The Child Mind BlogBrainstorm
Mindfulness: How and Why It Works
May 19, 2015 Caroline Miller
The path that led Dan Harris to mindfulness meditation started with a panic attack on national television. It was Good Morning America, to be specific, which means it was witnessed, he notes, by an estimated 5.019 million people.
Harris spoke about his experience at the Child Mind Institute's 2015 Spring Luncheon yesterday, headlining a panel on the benefits of mindfulness that was moderated by psychiatrist Gail Saltz. An ABC News correspondent, Harris is the author of 10% Happier: How I Tamed the Voice in My Head, Reduced Stress Without Losing My Edge and Found Self-Help That Really Works-a True Story. Panelists explained mindfulness in both scientific terms and practical terms.
"Mindfulness is the ability to see what's going in your head, " Harris said, "combined with the ability to not get carried away with it."
Dr. Allison Baker explained the role of mindfulness in managing anxious or negative thoughts. "It helps you step back and look at that thought as just a thought, as opposed to a reality," she said. "That in turn is allows you to have a little distance and not necessarily engage in that thought and get agitated about it, or have your sleep disrupted because of it."
Over time it means that you have choices in terms of how you engage in or react to that thought, she added, and that sense of control is very powerful.
Cameron Craddock, the Child Mind Institute's Director of Imaging, described research he and others are doing that shows that there's a brain network—they call it the default mode network—that is constantly active when you are having recurring, repetitive thoughts. "This is a network that is turned off when we are performing an external, goal-driven task. And we've shown that if that network doesn't go off, you actually can't perform that task."
The research shows, Dr. Craddock said, "that people who practice mindfulness meditation over time end up being much better at turning off this network and holding it off, as well as being able to turn it on in times when it's appropriate to turn it on."
Added Harris: "What the good doctor calls turning off the default mode network, I call getting out of your own way. "
Dr. Craddock described mindfulness mediation as exercising that part of your brain that modulates, or turns that network on and off. Harris used the same metaphor: When you're practicing mindfulness meditation, every time your thoughts wander from the present moment, and you bring them back, "that's a bicep curl for your brain."
The reason to practice mindfulness, he noted, is that "most of the things that you are most embarrassed by in life come from mindlessness: Finding yourself with your hand in the refrigerator when you're not hungry. Checking your cell phone when your kid is trying to talk to you. Losing your temper when it's strategically unwise."
Bottom line: "Meditation is a pretty common sense way to see what's happening in your head," he said, "so you're not yanked around by it. "View Comments | Add Comment
Change Maker Awards: Tim Murphy, for Championing Mental Health in Congress
May 15, 2015 Harry Kimball
US Representative Tim Murphy is a clinical psychologist, but his first experience of mental illness came long before he decided on his first profession. "I remember when I was ten or eleven years old, growing up in Ohio, there was this railroad track in front of the house," he told us in Washington, DC. "And one time when the train was supposed to come, it didn't—and all I saw was this light. I asked my Dad about it, and he said someone had escaped from the local psychiatric hospital and laid on the tracks."
"How could that be?" he remembers thinking. "How could someone do that?" That formative memory and his years working in the mental health field have led to a political career committed to making change for people and families struggling with psychiatric disease. Congressman Murphy is co-chair of the Congressional Mental Health Caucus and sponsor of landmark mental health reform legislation, the Helping Families in Mental Health Crisis Act, which he hopes will bring real, transformative change to a broken system.
Murphy has not forgotten that childhood thought—"How could that be?"—and brings it to bear on the state of mental health care in the US, which he has called "immoral" and "embarrassing." He is confident that his bill can work to address the problem legislatively-but he also knows that this issue is deeply personal, and that change begins with each of us.
People and families struggling with mental illness exhibit "courage under fire," Rep. Murphy told the crowd at the Change Maker Awards. They face a complicated, confusing system—and illnesses that are so misunderstood and maligned that most people would rather ignore the problem. But the bravery of these families must be matched by our own resolve.
