
2
My husband and I finally concluded last year that our 10 yr old daughter might benefit from some psychological counseling to help her cope with anxiety. It has taken us a couple tries, but we have found an excellent therapist who specializes in children with anxiety, depression and ADHD. My point? We really weren't sure if it was anxiety (I have bouts of it) and we didn't have any experience with recognizing it in a child. However, we went with our gut instinct because we could see our daughter was in pain. It was affecting her schoolwork - to the point where her teachers thoughts she had ADHD. I had to get her tested to prove them wrong. Her anxiety was causing her to literally freeze and be unable to ask questions, thus making it appear she wasn't paying attention. Her primary care doctor wanted to start her on medication and my daughter balked at the idea. I certainly wasn't going to force the issue - it's her body! Anxiety is real for some of these kids, but treatment can make a world of difference and of course, the love and support of their family.
17
As a "NAMI Basics: Caring for You, Your Family and Your Child with Mental Illness" teacher and teacher trainer, a call I get too often is about a child who was misdiagnosed by the family physician/pediatrician and put on an antidepressant or stimulant and who subsequently became manic and/or psychotic. Being untrained, these doctors do not know how to rule out bipolar disorder and by giving antidepressants without first a mood stabilizer, leave the patient vulnerable to worsening illness if they do have bipolar. Any evaluation really needs to be done by a child psychiatrist or psychologist. These folks are rare as hen's teethe. Thank the higher power that you did listen to your daughter. The right meds can be life-saving, the wrong meds can be life threatening. And, its never just about the meds. Good therapy, services, and an educated family all combine for best possible outcomes.
Parents, if you have concerns, its better to know. Get your child evaluated and if it looks like there is a mental health problem, get educated.
Parents, if you have concerns, its better to know. Get your child evaluated and if it looks like there is a mental health problem, get educated.
1
If we all treated our mental health more like our dental health, we might avoid even more mental illness.
“I certainly wasn’t going to force the decision- It’s her body”.
Is that your stance on immunizations,antibiotics, stitches, bandages,and casts as well?
If a doctor prescribed insulin for your daughter,would you say” It’s her body.”?!
I think not.
I don’t believe primary care doctors should be allowed to prescribe psychotropic
medications,any more than they should be doing surgery. The same doctors who
would never stitch up a child believe they are experts in prescribing psychotropic
medications after doing a 3 month psychiatry rotation, just as they have done a
a 3 month rotation in cardiology,oncology,surgery,and all the other specialities.
I am not suggesting that your daughter take psychotropic medication. I am glad that you took your daughter for help, but was really thrown off by your statement “ I certainly wasn’t about to force the issue-it’s her body” .
Is that your stance on immunizations,antibiotics, stitches, bandages,and casts as well?
If a doctor prescribed insulin for your daughter,would you say” It’s her body.”?!
I think not.
I don’t believe primary care doctors should be allowed to prescribe psychotropic
medications,any more than they should be doing surgery. The same doctors who
would never stitch up a child believe they are experts in prescribing psychotropic
medications after doing a 3 month psychiatry rotation, just as they have done a
a 3 month rotation in cardiology,oncology,surgery,and all the other specialities.
I am not suggesting that your daughter take psychotropic medication. I am glad that you took your daughter for help, but was really thrown off by your statement “ I certainly wasn’t about to force the issue-it’s her body” .
So much which is treated today was simply dismissed when I was a child. Kids were not seen to have a problem unless they were 1) really acting out, e.g., actually hurting a sibling, destroying property etc., and even then might simply be labeled a behavior problem, not as having a psychiatric issue; 2) actively self-destructive.
As for teens, eating disorders were narrowly defined as anorexia. Girls who binged simply were seen as lacking self-control. Purging was a secret sometimes shared in the girls bathroom more as a neat tip than as a problem to be treated. Teens who were likely depressed were labeled 'moody' and encouraged to go out more.
None of this is good, but I'm not sure more problems exist today so much as society is wearing a different set of glasses in looking at who kids are and how they behave.
As for teens, eating disorders were narrowly defined as anorexia. Girls who binged simply were seen as lacking self-control. Purging was a secret sometimes shared in the girls bathroom more as a neat tip than as a problem to be treated. Teens who were likely depressed were labeled 'moody' and encouraged to go out more.
