Child Mental Health Resources

Young people can have mental, emotional, and behavioral problems that are real, painful, and costly. These problems, often called "disorders," are sources of stress for children and their families, schools, and communities.

The number of young people and their families who are affected by mental, emotional, and behavioral disorders is significant. It is estimated that as many as one in five children and adolescents may have a mental health disorder that can be identified and require treatment.

Mental health disorders in children and adolescents are caused by biology, environment, or a combination of the two. Examples of biological factors are genetics, chemical imbalances in the body, and damage to the central nervous system, such as a head injury. Many environmental factors also can affect mental health, including exposure to violence, extreme stress, and the loss of an important person.

Families and communities, working together, can help children and adolescents with mental disorders. A broad range of services is often necessary to meet the needs of these young people and their families.

The Disorders

Below are descriptions of particular mental, emotional, and behavioral disorders that may occur during childhood and adolescence. All can have a serious impact on a child's overall health. Some disorders are more common than others, and conditions range from mild to severe. Often, a child has more than one disorder.

This list of disorders must not be used for the purpose of making a diagnosis. It is to be used only as a reference about behavior encountered in the classroom.

Anxiety Disorders

All children feel anxious at times. Many feel stress, for example, when separated from parents; others fear the dark. Some though suffer enough to interfere with their daily activities. Anxious students may lose friends and be left out of social activities. Because they are quiet and compliant, the signs are often missed. They commonly experience academic failure and low self-esteem.

As many as 1 in 10 young people suffer from an AD. About 50% with AD also have a second AD or other behavioral disorder (e.g. depression). Adolescent girls are more affected than boys. Etiology is unknown (biological or environmental) but studies suggest that young people are at greater risk if their parents experienced AD. The most common anxiety disorders are:

• Generalized: extreme, unrealistic worry unrelated to recent events. They are often self-conscious and tense; they may suffer from aches and pains that appear to have no physical basis.
• Phobias: unrealistic and excessive fears. Specific phobias center on animals, storms, or situations such as being in an enclosed space.
• Panic Disorder: repeated attacks of intense fear w/o apparent cause. They may be accompanied by pounding heartbeat, nausea or a feeling of imminent death. Some may go to great lengths to avoid the attacks (such as refusing to attend school).
• Obsessive Compulsive Disorder: being trapped in a pattern of repetitive thoughts and behaviors. These may include hand washing, counting, or arranging and rearranging objects.
• Post Traumatic Stress Disorder: experiencing strong memories, flashbacks, or troublesome thoughts of traumatic events. These may include events of abuse, violence and/or disaster. They may try to avoid anything associated with event. They may over-react when startled or have sleep disorders.

Asperger's Syndrome

Asperger's is a subset of the autism spectrum disorders. Before our knowledge base expanded it was referred to as "high functioning autism." It is a neurobiological disorder that impacts behavior, sensory systems, and visual and auditory processing. Students are usually highly verbal and test average to above-average IQ's. The disorder impacts cognition, language, socialization, sensory issues, visual processing and behavior. There is often a preoccupation with a single subject or activity. They might also display excessive rigidity (resistance to change), nonfunctional routines or rituals, repetitive motor movements, or persistent preoccupation with a part of an object rather than functional use of the whole (i.e. spinning the wheels of a toy car rather than "driving" it around). The most common characteristic occurs with impairment of social interactions, which may include failure to use or comprehend nonverbal gestures in others, failure to develop age-appropriate peer relationships and a lack of empathy.

Attention-Deficit Hyperactivity Disorder (AD/HD)

Symptoms may be situation-specific. For example, students with AD/HD may not exhibit some behaviors at home if that environment is less stressful, less stimulating or is more structured than school. Or students may stay on task when doing a project they enjoy, such as art.

An estimated 5% of children have a form of AD/HD. More boys are diagnosed than girls; it is the leading cause of referrals to mental health professionals, SPED, and juvenile justice programs. Students with ADD only, tend to be overlooked or dismissed as "quiet and unmotivated" because they can't organize their work on time.

Students with AD/HD are at higher risk for learning disorders, anxiety disorder, conduct disorder, and mood disorders such as depression. Without proper treatment children are at high risk for school failure. They may also have difficulty maintaining friendships, and their self-esteem will suffer from experiencing frequent failure because of their disability.

If you suspect AD/HD refer the student for mental health assessment. Many will benefit from medication. This must be managed by an experienced mental health professional (psychiatrist, pediatrician, neurologist) in treating AD/HD. Multi-disciplinary approaches that include family, school and mental health can prove successful.

Children identified at an early age should be monitored because changing symptoms may indicate related disorders such as bipolar, depression, Tourette's disorder, or underlying conditions such as FASD (Fetal Alcohol).

Remember that AD/HD is a neurobiological disorder. Students can't get organized or learn social skills on their own, but you can find interventions that greatly increase their capacity to succeed.

Bipolar Disorder

Also know as manic-depressive illness, bipolar disorder, is a brain disorder that causes unusual shifts in a person's mood energy, and ability to function. The symptoms are severe and can result in damaged relationships, poor job or school performance, and even suicide. More than 2 million adults (1% of the population18 and older) in any given year have bipolar. Children and adolescents can also develop the disorder. Like diabetes, or heart disease, it is a long term illness that requires careful management. Youth with the illness experience very fast mood swings between depression and mania many times a time. Manic children are more likely to be irritable and prone to destructive tantrums than to be happy or elated. Older adolescents tend to develop classic, adult-type episodes and symptoms. Bipolar disorder in youth is often hard to differentiate from symptoms of other disorders (e.g. drug abuse). Effective treatment requires appropriate evaluation and diagnosis. Adolescents with bipolar are at higher risk of suicide. Any talk about of feelings of suicide require immediate referral.

Conduct Disorder (CD)

Youth with conduct disorder are highly visible, demonstrating a complicated group of behavioral and emotional problems. Serious, repetitive, and persistent misbehavior is the essential feature. These behaviors fall into 4 main groups:

1. aggressive behavior toward people or animals
2. destruction of property
3. deceitfulness/theft
4. serious violations of rules.

To receive a diagnosis, the youth must have displayed 3 or more characteristic behaviors in the past 12 months. At least 1 must have been evident during the part 6 months. Diagnosing can be a dilemma because youth are constantly changing. Many children with CD also have learning disabilities and about 1/3 are depressed. Many stop exhibiting the behavior problems when treated for depression.

USDHHS estimate between 6 and 16% of males and 2 to 9% of females under 18 have CD that ranges in severity from mild to severe.

Other disorders associated with CD are AD/HD or oppositional defiant (ODD). The majority of youth with CD may have life-long patterns of anti-social behavior and are at higher risk for mood or anxiety disorder. But for many, the disorder may subside in later adulthood.

Social context (poverty, high crime) may influence what we view as anti-social behavior. In these cases, CD may be misapplied to individuals whose behaviors may be protective or exist within cultural context. A child with suspected CD needs to be referred for assessment. If symptoms are mild, the child may receive services and remain in the school environment. More seriously troubled youth, however, may need more specialized educational environments.

Depression

All children feel blue or sad at times, but feelings of sadness with great intensity that persist for weeks/months may be a symptom of major depressive disorder or dysthymic disorder (chronic depression). These disorders affect a young person's thoughts, feeling, behavior, body and can lead to school failure, alcohol/drug abuse and even suicide.