"That's what we need to do when it comes to dealing with mental illness, to have courage," he said after accepting the Champion Award. "To have the courage to say, 'We will stand up for this. We will work for this. We will forget all the barriers that divide us, and see that this is something that must unite us.'"
Rep. Murphy's thinking follows a clear line—from that speechless 11-year-old boy to the Pennsylvania psychologist all the through to the politician and Naval Reserve officer who treats patients at Walter Reed. "Mental illness doesn't know income level, or race, or gender, or preference, or party," he said. "Let's work together." We couldn't agree more.View Comments | Add Comment
Change Maker Awards: Active Minds, for Fighting Stigma on Campus
May 13, 2015 Caroline Miller
For Alison Malmon, the more than 1,100 college students who commit suicide in this country every year are much more than a statistic. Her brother was one of them.
When she was a freshman at Penn, her older brother Brian took his own life. Alison and Brian had been so close people thought that they could be twins. But when Brian found himself plunging into psychosis and a deep depression, he'd hidden his symptoms. "He was ashamed. He was scared. He thought it was his fault," Alison explains. "He thought he was the only one not having the best time of his life in college, and that's why he kept it quiet."
And that's why Alison founded Active Minds—so that other college students who are struggling emotionally will know they're not alone. Active Minds encourages students to speak openly about mental health, to dissolve the stigma and secrecy around mental illness.
"Brian needed to hear from his peers, from his friends, from people who had graduated from his university and were successful, that they too had struggled, and yet they were okay, and they were living with and managing their disorder as part of their everyday life," Alison adds. "But he never got that message."
Now more than 10 years old, Active Minds involves 10,000 students a year in student-run chapters on 400 college and high school campuses across the country. These groups promote awareness of mental health, support students who are struggling, and help connect them to counseling. They are changing the environment on campuses by welcoming students to share their suffering and seek help.
Research shows that 60 percent of young people with depression and 80 percent of those struggling with anxiety don't get treatment. Untreated anxiety and depression are major risk factors for suicide.
And as Lucy Ingram, who was diagnosed with bipolar disorder when she was a Connecticut College student, discovered, isolation is a huge barrier to getting effective treatment.
"In addition to the depression and anxiety I was experiencing, I distinctly remember how lonely, isolated and confused I felt during that time," Lucy writes on the Active Minds web site. "I felt intensely embarrassed and ashamed, and was scared to tell my friends, family and teachers about the difficulties I was experiencing. I had no idea what was happening to me, and did not have an adequate understanding of what mental illness was and where I could go to seek help."
Active Minds was a life saver for Lucy. "While it remained challenging to be a college student with mental illness, reaching out for help and sharing my experience with those around me proved invaluable to my recovery."
So the role of Active Minds is to fight that isolation, explains Alison, now the organization's executive director, by building a community of young adults who know what to say to friends who are distressed, and who know how to connect with the on-campus counseling services, or the crisis text line, or whatever it may take to get to people help as soon as they need it.
"Had Brian gotten support earlier," she said, "I think his life would have been different.View Comments | Add Comment
Spotting Moms' Depression at Kids' Checkups
May 12, 2015 Harry Kimball
Depression screening at the doctor's office is familiar to most adults. A new study out of UC Davis gives it a twist: screening moms for symptoms of depression when they bring their kids for a checkup. And why not? "Pediatricians are in a position to talk to moms about the effects of depression on their children and use that as a motivation to get their symptoms evaluated," the lead author tells ScienceDaily.
The study tested the effectiveness of a very specific intervention, composed of a questionnaire and then "targeted education that focused on removing the stigma associated with depression and how treatment could improve their children's health" for mothers with symptoms. Nearly 74% of them sought help, compared with 54% of controls who were simply screened and given more general information,
That seems like a win-win, and suggests that whether you stick to a specific intervention or not, pediatricians talking to moms about mental health is a good idea. And it certainly makes sense that emphasizing the powerful effects of a mother's wellbeing on her child's health is a good motivator. "If I can give pediatricians an efficient intervention to implement in their practices," the lead author says, "we can really increase our ability to identify women with depression."