None of this is good, but I'm not sure more problems exist today so much as society is wearing a different set of glasses in looking at who kids are and how they behave.
29
ALL PSYCHIATRIC RESEARCHERS USE STATISTICS . . .
...and, though figures don't lie, there a numerous ways of arriving at them. Some of the variables involve: differential ways of diagnosis, the manner of sampling, the structure of the methodology used ... and, etc.
Ergo, who knows? And, I am sure that as the years proceed, there will be different conclusions reached.
...and, though figures don't lie, there a numerous ways of arriving at them. Some of the variables involve: differential ways of diagnosis, the manner of sampling, the structure of the methodology used ... and, etc.
Ergo, who knows? And, I am sure that as the years proceed, there will be different conclusions reached.
12
Do we find this trend because we've eliminated school nurses from the budgets of most school districts?
16
As a child psychiatrist, with the perspective of a retiree, I find this study encouraging, surprising and likely to generate lots of debate. My personal impression is that it tells us more about where we've been and what we've done than it tells us where we are. It's the where-we-are part that will generate debate. In reading the study in the NEJM, I noticed a finding not mentioned here. Various forms of treatment have increased, including psychotherapy, but of particular interest, if not concern, is that the use of anti-psychotic medications in children has increased six-fold (!) during the time surveyed. Having long-term side effects, such as obesity, diabetes, hypertension, their marked increase in use suggests that there is a potential cost also associated with the improved outcome reported in some children.
56
How can anyone think that being psychotic is preferable to being overweight?
1
As one massively damaged by a prescription drug (the blockbuster of all time: statin) I recommend that you read Deadly Medicines and organized crime, by Peter C Gotzsche. It won first prize from the BMA and has forwards from editors of BMJ and JAMA.
Yes, massive over-prescription of drugs. Healthcare system essentially taken over by the pharmaceutical industry. HELP!
(You might google "statin myopathy" to see physical damage. What amphetamines like Adderral do to brains and minds...who knows...yet?)
Yes, massive over-prescription of drugs. Healthcare system essentially taken over by the pharmaceutical industry. HELP!
(You might google "statin myopathy" to see physical damage. What amphetamines like Adderral do to brains and minds...who knows...yet?)
2
There are long-term side effects to psychosis, too.
It is also true that, with extreme modern medical intervention, infants are surviving who in the past would have died at delivery, and with many medical problems, including those affecting the nervous system.
It is also true that, with extreme modern medical intervention, infants are surviving who in the past would have died at delivery, and with many medical problems, including those affecting the nervous system.
1
The first thing that came to my mind was expressed in the last paragraph of the piece.
Are parental assessments to be trusted?
Are parental assessments to be trusted?
33
That is a great question, pkbormes. And it works both ways.
Can parents be trusted to not under- or over- recognize possible mental health issues in their children?
My own experience tells me that it's difficult. My now adult daughter engaged in behaviors that were indicators of mental health issues even as far back in her early childhood. Neither I nor my wife ever thought a young child could have serious mental health concerns.
We eventually took her to a child psychologist, who after a few visits with our daughter, pronounced her mother at fault for her behavior. We stopped sending our daughter to her. We should have sought a doctor who was better able to detect mental health issues in children, but what did we know?
As a teenager our daughter's issues and behaviors became more pronounced and damaging but by then it was too late. She refused to acknowledge them or go for help, and her attempts to self-medicate led to life-threatening behavior several times. Only now has she acknowledged them and started to address her behavioral issues, but she has a long way to go.
My point is that parents are not experts, and medical professionals must be able to accept that mental health issues in children can occur, and be able to recognize them. As parents, we should not let the results of studies inform us as to the mental health of our own children. Let the medical professionals sort that out. We have to go with our gut and respond to our children's needs.
Can parents be trusted to not under- or over- recognize possible mental health issues in their children?
My own experience tells me that it's difficult. My now adult daughter engaged in behaviors that were indicators of mental health issues even as far back in her early childhood. Neither I nor my wife ever thought a young child could have serious mental health concerns.
We eventually took her to a child psychologist, who after a few visits with our daughter, pronounced her mother at fault for her behavior. We stopped sending our daughter to her. We should have sought a doctor who was better able to detect mental health issues in children, but what did we know?
