mental health in
Childhood and Adolescent Mental Illness
The US Surgeon General reports that about 5 million children and adolescents
in the United States have a serious mental illness. A serious mental illness
is a diagnosable mental disorder that impairs the child’s daily life. A
challenge the practitioner faces is to differentiate between normal growth and
development and symptoms of a mental illness or mental disorder. For example,
is defying authority a sign of autonomy or a symptom of oppositional defiant disorder?
Until recently, researchers focused attention on adult mental illness primarily
because of the difficulty in differentiating between normal and abnormal
growth and development. A child’s behavior might appear bizarre at age 2, yet
the child demonstrates normal behavior at age 3. The bizarre behavior is considered normal growth and development. Today researchers are investigating
factors that may lead to childhood and adolescent mental illness such as neglect, severe emotional trauma, physical abuse, and extreme stress. Researchers are also assessing if chemical messengers in the brain, called neurotransmitters, are unbalanced.
Diagnosing
Diagnosing a mental illness in children and adolescents is an involved process.
The practitioner initially must rule out other causes for the behavior. In addition to normal growth and development, medical conditions can produce
symptoms similar to symptoms of a mental disorder. For example, a metabolic
disorder may present with signs similar to depression. Therefore, the practitioner must rule out both developmental and medical causes for the behavior.
There is no definitive test for diagnosing a mental disorder. Practitioners
diagnose a mental disorder by accessing information reported by the patient
and by third parties such as the patient’s family and friends. Practitioners also gather information by clinically observing the patient. Once the practitioner assembles a database of information about the patient, the practitioner lists signs and symptoms presented by the patient and compares them to signs and symptoms described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) published by the American Psychiatric Association. The DSM-5 defines each mental disorder as a set of signs and symptoms.
Treatment
Childhood and adolescent mental disorders require ongoing treatment. There
are two categories of treatment that are effective. These are medication and
psychotherapy. Medication is available to treat some, but not all, childhood and adolescent mental disorders by restoring the chemical balance in the brain.
Psychotherapy, which includes various types of counseling, focuses on strategies that help the patient understand and deal with symptoms and behaviors. Psychotherapy is offered individually for the patient, and family psychotherapy is used to address family problems. Patients also attend group therapy where their peers help to explore symptoms and behaviors.
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