This all just begs the question—why not also give pediatricians the tools and education they need so they can also identify kids with depression?View Comments | Add Comment
More Kids Experiencing Mental Health Disorders
May 6, 2015 NBC Illinois
The Children's Mental Health Report is featured.View Comments | Add Comment
CMI Honors Change Makers From City Hall to DC to PS 59
May 5, 2015 Caroline Miller
Last night the Child Mind Institute celebrated five great people and organizations that are changing the way we think about and treat kids struggling with mental illness.
The Change Maker Awards, as we're calling them, were the kickoff of our annual Speak Up for Kids campaign, held each May. As the host for the evening, actress and comedian Ali Wentworth, put it: "Raising our voices lets struggling young people know that it's okay to ask for help and that help exists."
Here are the evening's honorees:
The Advocate Award: New York First Lady Chirlane McCray knows from personal experience what a struggle it can be to find the right help for an adolescent wrestling with mental illness. She helped her daughter Chiara get treatment for depression, anxiety and substance abuse. And now she's trying to help the whole city get better access to care. Chirlane is leading the creation of New York City's first "road map" to construct a more inclusive mental health system. Its recommendations will cut through bureaucracy to deliver quality care faster.
The Corporate Advocate Award: Everyone knows Bloomingdale's, but not everyone knows the courage Bloomingdale's has shown in the causes it supports, from AIDS prevention and treatment back in the 1980s to fighting the stigma around mental illness. Bloomingdale's has supported the Child Mind Institute since its inception with fund-raising events and products, and has helped spread the word that it's important to talk openly about psychiatric and learning problems so kids can get the care they need. The award was accepted by Bloomingdale's CEO Tony Spring.
The Local Hero Award: Angela Renz is a social worker in two New York City schools who is known for moving mountains to help kids get attention for emotional and family problems. Angela is alert to the impact of trauma on kids, and she connects them to the services they need. Whether they lost a home in Hurricane Sandy or they face stress and violence on a daily basis, she is there. Angela also helps teachers at risk of burning out, getting them the support they need so they can remain a consistent force of good in her kids' lives.
The Community Builder Award: We know that isolation is one of the most destructive and painful aspects of mental illness—something Alison Malmon learned first hand in college, when her older brother Brian took his own life. Brian had struggled with depression and psychosis, but he hid his symptoms, even from his sister. After Brian's death, Alison founded Active Minds to help other college students get the support they need to get treatment and get better. Now in 400 colleges, Active Minds empowers students to speak openly about mental health: with each other, with their school administrations, with government officials. They run mental health first aid training and a suicide prevention campaign.
The Champion Award: Congressman Tim Murphy, a Republican from Pennsylvania, has committed his life's work, twice, to getting help to people with mental illness. For the first half of his career, he was "Dr. Tim," a clinical psychologist. These days, he is co-chair of the Congressional Mental Health Caucus and the most outspoken advocate for mental health care in Washington. In December, Rep. Murphy unveiled the Helping Families in Mental Health Crisis Act to create meaningful changes in the US health care system.
