Experts Design 'Toolkit' to Help Spot Teens With Mental Health Issues

FRIDAY Oct. 28, 2011 -- Because many adolescents with mental health problems are never diagnosed and treated, an expert team has come up with a "toolkit" aimed at identifying those kids and getting them the right help.

"One in 10 youths have a mental health condition that is severe enough to impair functioning, either at home, school or in the community," said Gary Blau, chief of the child, adolescent and family branch of the Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services.

Blau spoke at a Friday news conference to unveil the toolkit, which appeared online simultaneously in Pediatrics. Although the journal is published by the American Academy of Pediatrics, that organization has not endorsed the toolkit. SAMHSA provided partial funding for the project.

"This toolkit will allow pediatricians, teachers and others that could help get the word out to families we can close the gap so the three out of four children with mental health disorders who aren't identified do get identified," said Dr. Peter Jensen, who was the lead investigator on the project.

About half of mental health disorders manifest themselves by the time a child has turned 14, and 75 percent manifest by age 24, Blau said.

Yet treatment is often years away for that child, added Lisa Hunter Romanelli, an assistant professor of clinical psychology in psychiatry at Columbia University College of Physicians & Surgeons in New York City.

"That is too long in the life of a child," said Romanelli, who is also executive director of the nonprofit REACH Institute, whose mission is to shorten the length of time it takes for effective interventions to reach teens. Jensen is president and CEO of the institute.

Researchers convened over a period of several years to analyze data collected from more than 6,000 children and parents to identify the most common symptoms of mental health disorders and to see if children with these troubling signs were receiving appropriate care.

This information was then translated into warning signs that are written in "crisp, easy-to-understand language," said Jensen, who is vice chair of research in the department of psychiatry and psychology at the Mayo Clinic in Rochester, Minn. "They don't sound like mental health jargon. It was deliberate, to make them as parent-friendly as possible."

Because differentiating a true mental health disorder from the inevitable ups and downs of adolescence is difficult, the authors chose to focus on the more severe end of the mental health spectrum.

"We realized there was a potential for harm for parents to worry when they didn't need to be worried," said Jensen. "So we decided to target not the 15 percent or so who have these problems, but the 8 percent who are at the more severe end."

If your child has any of these 11 warning signs, he or she may have a mental health disorder and should be referred to treatment as soon as possible:

  • Feeling very sad or withdrawn for two or more weeks
  • Seriously trying to harm or kill themselves, or making plans to do so
  • Sudden overwhelming fear for no reason, sometimes with a racing heart or fast breathing
  • Involved in multiple fights, using a weapon, or wanting badly to hurt others
  • Severe out-of-control behavior that can hurt the teenager or others
  • Not eating, throwing up, or using laxatives to lose weight
  • Intense worries or fears that get in the way of daily activities
  • Extreme difficulty in concentrating or staying still that puts a teenager in physical danger or causes school failure
  • Repeated use of drugs or alcohol
  • Severe mood swings that cause problems in relationships
  • Drastic changes in behavior or personality

"This data substantiates what we already knew, that there are warning signs of significant mental illness, but children and adolescents aren't getting help because health care providers don't share the same language," said Dr. Abigail Schlesinger, medical director of outpatient behavioral health services at Children's Hospital Pittsburgh.

"This toolkit will help mental health providers and others on the front lines, such as teachers, people in the juvenile justice system [and] parents speak the same language," added Schlesinger, who was not part of the research team.

More information

The U.S. National Institute of Mental Health has more on child and adolescent mental health issues.

Posted: October 2011


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