As a teenager our daughter's issues and behaviors became more pronounced and damaging but by then it was too late. She refused to acknowledge them or go for help, and her attempts to self-medicate led to life-threatening behavior several times. Only now has she acknowledged them and started to address her behavioral issues, but she has a long way to go.
My point is that parents are not experts, and medical professionals must be able to accept that mental health issues in children can occur, and be able to recognize them. As parents, we should not let the results of studies inform us as to the mental health of our own children. Let the medical professionals sort that out. We have to go with our gut and respond to our children's needs.
23
There are many difficulties in their reporting - but,arguably, parents on the whole have much more knowledge of mental health issues and familiarity with treatments than ever before. Perhaps many are recognizing some issues early and seeking help, which actually has a positive impact. Many parents also parent differently, with more " emotional intelligence" if you will, and that too may result in less serious disorders in children.
Certainly for those of us who were raised in different times - not so long ago there was not even recognition even of learning problems, forget about seeing depression, ADHD or other mental health issues. And my memory is good enough to remember some classmates who did show signs that would be picked up today. Then they were ignored, classified as difficult or unable to learn.
Certainly for those of us who were raised in different times - not so long ago there was not even recognition even of learning problems, forget about seeing depression, ADHD or other mental health issues. And my memory is good enough to remember some classmates who did show signs that would be picked up today. Then they were ignored, classified as difficult or unable to learn.
It's true that parents have often been blamed for children's conditions that were not rooted in their parenting. But to pretend that parents don't have a huge impact on their children's emotional well-being is ludicrous and perilous: it means no change is needed, no self-examination called for.
Our society seems to be utterly split and unable to work through this issue. Many parents harbor undue fear that even their tiniest error will severely impact their child; yet, on the other hand, when children do run into serious trouble, genes, a virus, the water, the "badness" of the child -- anything but parents and family life -- is almost inevitably held responsible. So, we overdiagnose and medicate ADHD and make no attempt to discover and ameliorate possible causes.
Our society seems to be utterly split and unable to work through this issue. Many parents harbor undue fear that even their tiniest error will severely impact their child; yet, on the other hand, when children do run into serious trouble, genes, a virus, the water, the "badness" of the child -- anything but parents and family life -- is almost inevitably held responsible. So, we overdiagnose and medicate ADHD and make no attempt to discover and ameliorate possible causes.
6
Parents are usually in denial about their children's mental problems and many think that accepting or advertizing the existence of mental illness in their children would reflect poorly on their parenting or get their children ostracized. Societal stigma against mental illness persists and does not help unravel true statistics about the occurrence of mental illness among children or among adults in this country. This study is unconvincing especially since modern existence besets children with numerous pressures--academic, psychological and social. Children are copping out. Many are not keeping up academically, many drop out of school, suicide rate among male teens remains a problem, all teens face pressures to conform, social media creates its own angst and self doubt and drug use is always a threat. Drug use starts in middle school for some and sex starts early too.
This study seems incongruous with the realities of existence and to glibly declare that parents must be doing a better job of recognizing serious mental problems and getting psych help to ameliorate these problems earlier is to deny that our prisons are filled with the mentally ill. Didn't Chicago just appoint a female psychologist to head its prisons because those prisons now hold mostly mentally ill folks?
I am not buying this survey. Ask any professional--a lawyer, a doctor, an editor to admit to his boss he's mentally ill without fear of reprisal. Won't happen. This is the world we inhabit.
This study seems incongruous with the realities of existence and to glibly declare that parents must be doing a better job of recognizing serious mental problems and getting psych help to ameliorate these problems earlier is to deny that our prisons are filled with the mentally ill. Didn't Chicago just appoint a female psychologist to head its prisons because those prisons now hold mostly mentally ill folks?
I am not buying this survey. Ask any professional--a lawyer, a doctor, an editor to admit to his boss he's mentally ill without fear of reprisal. Won't happen. This is the world we inhabit.
47
How do the things you mention, such as dropping out of school, constitute mental illness? I'm scratching my head here. The mere fact of being counterproductive doesn't make a behavior mental illness! Now autism -- schizophrenia -- bipolar disorder -- *those* are mental illnesses, and it does no one any good to say that a child who doesn't keep up academically is mentally ill -- not the children who genuinely are mentally ill, and not the children who aren't but are stigmatized by the diagnosis.