George Stephanopoulos, host of ABC's This Week and Good Morning America, gave the award to Rep. Murphy. Stephanopoulos noted that the congressman "talks loudly and with great authority about the fact that millions of Americans-many of them children-have severe mental illnesses that go untreated because their families struggle to get them access to good care. Tim Murphy won't stop until we ALL feel better."View Comments | Add Comment
Mental Illness Affects 17 Million Under 18: CMI Children's Mental Health Report
May 5, 2015 Harry Kimball
Last night at the inaugural Change Maker Awards, the Child Mind Institute released its first annual Children's Mental Health Report. Founder and President Harold S. Koplewicz, MD, mentioned just a few of the findings:
• An estimated 17.1 million US children and adolescents now have, or have had in the past, a diagnosable psychiatric disorder
• Two thirds of children with a mental illness do not get treatment
• Anxiety is the most prevalent mental illness among children
• 80% of kids with an anxiety disorder don't get treatment
• The cost to society of untreated mental illness in young people is hundreds of billions of dollars a year
"These numbers defy the imagination," Dr. Koplewicz said. "They are unacceptable." But they do make it more clear what we can do to change things for the better. Dr. Koplewicz hit on three major takeaways. "Access to care is a huge problem," he said, "and public awareness is lacking." Furthermore, "we do far too little research into psychiatric disorders in kids, particularly in the youngest people, where intervening can be so transformative."
The report synthesizes the most reliable data available on the prevalence of mental illness in children and adolescents, the gap between the need and care, and the efficacy of treatment. All numbers include sourcing. The report attempts to gather what we know—but also call attention to what we don't.
Dr. Koplewicz pledged to continue producing the report annually in the hope that "it will raise awareness both of the magnitude of the problem and of the clear benefits of confronting it head on," including the "research dollars, training programs, and public education efforts we need to bring these kids out of the shadows."
But childhood mental illness is not just a public health problem—it's a very personal, family-based struggle, too. We want to assume that our kids are healthy, so sometimes we look the other way when there are signs of trouble, Dr. Koplewicz tells Web MD in an interview about the Children's Mental Health Report. "But this is really one of those times when looking the other way can be detrimental to the child."View Comments | Add Comment
Best Picture Books about Autism
April 20, 2015 Leigh Merryday
This is a guest post from Leigh Merryday, a teacher and librarian who blogs about early childhood autism at Flappiness Is... She tells us she has worked in middle school for 20 years and has seen the difference for autistic kids whose peers have had autism explained to them early.
A few weeks ago, I was asked if I might be willing to come in and talk to a group of kindergarteners about autism. Of course, this isn't just any group of kindergarteners. It's my autistic son's peers. So, I wanted a read aloud one or two books, and I wanted them to be good. Being a school librarian, I know that there are an awful lot of children's books out there. So, I asked the most qualified people I know—my readers—to offer their suggestions on my Facebook page. I got a lot of them.
I couldn't afford to buy them all, so I ordered several that seemed to fit the age group and read them all in one sitting. No, I didn't like all of them. I've included only the ones here I'm recommending. I don't find negative reviews useful to an audience of readers who already have limited time. I tend to shy away from the preachy ones, believing that children are much savvier readers (and listeners) than we give them credit for. And I like books that are a bit subtle and lend themselves to fruitful discussion. Because that's where you reach hearts and minds.
1. Looking after Louis by Lesley Ely, illustrated by Polly Dunbar
Looking after Louis is the story of a little boy, Louis, who is autistic and is a student in a regular elementary classroom. His friend, an unnamed little girl, narrates the story as she and her classmates try to understand Louis and some of his unusual behaviors. Louis repeats what others say. He colors pictures that others don't understand. He runs about through the children's soccer game. Though the children are sweet and generally accepting of Louis, they do begin to notice that Louis is allowed to do some things they aren't—and point it out. But then a moment comes along in which everyone recognizes Louis's effort to communicate something special to him. That leads another child to invite Louis to play with him, but it isn't recess. His teacher, understanding that this is a teachable moment, allows them to go outside with Louis's aide. The little girl at first resents what she views as special treatment, until her teachers gives her a moment to consider her opinion. Ultimately, she decides that sometimes it's okay to break rules and expectations for special people—thus supporting the idea of inclusion in the regular classroom. It's okay that some things are different for students who require it, but everyone can be friends.
