The Child Mind BlogBrainstorm
Dark and Bright Sides
of Mental Health Post-9/11
Aug. 10, 2011 Harry Kimball
Today we read in the New York Times about the staggering impact the September 11 attacks have had on the mental wellbeing of New Yorkers involved in the rescue and recovery attempts, as well as those who lived in the immediate area of the World Trade Center. The article is heartbreaking in many of its details and also in its scope: New York City estimates that at least 10,000 people intimately exposed to the horrors of that day have had a diagnosis of post-traumatic stress disorder (PTSD) in the last 10 years, and maybe 60,000 have been symptomatic.
But the story also illustrates a fantastic effort to provide care to people who have been truly injured by a terrorist attack-a national disaster-though they may bear no physical scars. The mental health coverage in the federal James Zadroga 9/11 Health and Compensation Act that funds care for people harmed by the attacks is far from perfect, reflecting a persistent wariness in the halls of power about psychiatric illness. But it is something, and New York City has grabbed ahold and made it available to more than 400,000 people. At the same time, the city and federal governments have made a step towards acknowledging the reality of these wounds.View Comments | Add Comment
Aug. 9, 2011 Harold S. Koplewicz, MD
A few days ago the New York Times profiled Joe Holt, a 50-year-old man with schizophrenia who was on the brink of suicide—loaded gun in hand—when he began to find a way out of his nightmare of paranoid delusions. What's worked for him, with support from his wife, Patsy, is a self-devised regimen that helps him cope with severe negative feelings and hostile voices that can drive him to the edge some days. He has been medication-free since 2006, Benedict Carey reports in the article, "but considers it a valuable safety net."
In the ensuing decade Holt has achieved a successful marriage and a successful career, and has nurtured many foster children in his Missouri home. It's a compelling, encouraging story, but one that draws conclusions that do a grave disservice to the majority of people with schizophrenia. Holt is able to recognize his delusions and battle them with admirable grit and discipline. But reporter Benedict Carey notes that "the ability to catch one's own mind straying from reality is no small gift; perhaps half the people with schizophrenia have no such self-awareness."
And furthermore, the fact is that for the overwhelming majority of people with schizophrenia, the symptoms are severely impairing, whether they are aware of their disorder or not, and a closely monitored regimen of antipsychotic medication has been shown time and again to be the best way to manage this chronic condition. Moreover, disturbingly the decision to drop medication leads to disaster for these patients—relapse, drug abuse, homelessness, incarceration—and their families.
Patsy Holt's can-do attitude and faith in her husband are admirable, but she's wrong when she tells him his battles are like everyone else's: "I tell him everyone struggles with doubts, with fears—that it's normal. Normal."
The severe anguish people with schizophrenia experience is not like ordinary doubts and fears, people with schizophrenia are not weaker than other people, they have a very real illness, and getting medication treatment is not only more effective for them, and their families, but significantly less risky than toughing it out on their own. Joe Holt's wife is telling him to be brave, but the bravest thing is to get scientifically sound help when one is ill.View Comments | Add Comment
A Desperate Mother Kills Her Son, Herself
Aug. 8, 2011 Beth Arky
The news that a respected Maryland psychiatrist last week killed her 13-year-old son, and herself, is doubly tragic. Police say Dr. Margaret F. Jensvold, 54, fatally shot her son, Benjamin Barnhard, before turning the gun on herself. Jensvold was reportedly distraught after her local school district denied tuition assistance for a private treatment program for Ben, who struggled with several issues. Some reports say he had been diagnosed with ADHD, obesity, and PANDAS, an OCD-like disorder, usually short-lived, that is caused by an autoimmune reaction to a strep infection. His father, divorced from his mother, told reporters that Ben was on the autism spectrum.View Comments | Add Comment
Jensvold, described by all, including her ex-husband, as a doting mother, gave up her private practice to become a salaried psychiatrist for Kaiser Permanente, allowing her more time to manage her son's medical care and educational opportunities.
Ben's father said "bullying and harassment" in the public schools had led to his son's "tremendous" weight gain; in fact, the teen had recently lost more than 100 pounds after attending a special program featured on cable's Too Fat for 15. Barnhard said his ex-wife had told him on several occasions that the school system was failing to address Ben's needs and that he thought the stress over her son's future "played a significant role" in her desperate act. "She didn't want him to suffer."
We'll never know how Ben would have done in a public school setting, but we can testify that many parents encounter enormous obstacles while trying to obtain the services their children—and families—need. It's critical that we help them before they spiral into the kind of hopelessness that can lead to such a tragic ending.
