Half of all lifetime cases of mental illness begin by 14
FARGO — Children grow out of clothes, but they don’t outgrow mental illness. Half of all lifetime cases of mental health disorders begin by age 14, according to a study by Harvard University, the University of Michigan and the National Institute of Mental Health Intramural Research Program.
Psychiatric disorders in children are not “a phase,” and early intervention is crucial.
“Growing research evidence has demonstrated that the earlier intervention takes place, the better the outcome,” says Dr. Eduardo E. Meza, a child, adolescent and adult psychiatrist and the medical director of Prairie St. John’s in Fargo.
“Even where research evidence is still relatively sparse, the consensus by essentially all experts is that outcomes will be improved by early intervention.”
The Centers for Disease Control and Prevention explains mental disorders among children as “serious deviations from expected cognitive, social and emotional development.”
Mental Health America estimates that 20 percent of children have a diagnosable mental health problem but two-thirds of those kids get little or no help.
“Kids will get better with time and treatment and may need fewer interventions, and then other kids will need more of a continuing, ongoing intervention. They really don’t outgrow it. They can get better,” says Dawn Krieger, West Central Human Service Center’s program administrator for the Partnership Program for Children’s Mental Health.
Meza lists autism spectrum disorders (including autistic disorders and Asperger’s) as an example of a mental health disorder that has a better outcome with early intervention.
Without intervention, children are at risk of veering from a normal developmental path, which can affect academics, physical health, and peer and family relationships, says child therapist Joni Medenwald of The Village Family Service Center in Moorhead.
However, diagnosing children can be challenging.
Communication can be a barrier to adults and providers fully understanding a child’s needs, Medenwald says, which is why other modes of communication, like play and art, are important.
A child’s understanding of what is normal versus abnormal can also present challenges because they may not know how to alert others to their needs, she says.
When to seek help
Changes in a child’s behavior, sleep, appetite, mood or energy level that last a few weeks are signs that they should seek a mental health assessment, Medenwald says.
For instance, parents should seek help for a child that could once talk but is no longer talking like they did before.
Traumatic events like the loss of a caregiver, divorce or the loss of skills are also indications a child could need help.
Krieger notes that children with a mental illness may have a sudden drop in grades in school or severe anxiety and difficulty concentrating.
In short, any consistent change from a child’s normal behavior and developmental trajectory prompts assessment.
“All of us have bad days,” Prairie St. John’s Meza says. “However, if every single day is a bad day, there may be an issue.”
Mental illness is diagnosed in children differently from state to state, but a qualified provider typically administers a diagnostic assessment that looks at a child’s abilities and functioning.
Sometimes psychological testing is completed as well.
Conversations with caretakers, such as parents and other people who have a lot of contact with the child, are important when diagnosing a child, Krieger says.
“With kids, it’s going to come from a lot of conversations with caretakers, where with an adult, it’s a self-report,” she says.
Medenwald, of The Village Family Service Center, frequently sees children who have attention deficit disorders, anxiety, depression, autism spectrum disorder, adjustment disorders, attachment disorders and post-traumatic stress disorder.
Conditions like bipolar disorders are diagnosed in youth less often, Meza says.
Children are treated differently than adults.
Age, history and reported concerns are factored in to the type of treatment they receive.
For example, infants and up to children age 5 have different treatment for trauma than older children because of their neurological development, maturity and communication and emotional needs, Medenwald says.
Treatment doesn’t refer to medications alone, although medications can be safe and effective for treating psychiatric disorders in children, Meza stresses.
“Prominently, nonmedication interventions are crucial in the treatment of most psychiatric conditions in children and adolescents,” he says.
A child will typically see an individual therapist, a family therapist, a school counselor or a child psychiatrist and usually have a pediatrician or other primary-care provider involved in their care, too.
Meza calls the approach “multi-systemic.”
Anyone who is with the child for significant periods of time, such as day care providers and teachers, benefits from knowing about a child’s mental health concerns, Medenwald says.
“It is very important that everyone involved in caring for the child is able to openly communicate to ensure the child’s needs are being met — it needs to be a team approach,” she says.
When seeking help, Medenwald says trusting the provider (therapist, psychiatrist, physician, etc.) is crucial.
“Having an open working relationship with the professionals that are helping your child is very important to the success of the service and ultimately the growth of the child,” she says.
She encourages caregivers to learn about the child’s illness through reading, support groups and asking questions.
Above all, experts insist that caregivers seek help if they’re concerned about a child.
“I really feel that we have become more educated as a public, and I think early intervention is the key for kids,” says Krieger of the West Central Human Service Center. “It really can prevent a lot of issues down the road for the child, and they can be very successful.”
Where to get help
Besides private practitioners and primary-care physicians, a number of services in the Grand Forks and? Fargo-Moorhead area aim to help children with mental illness.
- For immediate help if a child is a danger to themselves or others, visit an emergency room or call 911.
- Altru Psychiatry Center (701) 780-6697
- Sanford Children’s (701) 234-5423
- Prairie St. John’s 24-hour line: 1 (877) 333-9565
- Northeast Human Service Center 24-hour crisis line: (701) 795-3000
- Southeast Human Service Center 24-hour crisis line: (701) 298-4500 Other inquiries: (701) 298-4500
- Northwestern Mental Health Center, Crookston, Minn. (218) 281- 3940 or crisis line (for Polk, Mahnomen, Norman, Marshall, Kittson and Red Lake counties): 1-800-282-5005
- Sanford Thief River Falls Behavioral Health Hospital crisis line: (218) 683-4349 and
- Behavioral Health Outpatient Clinic: (218) 683-4351
- Lakeland Mental Health Center 24-hour crisis line: 1 (800) 223-4512 Other inquiries: (218) 233-7524
- The Village Family Service Center in Grand Forks: (701) 746-4584 or in Fargo: (701) 451-4811
- North Dakota Department of Human Services Partnerships Program for Children’s Mental Health. Find your county’s contact person by visiting www.nd.gov/dhs/ services/mentalhealth/partners.html.