– [Voiceover] Growing pains. Mental health and
Mississippi’s Children. – His background may have
been from neglect and abuse. – You can’t rob a bank and
then run out in the street and say
I’m having a mental health crisis
and we go, oh, okay. Well let’s put the money back
and we’re now gonna carry you for
an assessment. That’s not the
way it works. – I have bipolar
disorder type one with psychotic
features. And in the year
2000, I survived a jump off of the
Golden Gate Bridge in an attempt
to end my life. – [Voiceover] And
now, Dr. Rick deShazo and Melissa
Faith Payne – Anxiety, schizophrenia,
depression, bipolar disorder,
post traumatic stress. More than 42 million Americans
suffer from mental illness each year and one in
five children in the US have poor mental health. – But did you know that
35,000 children in Mississippi have severe and persistent
mental health needs? On this program, we’ll discuss
mental illness in children with highly trained
professionals who have extensive experience in this field. – And we’ll hear from
parents of children with mental illness who
live the struggle every day, but first what is
mental illness? – It’s difficulty. An illness that
comes from the brain and that affects mental
or emotional well-being. It can affect the way we think, the way we feel, the
way we concentrate, and the way we
interact with others. – [Melissa] Dr.
Susan Buttross says mental illness a complex world
with emotional highs and lows especially in children. – Unfortunately, one
problem in children is that the recognition is
often very delayed. Often children don’t know
what they’re experiencing. Many times they are viewed
as behavioral issues, behavioral disorders,
children who are just bad. The face of a child
who’s depressed often is an angry child. Behaviorally acting out child. So it’s not recognized
that this is a child who is sad. Many times an anxious
child is a child who will refuse
to go to school or a child who will
refuse to go out and play, or interact
with others. – [Melissa] According to the
Centers for Disease Control, the most prevalent
diagnosis among children is attention deficit or
hyperactivity disorder, also known as ADD and ADHD followed by behavior
or conduct problems, anxiety, and depression. – [Sharon] I’m Sharon Townsend. I have an 11 year
old son named Damien whose official
diagnoses at this point are ADHD, severe oppositional
defiant disorder, bipolar disorder, dysgraphia. We call it anger
issues and ADHD. Technically or officially, his classification is
emotionally disturbed. – [Melissa] Historically,
most families have just dealt with the mentally ill
at home. The State of Mississippi
provided asylums for the seriously mentally ill,
away from the public starting in the
late 19th century. In the mid 20th century,
asylums were closed and government funded
community health centers were opened, but the state
hospitals located in four areas of the state still serve those
with serious mental illness. – Public community
mental health centers. There are 14 across the state and they do not turn away
anybody regardless of whether they can pay or not. – [Melissa] Community based
treatment for children from therapists, psychologists,
and psychiatrists is available in outpatient
settings like an office. It’s also available in inpatient
settings like acute care facilities and long term
residential facilities for children. Navigating the system
for the appropriate care in the appropriate setting
has been called difficult. – [Sharon] If a child has
more than a case of mild ADHD, quality mental healthcare
can be difficult to get in this state. Emotional disorders. There really isn’t a set
support group in this area for that. Most of the help is
geared toward people with physical disabilities
not emotional disorders. If you have a child who has
true emotional disorders, you’re basically
on your own especially when you
have one like my son who’s extremely
intelligent. People tell me all the
time, I don’t see it. So then the parents ends
up looking like the villian ’cause I don’t see that. I just can’t believe
that child is like that. (slow music) – [Melissa] Dr. Rick deShazo
talks with a mental health expert about children’s
mental health. Joining him are Dr.
Timothy Summers, Dr. Susan Buttross,
and Dr. David Elkin. – We’re talking about
mental illnesses in children and mental health
in children. How do you classify the
disorders of mental health in children? – There’s large categories
and to start off with you would think of developmental
disorders to begin with. Things such as, perhaps
autism spectrum disorder and developmental
disorders in general. You’d also move to
behavioral disorders, sort of oppositional
defiant disorders, and things like that. And you also have mood
disorders that would include anxiety disorders
and depression. You’d also have
another large category of learning disorders. Children who have difficulty
with, say, dyslexia. Or difficulty reading, or
learning math problems, or things like that. Finally, though it’s rare, you would have
psychotic disorders. Those are some
broad spectrums. There are other
things out there, but in terms of what
we’re looking at it’s a very wide array of
things that children face. In fact, they
mimic obviously, a lot of things
that adults face, but in a different way. – So Dr. Summers, as a
psychiatrist in practice, and I understand we have
very few psychiatrists in Mississippi who see
children and young adults. What part of the spectrums
seem to be most common in your practice? – Well the problems that
I see most often are generally by the time
a child or adolescent comes to see me, their
problems are of such a nature that they’re not able
to function in school. They’re not functioning
well at home and they’re not functioning
well in the community. – So it’s almost a
crisis by the time they get to
the psychiatrist? – It may be a crisis, but it may be a
chronic type of crisis. Chronic in the
sense that they might have
been in multiple treatment
interventions before. Outpatient, other
inpatient settings, but generally inpatient
settings that have been a short duration and a
lot of different things have been tried. A lot of different
interventions have been tried, but none have
been successful. (slow music) – [Melissa] Mental illness
takes a toll on those with it and those who care for them. It can be complicated
and costly, unfair and frustrating. In a study by the CDC, approximately 8% of adolescents aged 12 through 17
years reported more than 14 mentally unhealthy
days in the past month. Experts say, not dealing with
mental disorders a child has can lead to deeper problems
in their teen years. Some teens develop
mental disorders, drug and alcohol abuse,
self-harm and suicide are among them. According to the CDC,
4.7% of adolescents between 12 and 17 years of age reported an illicit drug use
disorder in the past year and the overall suicide
rate for persons between 10 and 19 years old
was 4.5 suicides per 100,000 persons