2
You are conflating different issues: rates of child mental health impairments and a concern about adult mental health impairments in prison populations. And while parent report surveys do have their limitations, it is important to keep in mind that the survey is anonymous- there is no boss or anyone else in the parent's life who will read their responses. If concern about stigma has impact on the ratings, it is internalized stigma. The researchers sought to minimize this by using a scale that looked at rates of specific behaviors- all of which might be considered "normal" to some degree.
2
I have a problem with the survey, but not the reason stated here--parental biases and the writer's perception that social pressures on kids have gotten worse. The latter point simply isn't true. On biases, those have always existed, and I'd wager it was worse in the past. Even if not, presumably parents in 1996 had at least a similar reluctance as parents in 2012 to admit their children had trouble. So this point about bias isn't important given the point the researchers are making. They are not making claims that their numbers are useful as an absolute measure of the emotional health of children, it is the relative change that is notable. The bias inherent in both periods washes out.
My problem with this is more basic. Even with 53,000 kids surveyed, I am always reluctant to ascribe much significance to a 16% drop based on opinion surveys. Professional journals are filled with such studies, and they are often just measuring noise.
My problem with this is more basic. Even with 53,000 kids surveyed, I am always reluctant to ascribe much significance to a 16% drop based on opinion surveys. Professional journals are filled with such studies, and they are often just measuring noise.
My understanding is that the rate at which young children are being medicated with heavy psychotropic drugs, either for the recently popularized pediatric bipolar diagnosis, ADHD or often for behavioral control purposes has skyrocketed in the past two decades. These medications have serious side effects that add up and over time. Label or no label, children are taking many more psychiatric medication these days...
38
Your ‘understandings’ mean nothing. To lump bipolar disorder and ADHD in the same category is beyond ignorant. It is stupid.
23
I am 64 years old. When I was young I was considered disruptive in school, had many fights and was even expelled for a year because of my ruthlessness in a fight. Yet I tested a well above average intelligence.
School was boring. I sucked up lessons in rapid time leaving me nothing to do while the rest caught up. The expulsion was great. I went to the Washington Irving branch of the library 2-3 times a week and read the newspapers from around the world, wandered the shelves reading whatever interested me. I wandered all over New York City jumping turnstiles, hanging on the backs of buses went to the World's Fair twice. I started using drugs at 13 and finished with them at 18. I was in the Dade County Childrens Home and the State School For Boys in Okeechobee. The thrill was gone.
I was self educating. I didn't finish high school.The educational system was failing me. Today, I'd be doped up so I'd conform.
But as an adult I've spent four years in the military, owned my own business . been married 43 years, raised a good son who is a Civil Engineer.
I still self educate. I want to know what I want and decide what I need to know. Doping kids is society's demand that they conform to it's standards. Some of us have our own standards.
School was boring. I sucked up lessons in rapid time leaving me nothing to do while the rest caught up. The expulsion was great. I went to the Washington Irving branch of the library 2-3 times a week and read the newspapers from around the world, wandered the shelves reading whatever interested me. I wandered all over New York City jumping turnstiles, hanging on the backs of buses went to the World's Fair twice. I started using drugs at 13 and finished with them at 18. I was in the Dade County Childrens Home and the State School For Boys in Okeechobee. The thrill was gone.
I was self educating. I didn't finish high school.The educational system was failing me. Today, I'd be doped up so I'd conform.
But as an adult I've spent four years in the military, owned my own business . been married 43 years, raised a good son who is a Civil Engineer.
I still self educate. I want to know what I want and decide what I need to know. Doping kids is society's demand that they conform to it's standards. Some of us have our own standards.
6
Please don't call me stupid. Childhood Bipolar diagnoses have skyrocketed in recent times; they often happen to kids previously treated for ADHD and are correlated with ADHD diagnoses. There is mounting evidence that ADHD drugs may trigger mood disorders and that the drugs used to treat these disorders may further exacerbate the symptoms first identified.
http://www.sciencedirect.com/science/article/pii/S0165032712002340
http://www.sciencedirect.com/science/article/pii/S0165032712002340
6
Since no reason is given for the decline, the result might reflect parents know their children better or think unrealistically high of their children. We learn little about the real picture here.