I really liked this little story, mainly because the range of emotions for these children is honest. At times, they are encouraging of Louis. Sometimes, they are bewildered. And others they are a little resentful of what they view as unfair. However, because of their teacher's open and accepting handling of Louis, they learn about the true spirit of inclusion. This would make a great read aloud that could lead to a productive conversation about differences. Instead of telling, this book shows what a tolerant and welcoming classroom should look like—a point in its favor and one that distinguishes it from preachier special needs children's literature. Recommended.
2. Andy and His Yellow Frisbee by Mary Thompson
Andy and His Yellow Frisbee is the story of Sarah, a new girl at Andy and Rosie's school. Sarah has noticed Andy, who is autistic, each day at recess, spinning the same yellow Frisbee over and over. She decides to try to connect to Andy by inviting him to spin her pink Frisbee, which she has clearly brought from home in an effort to engage him. Andy's sister Rosie, playing soccer nearby, faithfully watches over him. She becomes concerned when she sees Sarah sit down next to Andy, knowing that others do not always understand him. She leaves the game and comes over to observe them, seeing Sarah's gentle effort to interact with Andy and her acceptance that perhaps he'll choose to do so on another day. Sarah and Rosie decide to play Frisbee together.
I loved this subtle story of acceptance, probably because Sarah reminds me of my daughter. Between Sarah's effort and Rose's calm but protective wait-and-see, this story gently conveys to typical children that there is no magic formula for interacting with someone who is autistic. What's important is to realize that effort does make a difference, even if there isn't an immediate reward. Andy did notice Sarah's Frisbee offering, though he continued to play by himself. Sarah's acceptance of that is beautiful and will serve as a model for typical students wanting to interact with their autistic peers, but unsure of how to do so. Andy and His Yellow Frisbee isn't what I would choose as a first read aloud when introducing the concept of autism to typical students, because its focus is narrower. But I think it's ideal as a follow-up later to reinforce lessons on differences and to help students learn to engage with their autistic peers. It is also a lovely story for protective siblings of children on the spectrum. Recommended.
3. Ian's Walk: A Story about Autism by Laurie Lears, illustrated by Karen Ritz
Ian's Walk is the story of siblings Julie, Tara, and Ian—who is autistic—and their walk to the park. Julie initially doesn't want Ian to tag along, but gives in when he whines. Her mother admonishes Julie that she must be sure to keep a close eye on Ian. As they head out on their walk, Julie observes the different ways that Ian hears, sees, smells, and feels things. Even though she makes these observations, she finds herself frustrated with the inconveniences of Ian's differences and loses her patience. When the girls stop to get pizza, Tara reminds Julie to watch Ian. But Julie is distracted and suddenly realizes that Ian has disappeared. The sisters race about, frantic to find their vulnerable little brother. Then Julie focuses and decides to think and experience their surroundings like Ian—where would he be? Sure enough, that's how she finds him, making the big bell at the park gong back and forth. Julie is so grateful he is safe that she now has a new perspective on their walk back. This time, she allows Ian to enjoy the walk as he wants to experience it, allowing him to stop and immerse himself in the sights, smells, and sensations he loves.
Ian's Walk is a beautiful story with a simple plot, but one that conveys the complex sibling relationships inherent in special needs families. It's an obvious story to share with siblings of autistic and special needs children (or even in support groups for such). But because the story also describes so well many aspects of autism and sensory integration disorder, it would also be a great introductory read aloud for the topic. My 7-year-old loved this story and recognized both her brother in the story as well as her own emotions in it. Recommended.
4. My Friend with Autism, Enhanced Edition with CD by Beverly Bishop, illustrated by Craig Bishop
My Friend with Autism isn't a story so much as a narration by a peer, who tells readers about his friend, who is autistic. It begins with an explanation of all the things his friend is good at—hearing, seeing, touching, tasting, being smart, etc. For each thing his friend is good at comes an explanation of how that affects the friend (examples: extra-sensitive ears that hear before others but cause him to sometimes cover his ears). This part is a positive outlook on autism, but matter-of-fact. There is a shift about halfway through when the narrator explains that—while his friend is good at many things—there are some things that are difficult (talking, understanding feelings, sharing, etc.) What's good about this part is how the narrator makes suggestions of what can be done to help the friend when these things occur.