in 2010. – My name is Kevin Hines. I have bipolar disorder type
one with psychotic features and in the year 2000,
I survived a jump off of the Golden Gate Bridge in an attempt
to end my life. Worst day of my life and
in some ways the best. Because I lived, I was
able to recuperate. Find recovery with living
with a severe mental illness. – [Melissa] Kevin was 19 and
been battling mental illness for two years. He was seeing a psychiatrist
after having a mental breakdown his junior year
of high school. – Because I was in
such great denial. I was seeing
a psychiatrist. I was talking
to therapists. I was going to these
places and I was pretending to be okay. – [Melissa] Kevin, now in
his 30s takes his story to mental health professionals
around the country. He says part of the
problem was not following his treatment plan. – Part of it was that on
the weekends I’d binge drink till blackout. While on psychiatric
meds, something that could’ve killed me. Another piece of it
was this great denial. I don’t have this, I
don’t wanna have this, and I played football. I was a champion wrestler. I was on the speech
and debate team. It didn’t make
sense, so I hated it. – [Melissa] How do mental health
illness start in children? Find out more with Dr. Rick. – Do you see a connection
between developmental disorders and we need to explain
what those are, and mental illness
in children? – Right, one thing
that a friend of mine a few years ago coined
was brain health and brain illness rather
than mental illness because of the connotation
and child development is part of that
brain health and normal development
or typical development is what we see in children
and then when it falls out of the line
of normal, then we start looking at the
reasons that it could be. It could be ADHD. It could be
oppositional behavior. It could be something
as simple or maybe not so simple
as a sleep disorder. Or it could be
significant mood disorder that’s developing in
a very young child. So one thing that Dr. Summers
was mentioning is that by the time it gets to him,
the problems are so severe. One thing that can
happen is you can develop what we call
co-morbidity. Another issue that
develops because of what’s been going
on with the child, so you might have
a child with a learning disability,
and then what happens is the
learning disability’s not addressed, the child gets
anxious about what’s going on in school and then
maybe even depressed. Then they start
acting out because they’re
failing in school, people are telling
them they’re not trying and they’re trying. So it becomes just
a vicious cycle and so many times, by the
time the children go to a good psychiatrist, they are
already in the ditch and having great trouble. – Where are these
usually picked up? Are pediatricians
good at picking up the kinds of disorders that
need to be referred out or do they try to take
care of them themselves? What are the
guidelines for that? – Well, there are
guidelines to pick up developmental disabilities
in that pediatricians are supposed to at
well-child checkups screen children for
developmental delays. Developmental or
behavioral issues, so typically they
screen for not just when they’re crawling
and walking and sitting, but also when
they’re talking. How they’re doing
socially and emotionally. Whether or not they seemed
connected to the parent. Whether or not
they’re acting out and things like that are part
of the well-child checkup and part of the
screening process. Most pediatricians
are doing that now though not all. Sometimes the children
aren’t picked up and having their developmental
problems until they enter school, which
is really late. What we really hope
is that one, parents understand that
if they see something that concerns them, that
they need to go and talk to their primary
care provider whether that’s
their pediatrician or family practitioner
or nurse practitioner. They need to let them
know they have a concern and then insist that
this be addressed. (slow music) – [Debbie] My name
is Debbie Waller. I have a son diagnosed
with a mental illness. – [Melissa] Debbie and
Larry Waller adopted their son, Michael, shortly
before he turned five years old, but when he got older, they
knew something wasn’t right. – He did have some
behavioral issues early on. His background may have
been from neglect and abuse. And as we got to know some
of his biological family, we found out there was
some mental health issues. We didn’t know exactly
what they were. – [Melissa] She says Michael
started showing signs of a problem in fifth grade
and was diagnosed with attention deficit disorder. – He’s one of those would just
zone out in the classroom, and he’s a smart,
bright individual, but just tuned out. Didn’t know what the
teacher was asking him. What the teacher was saying. He wouldn’t remember
to study for a test or any of those things,
so we had to work with them a lot,
with the teachers, and with me being the
teacher and helping him. – [Melissa] Then he started
showing other troubling signs in high school. – Socially, be more
awkward, didn’t he, Larry? – Yeah. – More trouble fitting in. Not how to… How would
you say it? Communicate
with others. His social role, how to play
that social role with others. I mean he was always
wanting to be the one that had lots of friends,
but he never knew quite how to make that friend. He became more isolated. He stayed in his room more. He didn’t interact as
much with his brother. Kids do that, they
stay to them self. You think it’s just a phase
they’re going through. – He got agitated
real easy. – Yes, especially
with us. – Yeah. – Things seemed to
bother him more. – And looking back,
we can see it, but at the moment, we thought maybe he was
just a typical teenager. – [Melissa] Debbie and
Larry say the stigma that goes along with mental
illness has been the biggest barrier during their journey
taking care of their son. – I think one of the biggest
thing that bothers me the most people think intellectual disabilities
and mental illness is the same thing
and it’s not. Mental illness, mental
health, they are very intelligent individuals. I even think family members
talk to him differently like he’s a child, not
adult conversations. And just him living
in the community. I mean, there’s not
many people that really reach
out to him. – [Melissa] What
challenges do teens with mental health
problems face? – Teenagers frequently
get disconnected from pediatricians
and get to specialists like clinical
psychologist, like you are and psychiatrist
through other routes. How do they get to you? How are these problems
picked up in teenagers? – Often times the teenagers
will come to us from pediatricians as you said, but most often from
parents themselves because a teenager
when he or she is acting up usually
are acting up in ways that are pretty visible
and the parents often times feel like they can’t
handle it on their own. – Is there a difference in
the natural history as to whether you recover from one? