Issues Surrounding Children with Mental Health - Research Paper Example

Literature Review on Issues Surrounding Children with Mental Health and Their Access to Adequate Services College Course Name Introduction Mental health is defined as the cognitive and emotional wellbeing of a person and it involves how individuals feel, think and behave. Mental health status of an individual affects his/her daily life, physical health and the relationship lives. Mental health also affects an individual’s ability to attain a balance between the activities of life and personal efforts that help in achieving psychological resilience. There are increasing numbers of people being diagnosed with mental problems. As things stand now, the World Health Organization (WHO) asserts that America has the highest number of citizens with diagnosed mental problems (Pathare 2003, 10). About 20% of American children are believed to suffer from mental illnesses and problems that can be diagnosed. Additionally, almost 5million American adolescents and children suffer from serious or perhaps chronic mental illnesses that significantly affect their day to day lives. The common mental illnesses and disorders in children include anxiety disorders, disruptive behavior disorders, pervasive development disorders, attention deficit/hyperactivity disorder (ADHD), eating disorders, elimination disorders, learning and communication disorders, affective disorders, and schizophrenia among others (Scheffler et al 2009, 1274). Although some of these mental illnesses start and end during childhood, others may be carried well into adulthood. For example, elimination disorders are a preserve of childhood. Symptoms of the mental illnesses are sometimes hard to tell in children since they remain rather asymptomatic. However, a parent and/caretaker have reasons to be concerned when the children show such signs as; drug and/or alcohol abuse, changes in eating and sleeping patterns, intense fear/anxiety over the unknown, rages of anger, disinterest in activities and friends whose company they always enjoyed before, and unexplained withdrawal, hyperactivity, aggressive behavior, hallucinations and unexplained mood swings that persist over a long period of time (Nicholson 2010). Mental illnesses have a variety of courses; hereditary, environmental stress, psychological traumas and biological problems. Although mental problems may be hard to diagnose in children, there are treatment options like medication, psychotherapy and creative therapies (Scott 1993). In addition, although most research on mental health in the past have centered on mental disorders in adults, there are new researches where researchers are studying children based on what is normal and what is not. Researchers are endeavoring to understand the relationship between factors of child development and mental health of a child. There is hope that early diagnosis of mental problems facilitates prevention or minimization of the effects of mental health. This literature review focuses on people more so children with mental health problems and how these problems have been handled. It will focus on literature that touch on issues that surround children with mental health and if these children are receiving adequate medical, psychotherapy and social services. It will also entail using literature that touch on specific disorders in children. The literature to be reviewed will be mainly on mental problems in children, and will involve the use of academic research journals and books on the topic of discussion. Mental Health Problems in Children There is a common misunderstanding of the term mental retardation. American Academy of Child and Adolescent Psychiatry (July 2004) analyzed that some people have mistaken the word to mean that retardation is diagnosed solely on the basis of below normal IQ. Others have also believed that mentally retarded people cannot take care of themselves or even read by themselves. The truth is that mental retardation id measured as a function of the IQ and the everyday functioning both of which have got to be significantly lower than the expected level. Mental retardation may be complicated, resulting in emotional and physical problems. Although past interventions encouraged the caretakers and parents to institutionalize children with mental retardation, today the main focus is that the mentally retarded should take part in community projects and life. Most state laws guarantee the mentally challenged educational and wellbeing services at the expense of the general public (American Academy of Child and Adolescent Psychiatry 2006, p. 1). Importance is attached to medical examination results which gives the caretakers and the parents a clue of the strengths and weaknesses of the child. The major areas of examination include psychiatry, neurology, psychology, speech, hearing, special education and physical therapy which should be coordinated for best results. The family, the school and the psychiatrist then develop an effective plan in comprehensive treatment and education plan that is most effective for the child. There is need for early diagnosis of mental problems in children. This is in a bid to make the management of mental retardedness easy and manageable on the caretakers and parents. The American Academy of Child and Adolescent Psychiatry studied that mental impairment alone is not a problem; there are psychological and emotional burdens that result from improper management of mental retardedness of children (2006, p. 2). When a child is neglected because of such conditions, other conditions like depression and improper development of language and speech may also result. On the contrary, where an all inclusive approach in the management of mental retardedness is upheld, the child has higher potential to appreciate his/her condition and venture into ways that makes him/her productive and of importance to the society of residence at any given time. In addition, the show of appreciation helps the child to find a way of expressing their dissatisfactions and problems. Given that mental illness in children affects more than just the child, it impacts on all the parties that are involved in the everyday life of the child (Mount and Mendenhall 2011, p. 183). Depending on the intensity of the mental illness/ problem, parents undergo psychological pressure to keep a mentally challenged child on the right path more so of behavior. The strain of keeping and caring for a mentally challenged child can be draining on an individual’s personal social and family relationship life. It also has the potential to affect the parents work, physical, social and mental health. The parents of such children hence need to be thoroughly equipped with strength based and parent focused interventions in helping themselves to care for the children who are mentally challenged. In addition, the parents of children with mental problems should consider interventions that lean towards support, education and skill building. When parents focus on research and interventions that reduce caregiver strain, a healthy environment is created for all the family members where there are children with mental problems (Mount and Mendenhall 2011, p. 181). The tragedy however is that parents and caretakers do not only struggle to take care of children with mental illnesses, but they also struggle to get appropriate services from treatment providers. This is because most treatment providers do not include the family component in the therapeutic procedures through which the challenged children are put. Additionally, professionals in the specific emerging areas of mental illnesses seem to be in short supply. There are specialists who are broad based in what they do, for example, the psychologists who do counseling. A psychological counselor may not have ventured so much into neurology during training and/or practice thereby creating loopholes in professionalism and technical efficiency when handling new mental cases (Hinshaw & Silverman 2006, p. 6). Helping children with mental illnesses is the responsibility of many people. It involves the use of doctors, neurologists, psychologists, teachers, and families among others (Nicholson 2010, p. 8). Families of children with mental problems play a major role in a child’s ability to cope with the present mental condition. This is because families are the focus in the promotion of mental health, prevention of mental illness and treatment and rehabilitation of the sick children. A child with mental illnesses may live with the biological parents, step parents, foster families, relatives and adoptive families like children homes. The family setting may be formal or informal in nature. The outcomes of medical endeavors and other therapies are dependent on the contribution of the family in the medication and healing process. It is also important in determining the ability of a child to take therapy negatively or positively. From the studies of Nicholson (2010), mental illness rates are astronomical in Australian population. It affects almost half of the population during their lifetime and accounts for 20% of total population at any given point. From the statistics, only 33% of the affected families have access to the use of mental health facilities and services. Additionally, at least one third of young people aged between twelve (12) and twenty five (25) years have an episode of mental problems at this stage in life; the peak age being at the onset of teenage well into the early thirties. From previous research estimates, about 23% of Australian children have or have had a parent with mental illness. This hence means that where the parents have mental illnesses there are high chances that a child or two will also have a mental illness. This is assuming that heredity alone plays a major role in determining the rates of affection with mental illnesses (Pathare 2003, p. 8). Mental problems may be accompanied with learning problems. This forces the parents and caretakers to provide their services beyond face value but to go an extra mile of educating the children on what is expected of them. Parents carry out education not just on the mentally ill children, but also on the siblings who may be at risk through the daily experiences with children who have mental disorders. Information is hence vital in alleviating the emotional burdens that accompany caring for such patients. Researchers in the learning disabilities field have offered valuable information on the channels that are available for the parents, siblings and caretakers of children with such problems (Pathare 2003, 6). The whole family approach to dealing with mental illnesses determines the extent to which medical examinations and subscriptions to the mentally ill children will be. If the interventions of the medics and psychotherapists are to be effective, the family of the child with a mental problem must be fully engaged in the solution seeking process (Nicholson 2010, p. 7). This is because the family is highly able to reach the affected children in their natural settings and find useful solutions and interventions in those contexts. The use of mentors and individual case managers is a good way of providing individualized support and aid. Moreover, family settings and individualized help are important in instilling hope, self determination, and sense of agency, meaning and purpose of life, awareness and potentiality (Mount & Mendenhall 2000, p. 184). The environment to a large extent contributes to the mental well being of the individuals thereof. In the Great Britain for example, 1-2 million people may be homeless (Scott 1993, p. 316). Of these, 30-50% has mental illnesses of which the predominant problem is functional psychoses. Acute distress and personality dysfunctions are also common. Homeless individuals with mental illnesses have many social and cognitive assistance needs. Much as the populations of the homeless people are increasing and consequently causing an increase in the numbers of the mentally ill in those settings, “the evaluation of potential service solutions has received less attention” (Scott 1993, p. 314). The study of the mentally ill and homeless people in the population has proven especially hard because of the lack of reliable and valid assessments. This has made research results in this field to be a source of both confusion and knowledge. A source of confusion because what happens in theory is not similar to what happens in practice and vice versa and source of knowledge because it gives a clue of the prevailing trends of the illness and the solutions that are being provided for such problems. There are different types of mental illnesses that a child may display. Different types of mental problems require different kinds of care. For example, children with Attention Deficiency Hyperactivity Disorder (ADHD) require treatment that is geared towards psychosocial methods (National Resource Centre on ADHD 2011, p. 1). These are supposed to be behaviorally oriented; a technique also called behavior modification which is the only scientifically proven way of handling children with ADHD that do not involve medical procedures. Treating ADHD normally takes a multimodal approach in which parents and the child are involved in education about diagnosis and treatment. A comprehensive approach to mental illness treatment involves behavioral, educational and medical interventions. It also involves education on medication, behavior management techniques, school supports and programming. The components necessary in the approach that is given in treating ADHD depends on the severity and type of ADHD that the child being protected suffers from. Treatment and counseling should hence be tailored to meet children’s individual needs as well as family concerns (National Resource Centre on ADHD 2011, p. 1). Psychosocial treatments are used because children with ADHD face challenges beyond the normal inattentiveness, impulsivity and hyperactivity (Scheffler et al 2009, p. 1277). These characteristics are usually accompanied by poor academic performance in school, poor behavior, and poor relationships with peers, failure to obey authority and leadership and poor relations with parents and siblings. Given that ADHD affects an individual well into adulthood, it is important for parents to embrace effective parenting skills, form relationships and bonds with the children and follow up on the success of the affected child in school and social life (Vitiello et al 2011, p. 7). The only approach that touches on the named domains is the psychosocial treatments. The effectiveness of the psychosocial approach is not limited to helping the parents in forming bonds, the skills that are acquired in the process of learning are important throughout the life of the affected child. It is advisable that psychosocial treatments begin as soon as diagnosis of the disease is done on a child. This will encourage easy management of the disease and familiarity with the dynamics of the symptoms and signs. It will also better prepare the siblings of the child on how to best handle the child with mental problems. Informed decisions on treatment and therapeutic procedures are better made when the parents have the facts about the disease and the services that are available in alleviating its impacts. Early diagnosis of ADHD and any other mental illness provides the parent with an opportunity to decide early enough on the approaches of treatment to pursue (National Resource Centre on ADHD, 4). It also allows the parent of the child with mental impairments to make provisions for the financial implications of the medical endeavors that they choose to pursue. This also enables the parent and/or caretaker to make long term decisions on the management of such illnesses depending on the localization and severity of the illness. In their studies of psychotherapy, Silverman and Hinshaw (2008) extensively learnt that there was enough evidence to prove that psychosocial treatments for children with mental illnesses was effective despite the fact that it was not necessarily a medical procedure. Vitiello et al (2011) stated that in a case where stimulants were continually used on children with ADHDHD HD, modest effects occurred on the heart rate. Stimulants however would not result in hypertension in later lives of users. In their argument, the best treatment for ADHD is got when psychotherapy is combined with medical examinations and follow ups. Given that ADHD is a chronic disease/anomaly, the affected children might use stimulants for many years in their lives thereby resulting in heart related complications like hypertension, rapid increase in heart rates and other cardiovascular complications after a prolonged period of use. However, hypertension only results when the use of stimulants is accompanied with other drugs that have counter reactive mechanisms to the stimulants that are used in medication (Vitiello et al 2011, p. 1). Moreover, the needs of children with mental health problems in the juvenile justice system have “received more attention at the federal level in the past two years than in the past three decades” (Skowyra and Cocozza 2000, 3). This is because the civil rights division embarked on investigating the consistent inadequacy of mental health care services in the correctional facilities that handle juvenile citizens. In addition, the congress considered several amendments and bills that facilitated comprehensive mental health screening and mental problems treatment among the youth and children. The state has also recognized the importance of mental health management amongst youth in the present day. This is because the state has experienced challenges in providing health services to the juveniles who are mentally challenged in the correctional facilities. The current level of concern about the mental health issues of the youths in correctional facilities have been increasing especially owing to the fact that statistics show that there are increasing numbers of the general population that are affected with mental illnesses. In most cases, the ratio of mental health problem patients and medical access if low: the number of youths with mental health problems does not concur with those that seek medical and/or therapeutic solutions to their problems. In the correctional facilities for the juveniles, the concern for the mentally challenged children has seen the correctional facilities far and wide become surrogate mental facilities over the last few years. Much as there is a general commitment by the state to cater for the need of the mentally challenged youths and children in the juvenile justice system, efficiency is yet to be attained in the management of the problem because there is little knowledge on the needs of the victims of the problem. There have not been proper national studies on the number of youths with mental problems who come in contact with the juvenile justice system. In addition, “systematic information on how services are organized and delivered across the country and the relationship between mental health and the juvenile justice system is not always clear” (Skowyra and Cocozza 2000, p. 4). Information on the services that are available for the mentally ill youth, from whom and the effectiveness of those services is also not always readily available. This poses a challenge not just to the youth in the juvenile justice system but to all children and youth who have mental problems. Much as the government is committed to meeting the needs of the youth in theory, the scenario is different in practice. Parents and caretakers are left at the mercy of the service providers who may not necessarily be professionally approved to attend to the mentally ill children. The government, in practice, has not been actively committed in vetting service providers. The challenge is hence bound to reside with parents and caretakers who take care of children with mental problems unless the government moves in swiftly to take charge of the plight of this generation. If appropriate action is not taken to mitigate the gap between the affected (both the mentally ill and their caretakers and/or parents) and the services available, there is bound to be a deficit in human resources pool because some forms of mental problems have the potential to affect the work life and professional development of individuals (Mount & Mendenhall 2000, p. 183). References American Academy of Child and Adolescent Psychiatry 2004, Children who are mentally retarded, Facts for families, no. 23, pp. 1-2, viewed 2 December 2011, Hinshaw, P S & Silverman, K W 2008, “The second special issue on evidence based psychosocial treatments for children and adolescents: a 10-year update”, Journal of Clinical Child and Adolescent Psychology, vol. 37, no.1, pp.1-7. Mount K W & Mendenhall, AN 2000 “Exploring the caregiver experience and caregiver focused interventions”, Families in society, vol. 92, no. 2, viewed 2 December 2011, National Resource Centre on ADHD, Psychosocial treatment for children and adolescents with ADHD. What we know, viewed 2 December 2011 Nicholson, J 2010, “Mental illness: understanding the impact on families and how to help”, Centre for Mental Health Services Research, no 5, viewed 2 December 2011, Pathare, S 2003, Organization of services for mental health, World Health Organization, Geneva. Scheffler RM, Brown TT, Fulton BD, Hinshaw SP, Levine P & Stone S 2009, “Positive association between attention deficit/hyperactivity disorder medication use and academic achievement during elementary school”, Pediatrics, vol. 123, no. 5, pp. 1273-1279. Scott, J 1993, “Homelessness and mental illness” British journal of psychiatry, no. 162, pp. 314-324. Skowyra, K & Cocozza J 2000, “Youth with mental health disorders: issues and emerging health responses” viewed 2 December 2011, Vitiello B, Elliott GR, Swanson JM, Arnold E, Hechtman L, Abikoff H, Molina BSG, Wells K, Wigal T, Jensen PS, Greenhill LL, Kaltman JR, Severe JB, Odbert C, Hur K, & Gibbons R Sept 2, 2011, “Blood pressure and heart rate in the multimodal treatment of attention deficit/hyperactivity disorder study over 10 years”, American Journal of Psychiatry, Viewed December 2, 2011, Read More