My Friend with Autism is a practical and positive introduction to autism for typical students. It treats autism as something children shouldn't worry about and conveys to them that they really can be friends with their autistic classmates. This enhanced edition comes with a guide for adults that includes factual information about autism as well as tips for working with children on the spectrum. The CD includes coloring sheets of pages from the book for children to enjoy after the read aloud. I would suggest this book as a first read aloud for an inclusion classroom to be followed by one or more of the other stories in this list.
Leigh Merryday is a teacher and librarian who blogs at Flappiness Is... about navigating the world of early childhood autism. She has a daughter with ADHD and a son who is autistic. You can also follow her on Twitter, where she recently tweeted that her son just spoke his first complete sentence.View Comments | Add Comment
Study Shows Many Doctors Stalled Autism Diagnoses
April 20, 2015 Beth Arky
New analysis of a national 2011 survey showing that many healthcare providers were mistakenly dismissing parents' early concerns that their children might be on the autism spectrum comes as no surprise to moms and dads of kids who went on to receive an ASD diagnosis.
The results, published in the Journal of Pediatrics, also found that parents of autistic children were more likely to have their first concerns dismissed than were parents of children with other developmental delays, including intellectual disability. Autism is now diagnosed at a rate of 1 in 68 children in the United States.
On average, parents reported first raising concerns about possible signs of autism when their children were around 2 years old. Meanwhile, the average age of an autism diagnosis was close to age 5.
Parents on Autism Speaks' Facebook page reported that they were often told that "boys speak late" or that their child wanted to cuddle too much or had too much eye contact to be on the spectrum, leading to a lack of early interventions such as educational, behavioral, speech, occupational, and physical therapies that have been shown to improve outcomes in autistic children.
One mother on AS's Facebook page put it this way: "I was one of those parents. I pushed and got a new Doctor. If I listened to the first doctor my son would not have gotten the early intervention treatments and he wouldn't be where he is now. Go with your gut as a parent, you know your kids better than any professionals out there."
We hope that with better, earlier screening tools that have been developed in the ensuing years, fewer autistic children are now being allowed to slip through the cracks.View Comments | Add Comment
Mental and Physical Health Care: Equal Under Law, Still Separate
April 7, 2015 Harry Kimball
A report from the National Alliance of Mental Illness casts a pall on the dream of mental health parity—the federally legislated mandate that insurers reimburse mental health care providers at the same rate as those health professionals who treat physical illness. A key NAMI finding (based on a survey of consumers) is that insurance companies deny mental health claims twice as often as they do physical illness claims, based on questions about "medical necessity."
From NPR: "Basically, they look at someone's care and ask is it really medically necessary. And advocates say they're applying those sorts of cost-control techniques way more stringently on the mental health side and the substance abuse side than they are on the physical health side."
However, according to NAMI, there is no reason to think that the "medical necessity" of mental health care should be any different from physical care. The Mental Health Parity and Addiction Equity Act was intended to erase this disconnect. As the NAMI report says, "the reasonable expectation is that reported denials of care for mental health, substance use, and medical care would be roughly equal."
Not so. The survey shows that 29% of families "had been denied mental health care on the basis of medical necessity, more than twice the percentage who reported being denied general medical care."
The law (or the difficulty enforcing it) is not all to blame for the poor state of mental health care in the United States, NAMI admits. There aren't enough professionals; the ones we have are understandably wary of working with stingy insurance companies; and the lack of a robust mental health system means that many needy children and families go unrecognized.
But for the families who do reach a professional, we hope we can do better than turning them away because treating a mental illness isn't a "medical necessity."View Comments | Add Comment