17
This may need some time to get sorted out. But for openers: children's emotional problems are often related to their parents' emotional problems. For this and other reasons, parents may underestimate their children's problems, which could mean that the NEJM study is flawed.
37
Children's emotional problems are often *caused* by their parent's emotional problems.
Only the parents would deny this.
Only the parents would deny this.
Maybe because we banned lead in gasoline in 1996, a potent neurological toxin. It has has also been reliably correlated with a huge drop in violent crime in the US starting around the same time.
The neurological effect in adults across many countries is consistently two decades after the peak of lead use in gasoline in each, which occurred in the US in the early 1970s. In other words, when we stopped dosing the brains of urban children, we saw a wide range of positive neurological benefits as they reached adulthood.
The neurological effect in adults across many countries is consistently two decades after the peak of lead use in gasoline in each, which occurred in the US in the early 1970s. In other words, when we stopped dosing the brains of urban children, we saw a wide range of positive neurological benefits as they reached adulthood.
42
We must be very careful about making a causal correlation between these two parameters. The increase in autism directly correlates with the steady drop in lead levels and someone might claim that lead protects us from developing this condition.
18
The data are sound on the lead question. It is not merely a correlation.
A very interesting speculation, though correlation is not causation. There were other things going on in the United States, including get-tough policies that put a lot of violent people in prison and the waning of the crack epidemic.
1
As a pediatrician in the trenches, my approach is as follow: How is your child doing in life? And we go from there. Not fitting in is not the child's problem. And what's the home environment like? And many children process information in different ways. Often continued interest and contact with the child or adolescent is superior to a prescription pad.
P Miller Md
Portland, OR
P Miller Md
Portland, OR
62
As a teacher, I can tell you that not fitting in can be the child's problem -- maybe not one they can help, but their behaviors can push others away just as the behavior of adults can push others away. Some children could be helped if an adult helped them find better ways to get along but some behaviors seem to be hard wired. The child doesn't have to conform to group behavior but needs to learn not to antagonize others on a regular basis. For attention seeking chikdren or those with mental problems that can be hard. Adults need to be aware and need to help out in a gentle way. I agree that counseling can work but for some children, the behavior goes beyond anything that can be helped by counseling alone. I favor counseling and medication when needed. It's best to be flexible about using medications.
2
Phillip
Just curious - not fitting in is not the child's problem? Whose is it and how can it be helped? Because not fitting in is one big problem for kids. It "may not be the child's problem" but they sure do shoulder it and carry it around.
Can you clarify what you prescribe to help the child then?
Just curious - not fitting in is not the child's problem? Whose is it and how can it be helped? Because not fitting in is one big problem for kids. It "may not be the child's problem" but they sure do shoulder it and carry it around.
Can you clarify what you prescribe to help the child then?
1
Bravo. The first step is to assume you do NOT have all the answers, that you must learn with each person.
1
Given the see saw study reportage from the nejm we can benefit by backing up and understanding the larger picture. First we see many more early interventions, information age reality. This including putting a stop to much more domestic violence than none which was the prior case. And be it through new alcohol and drug abuse knowledge spousal and child abuse laws kids with inorganic mental illness' are likely halved at least. Then you have improved brain mapping, better treatment of and diagnosis of organic illness. Backing up further we now see norms that were never considered as such in previous generations. I believe there are more severely sick people generally partially due to stigma left over from abandonment of it as a reality by roland regan. His new normal we live with today embodied as the neo-conservative ugly american as a result. Just sayin..
5
Sometimes "treatment" is just giving psychotropic medication which is only a small part of true mental health care; the rise in treatment in the NEJM study seems to coincide with the marketing campaigns of drug companies in the late 1990s-early 2000s which led to an overdiagnosis of pediatric bipolar disorder which exists to this day.
26
Unadulterated nonsense! Conditions such as autism are disorders, yes. But answers to questions such as "feeling unhappy or sad" and "getting along with other kids" are not necessarily indicative of mental disorders. Indeed, they are far more likely to indicate that the child faces a difficult environment at home or at school.
Psychology and psychiatry desperately need a new paradigm, one that separates organic diseases such as autism and psychosis from normal adaptations to adverse circumstance. Otherwise, we stigmatize and overdiagnose. If a child is being beaten by a parent, or molest by a family friend, or is rejected by the other kids because he is overweight, the problem is the environment, not the child.
