Stories about: suicide

Children’s Mental Health Campaign

David DeMaso, MD

National Children’s Mental Health Awareness Week is May 6 though 12. In honor of the occasion David R. DeMaso, MD, psychiatrist-in-chief at Boston Children’s Hospital, addresses the work of the Children’s Mental Health Campaign in Massachusetts.

What is the state of children’s mental health in the Commonwealth?

The good news is that we’ve come a long way. Massachusetts is a national leader in children’s mental health. Since 2006, when Boston Children’s and Massachusetts Society for the Prevention of Cruelty to Children (MSPCC) released a joint report on children’s mental health, children are now more likely to receive timely care, delivered in the right setting, than six years ago. However, the system continues to be fragmented, which creates barriers to care. We still need to take important steps to expand access to effective, high quality and well-coordinated care for all children with mental health needs.

What is the Children’s Mental Health Campaign? What have been the most significant achievements of the Campaign to date?

Launched by Boston Children’s and the MSPCC, the Campaign also includes the following founding partners –Health Care for All, Health Law Advocates and the Parent Advocacy League. Since 2006 it has grown into a diverse coalition of more than 140 organizations with expertise in mental health, healthcare, law, child welfare, family advocacy and policy—all working together to advocate for systemic change of the children’s health care system.

Through the Campaign’s efforts, the landscape for children’s mental health in the Commonwealth has changed significantly. Three landmark laws have been enacted: the Children’s Mental Health Omnibus law of 2008, the Mental Health Parity reform law of 2008 and the Autism law of 2010.

These laws have improved access to care, spurned early identification of children with mental health needs, highlighted the importance of increasing schools’ capacity to address the mental health needs of students, expanded insurance coverage for children in need of mental healthcare services and reduced by more than 60 percent the number of kids “stuck” in inappropriate care settings.

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Studies explore gender identity and children

The journal Pediatrics released two studies this week that focused on the mental and physical wellbeing of children who don’t conform to typical gender roles.

The first study, led by Children’s Hospital Boston researcher S. Bryn Austin, ScD, indicates that kids who fail to adapt traditional gender stereotypes as children are at a significantly greater risk for physical, sexual and psychological abuse during childhood. These children are also more likely to develop post-traumatic stress disorder (PTSD) in young adulthood.

The study was funded by the National Institute of Health and compiled data from almost 9,000 young adults. Participants were asked to recall their childhood experiences, including their favorite toys and games growing up. The types of charters they related to as children, which roles they adopted during pretend play and their earliest understanding of masculinity and femininity where all reported on as well. Researchers also asked participants to disclose information about any physical, sexual or emotional abuse they experienced at the hands of parents, other adults or older children. Finally, participants were screened for PSTD.

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Sexual abuse and children: do you know the warning signs?

For the past week the nation’s attention has been focused on the child sex abuse scandal engulfing Penn State’s football program. It’s a heartbreaking story that has triggered feelings of anger and horror in millions of people. It also has many parents wondering about the safety of their own children.

Unfortunately, sexual abuse of female and male children is more prevalent than many people realize and many cases go unreported. Children stay silent about their abuse for a number of different developmental, social or psychological factors.  In some instances the victim is too young or otherwise unable to tell anyone what has happened, and may have some confusion about what has taken place. Other times the child may be afraid their abuser will hurt them or their family if they tell anyone, or they are embarrassed, ashamed or blame themselves for what happened.

As troubling as it may sound, there are also many victims who never come forward because they are protecting the person who hurt them. It’s not unusual for the abuser to have a bond with the child so strong that the victim is unwilling to identify him or her for fear of getting the perpetrator in trouble. If the abuser is a person of high regard— like a respected authority figure, or popular coach or teacher—the victim may think no one will believe the story, or be angry with them for accusing a respected person.

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When care requires more than simple answers

When teenagers stonewall adults, there can be many issues leading to the behavior

By Sarah Teasdale, MD, EdM pediatric hospitalist at Children’s Hospital Boston

It was near midnight about a year ago when I noticed a gaunt young man in his early twenties walking toward me in the Emergency Department. It was a young man who, about a decade earlier, had threatened to kill me.

For nearly ten years prior to becoming a physician I was a high school teacher. That particular July, I was teaching English in summer school for students who had failed the class during the regular school year. It was a group of 15 surly teenagers ages 14 to 19, beaten down by a system in which they could not—or chose not—to succeed.

The young man—I’ll call him Andre—was my student that summer. He was a gangly, thin 15-year-old who often wore the same ill-fitting clothes day after day, rarely made eye contact and showed a level of fatigue in the early morning that was extreme, even for a teenager. Whenever I tried to talk to him, he would simply say he was “a’right.” He meant: Stop asking.

So I stopped asking. In doing so, I lost a chance to help him.

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