College Sugar Babies
Aug. 4, 2011 Rachel Ehmke
We keep hearing about college girls acquiring sugar daddies. In case you haven't caught up with the trend, it seems there are several web sites designed to match up young girls with older, affluent men who are willing to help pay their bills—in exchange for services rendered, of course. And girls are taking the bait, with many citing the burden of tuition, student loans and a bad economy.
They're specifically targeting college students (or recent graduates)—one rewards girls who register with .edu email addresses by upgrading their accounts and stamping their profiles certified "college sugar baby." Another is called SeekingTuition.com.
The Huffington Post recently interviewed several college sugar babies in an eye-opening expose. From the interviews I was struck by the perplexing "I'm not a prostitute; I went to Sarah Lawrence" attitude that many of the girls shared. Maybe I shouldn't have been so surprised. Girls are taught from an early age to see their bodies as an asset that should be maximized (or augmented). The ideal girl is both smart and hot. Enter the college sugar baby industry, where sex work is practically wholesome—these johns are buying text books!
We've come a long way, but we're also losing ground—now our girls grow up knowing they can be Supreme Court justices, but in a pinch, their bodies are still where the money's at.View Comments | Add Comment
Matt Damon on What Motivates Teachers
Aug. 3, 2011 Caroline Miller
Matt Damon was looking incredibly hot at the recent Save Our Schools rally, and not just because of the haircut. When an interviewer asked him a really annoying question about whether doing away with tenure would motivate teachers to teach better, he shot back an irresistible retort. In the YouTube video the reporter posits the idea that actors work hard because they need to get the next job, ergo teachers would work harder if they had less job security. If you have ever been grateful to a wonderful teacher (whether or not you believe in tenure) you should check out his response.View Comments | Add Comment
A Tragedy Everyone Expected
Aug. 3, 2011 Rachel Ehmke
It was painful to read the story in the New York Times today about Pericles Clergeau, a mentally disturbed young man who murdered an employee at the homeless shelter he was staying in, only nine days after social worker Stephanie Moulton was also killed by a mentally ill man placed in her care.View Comments | Add Comment
While Pericles was never given diagnosis, doctors speculated that he was traumatized by the violence he witnessed in Haiti, and in turn became violent himself. According to his father, Pericles was a disturbed and aggressive child already at the age of four. His life was marked by increasingly unmanageable outbursts, and so he was shuttled from agency to agency. The New York Times account is peppered with quotes like this one, from his father, saying, "I knew something like that would be happening one day."
Stories about seemingly unreachable people often leave us feeling helpless, even fatalistic. This is a mistake. One of the commenters on the Times story drives this point home. JCN writes: "This article speaks of an all too common tragedy and lives that are destroyed, but again there is no mention of how to provide someone with a meaningful chance at life. It only paints a frightening picture for similarly afflicted families and forces them into silence out of fear that the prison system is the only system that will prevail."
Our pervasive culture of keeping silent about mental health issues, and of shuffling away problems, is an injustice to more than just Pericles Clergeau and the worker who died trying to help him. Keeping silent also hurts the families who are trying desperately to prevent a tragedy like this from happening.
Which reminds us of the essay from the Motherlode blog we wrote about yesterday, in which the mother of a charming, affectionate young boy who is also becoming violent describes her desperate efforts to curb his terrifying outbursts before he, too, hurts someone. What she asks for, from the public, is not answers but openness. "Be willing to talk knowledgeably about mental illness. Unless we erase the taboo we will not be able to make real progress toward protecting my little boy and all those lives he may one day touch - with, I hope, unimaginable beauty and joy."
A Child's Illness, a Mother's Reality
Aug. 2, 2011 Caroline Miller
One thing I hear a lot from parents of children with serious psychiatric illnesses is that other parents don't have any idea what it's like. They're on the receiving end of a lot of criticism, and skepticism, about the decision to medicate a child, and it's often implied—if not stated outright—that disruptive behavior is the result of poor parenting.
A new guest post in the Motherlode blog offers an important dose of reality. It's a mother's account of a charming, delightful 4-year-old—"a sweet, kind, creative, engaging, cuddly little boy"—who intermittently turns into a radically different child who his mother is terrified will hurt someone terribly. This other child is "cold, fierce, frightening and frightened," and he can't be left around anything that could be used as a weapon. The family has tried everything from diets to anti-psychotics and mood stabilizers. "He continues to get worse. And better. And then much worse again, all over the course of the first five minutes he is awake in any given day."