Psychology and psychiatry desperately need a new paradigm, one that separates organic diseases such as autism and psychosis from normal adaptations to adverse circumstance. Otherwise, we stigmatize and overdiagnose. If a child is being beaten by a parent, or molest by a family friend, or is rejected by the other kids because he is overweight, the problem is the environment, not the child.
111
Consider that these evaluations are being completed by parents, not by clinicians. Therefore the seemingly unclinical questions like "feeling unhappy or sad" are entirely appropriate. Child psychiatry has a long and useful history of employing questionnaires with questions to which ordinary parents can easily respond. Given the importance of parents in the life of the child patient, eliciting their input in a way they can relate to is valuable. As for your second point, it's often not so clear cut; biology and environment may overlap. A child with depression may need treatment for depression including medication and the child's family may need family treatment as well inasmuch as it's been an unhealthy environment for the child.
11
My understanding of children suffering from so called mental illnesses is that they live in hostile environments for their developmental - personal needs. My mother, brother, and uncles (pediatricians) work with what was formerly called "emotionally disturbed children" or just "disturbed children." Today, there is an upping of the diagnosis of these same kids with levels of autism or mental illness - "depression?"
I cannot understand how after professionals who have garnered decades of work with challenged children, that all of a sudden, their diagnosis shifts from "emotional disturbance" to "mentally ill."
I think the idea that a child - who barely has a complete mentality to call her or his own, could be "mentally ill" is appalling and suggests that there is an ulterior motive by the health professionals working with these kids, to advance their compensation and careers.
It's not the surveys that are questionable, it is the entire health care community. Who of the mental health care community is fighting for the rights of those challenged, emotionally or mentally, for treatment and care?
After Ron Regan, the mental health care industry experienced a drought, like that which California suffers - no new water - no relief, no compensation for mental health care workers in sight. The only professional advancement for mental health care has evolved from neuropharmacology and the drug manufacturers who profit from it.
I cannot understand how after professionals who have garnered decades of work with challenged children, that all of a sudden, their diagnosis shifts from "emotional disturbance" to "mentally ill."
I think the idea that a child - who barely has a complete mentality to call her or his own, could be "mentally ill" is appalling and suggests that there is an ulterior motive by the health professionals working with these kids, to advance their compensation and careers.
It's not the surveys that are questionable, it is the entire health care community. Who of the mental health care community is fighting for the rights of those challenged, emotionally or mentally, for treatment and care?
After Ron Regan, the mental health care industry experienced a drought, like that which California suffers - no new water - no relief, no compensation for mental health care workers in sight. The only professional advancement for mental health care has evolved from neuropharmacology and the drug manufacturers who profit from it.
14
There is quite a bit of separation between psychosis and normal reactions.
But the bisecting of disorders into "organic" and - I am not sure what - psychological maybe? gets more difficult as we learn more about how the brain is shaped not in some vague way, but in its physical makeup- by everything it is exposed to in its environment in addition to its own unique endowment.
As in - if a child has been severely neglected or abused, it can trigger mental illness - as well as easily understood reactions.
The labeling of young children bothers me - and it bothered child psychiatrists I've had contact with, but sometimes a descriptive diagnostic label fits the behavior. As for the jargon being pejorative, whenever there is an attempt to reassign a new descriptive word for a condition or syndrome, it seems to take on the implications of the discarded term. More important is assuring that good services are available, to everyone, and available in time to do the most good. And in the time since the Great recession, one of the major areas for public budget cuts has been in mental health.
But the bisecting of disorders into "organic" and - I am not sure what - psychological maybe? gets more difficult as we learn more about how the brain is shaped not in some vague way, but in its physical makeup- by everything it is exposed to in its environment in addition to its own unique endowment.
As in - if a child has been severely neglected or abused, it can trigger mental illness - as well as easily understood reactions.
The labeling of young children bothers me - and it bothered child psychiatrists I've had contact with, but sometimes a descriptive diagnostic label fits the behavior. As for the jargon being pejorative, whenever there is an attempt to reassign a new descriptive word for a condition or syndrome, it seems to take on the implications of the discarded term. More important is assuring that good services are available, to everyone, and available in time to do the most good. And in the time since the Great recession, one of the major areas for public budget cuts has been in mental health.
