Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Children Remain a Mystery We Don't Know as Much about Their Mental Health as You Think, Cautions Author

Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Children Remain a Mystery We Don't Know as Much about Their Mental Health as You Think, Cautions Author

Article excerpt

The recent news that the Sandy Hook shooter, Adam Lanza, was obsessed with video games and may have wanted to out-kill Anders Breivik, the deranged 2011 Norwegian murderer of 77, doesn't help us understand Lanza's motivations. In fact, it demonstrates how little we know about the many young people suffering from severe mental health disorders. We can't even agree on the definition of a disorder and how many are affected.

According to the U.S. surgeon general, about 15 million children and adolescents in the United States today experience signs or symptoms of a mental health problem. The National Health Interview Survey on Disability put the number at 4.1 million in 2004.

But numbers tell only part of the story, according to Ronald Dahl of the University of California at Berkeley, a leading expert in adolescent brain development. Dr. Dahl points out that we still lack a precise definition of a mental disorder.

"There are a lot of smart and well-motivated scientists who disagree vehemently about what a mental disorder actually is," he says. "Does it require something to be wrong in the brain and if so why don't we call these 'neurological disorders' rather than 'mental disorders'? Does any behavioral or emotional (or habit) problem that interferes with an individual's ability to function qualify as a 'mental disorder?' "

If we wait until a set of problems is bad enough to call it a diagnosable "mental disorder," Dr. Dahl maintains, "we actually missed the most important window of opportunity to intervene (i.e., early intervention/prevention). Yet, if we try to identify (and intervene early) in high-risk youth who are on their way to serious disorders, do we risk labeling and stigmatizing them too quickly?"

Another unanswered question relates to the affordability and options for treatment. According to the National Association of State Mental Health Program Directors, mental health spending by the states has decreased by $4.5 billion over the past four years, even as the price of treatment has risen rapidly. Total expenditures on mental health services increased nearly 64 percent during that period -- this from the Agency for Healthcare Research and Quality based on a survey of Americans and what they pay for mental health services. …

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