When very young children are medicated it's often because they are violent—and if you don't think a 4-year-old can be dangerous, to himself or someone else, read this piece. A friend who has a child on the autism spectrum said the other day she'd like to get a therapy dog for him, but she thinks it might not be safe—for the dog.
Like many mothers I've met, this mom is literally working around the clock to help her child and save her family. What she needs is for others to recognize that this kind of thing happens to "nice people" and "nice children." The fact that this mother posted anonymously speaks to the stigma she feels in revealing her child's illness and her family's reality.View Comments | Add Comment
What Even Extraordinary Teachers Can't Do
Aug. 1, 2011 Caroline Miller
A teacher named Ellie Herman has a riveting essay in the Los Angeles Times about the notion, which seems to be in vogue, that the only thing that's needed to make struggling schools better is extraordinary teachers—not smaller class size.View Comments | Add Comment
She gives us a snapshot of some of the 31 kids in her classroom: "two with learning disabilities, one who just moved here from Mexico, one with serious behavior problems, 10 who flunked this class last year and are repeating, seven who test below grade level, three who show up halfway through class every day, one who almost never comes." She also mentions one who hasn't done any homework since she was assaulted at knifepoint, one who is sleeping, head on his desk, because he works the night shift at a factory, one who is quietly weeping, and "the brainiac who's so bored she's reading Lolita under her desk."
It's a heartbreaking picture, because packing all these kids in one classroom is setting up someone who might very well be an extraordinary teacher to fail, not to speak of setting up kids to fail, too. Good teachers are tuned into kids with psychiatric and learning disorders, and often play a critical role in getting them connected to help. But not if they're so overwhelmed they don't have time to pay real attention to their needs. As Herman puts it, "To teach each child in my classroom, I have to know each child in my classroom." Sacrificing kids like these, and teachers like these, is a very short-sighted way to close a budget gap.
Does Your Kid Read the News?
Aug. 1, 2011 Rachel Ehmke
From NPR's Monkey See blog we recently learned about several online news sites written specially for kids. With easier words and more kid-friendly content, the sites seem like a great resource. Take stories like "Should Dogs Wear Seat Belts?" (it comes with awesome pictures of dogs in harnesses) and "Holland's Commuter Slide"—they're a shoo-in for a younger audience, and the stories are also a great way to introduce important subjects and debates to kids.
Of course, even if a news organization is committed to avoiding ghoulish or sensationalist topics, extra care needs to be taken when talking to kids about news that isn't G-rated, such as the recent tragedy in Norway. Some kids' sites chose not to cover the story at all. Claudia Heitler of Here There Everywhere explained that she didn't think her own son needed to know about the tragedy, so she wasn't about to tell other children. In her words, the news site "is not meant to be comprehensive. It is meant to start conversations."
It's good to hear that parents have some allies in the newsroom.View Comments | Add Comment
A Family's Uprooting and a Pleasant Surprise
July 29, 2011 Maria Xia
"Having a family means constructing an equation," writes Lisa Belkin on the New York Times' Motherlode blog. "Every choice, each conclusion, means shuffling all the factors, deciding how much weight to give to each." Parents of children with special needs are most aware of that balancing act, the child becoming the major player in each equation, the reason for a family's compromises and sacrifices. Right?View Comments | Add Comment
Apparently, not always. In the guest post, Lydia Denworth surprises us with the story of her family's move to China, and what that meant for her first grade son, Alex. He is almost entirely deaf, and his family calls upon a vast network of caregivers to support him. Denworth herself stopped working for several years to focus on him, and the family gave up on quite a few dreams of how they might live.
So when Denworth's husband suggested moving to Hong Kong, she thought immediately of Alex. Will the schools have teachers for him? Can the kids stand the shock of relocation? But she was "floored" by Alex's response. When he heard the news, he exclaimed that they were the best parents ever. "I want to see the Great Wall. I want to learn Mandarin," he said. I'll even try some Chinese food."
This is an inspiring story of the resilience of children — even those we treat with special attention-and the ways in which parenting can be a forgiving as well as a demanding activity. All parents want more for their children, and for Denworth this was a reminder that all along their efforts were aimed at letting Alex "exist in as wide a world as possible." Sometimes it's prudent to step lightly when it comes to surprises, to err on the side of safety and routine. But occasionally—and happily—our children show how much they want to grow up, and surprise us with the gifts.