1
The humans I meet that are diagnosed as mentally ill are mostly just exhibiting human behavior. We rush to judge illness when it may be that humans are just mostly abnormal. Whatever abnormal really is. You can't medicate everybody, or can you?
46
The Pharma companies would definitely like to try... but in a sense, we're always medicating ourselves. We're creatures that are collections of atoms and molecules seeking to reach homeostasis. When the complex dynamic equilibrium is perturbed (and it always is, since it's a complex system), actions are taken to restore the balance. This is what all illness is, but particularly mental illness, since it occurs on a holistic level. Drugs are one way to restore this balance and it is effective for some people but in general the correct treatment or cure is identifying the cause of any imbalance and correcting it by whatever means that works for THAT person.
They'd like to and they're doing their best to medicate us all. Big Pharma is running the medical care industry and greedy for profits. Just watch the evening news and beside the local car sales advertisements what else is advertising.
So, basically the NEJM and CDC have opposing viewpoints on the status of severe mental illness among children and adolescents.
Obviously, some "experts" are being very political in this delicate topic.
Obviously, some "experts" are being very political in this delicate topic.
4
"The finding is robust and real." I hope so, but how do they know that the change is not in the parents' perceptions?
39
Perhaps social media has a calming effect for many children. They may be in contact with far more peers than earlier generations. In the past kids had lunch table friends, now they might have lots of school friends through Facebook, Twitter or other service. They may also be able to reach out to or at least read about like minded children worldwide. Many of these relationships are shallow, but they may be comforting and allow the child to express feelings safely.
8
I was just thinking the opposite. These social media relations are pseudo-relations and they prevent children to be in touch with reality. Given the chance I certainly would like to be a child before the TV, tablet and cellphone era than the present world crammed with artificial ways of life. Perhaps distractions such as cyber games, social media and extensive use of cell phones help children and adolescents by kind of pacifying them, but this is at the cost of lowering their strength to cope with real problems and the quality of their life.
1
The problem with attributing mental illness to people, especially ADHD to children, is that it delegitimates actual problems.
I've experienced bipolar disorder and anxiety for the past five years, and it's exponentially more difficult than a child losing their pencil or dozing off in class. It's serious and doesn't deserve the "I'm so OCD" type jokes.
How about we invest in the most needy, and particularly those who fall into substance abuse and are institutionalized?
I hope we don't shortchange our society by jumping to the wrong conclusions about who is and isn't sick.
I've experienced bipolar disorder and anxiety for the past five years, and it's exponentially more difficult than a child losing their pencil or dozing off in class. It's serious and doesn't deserve the "I'm so OCD" type jokes.
How about we invest in the most needy, and particularly those who fall into substance abuse and are institutionalized?
I hope we don't shortchange our society by jumping to the wrong conclusions about who is and isn't sick.
28
Absolutely. This business of calling every personality trait a middle-class psychologist doesn't like a "disorder" has reached the point of ridiculousness. Which isn't to say that a child who is facing difficulties shouldn't or can't be helped. But normal variation or responses to adverse circumstances isn't illness, even if the response appears to be counterproductive.
38
Absolutely. And the other half of that is that by calling some of these behaviors mental illness, we stigmatize the children, expose them to inappropriate and harmful pharmaceuticals, and discourage people who do need counseling from getting it -- someone who has experienced severe trauma, for example, may not be mentally ill, but they can benefit strongly from professional intervention.
1
Schools that are set up to do this are often where any problems become clearer-.
I wish they were all set up to recognize, evaluate and then work within the school and with the parent(s) to help these children early on.
I wish they were all set up to recognize, evaluate and then work within the school and with the parent(s) to help these children early on.
“In the study, researchers analyzed mental disability in 53,622 young people age 6 to 17, BASED ON RATINGS PROVIDED BY PARENTS. The parents rated their children on a so called impairment scale."
Exactly when were parents licensed to diagnose mental health impairments?
Have parents been licensed to prescribe as well, or will they still have to go through the formality of requesting Adderall scripts from medical personnel?
There will be no shortage of ADHD and Autism Spectrum Diagnoses of Children by their parents, just as there is none now. Any diagnosis
that can be parlayed into special accommodations such as extra time
on standardized tests will be over diagnosed by parents.
Those children who are actually suffering,will be left to suffer. Children who suffer from mental illness need not be “impaired” to be suffering.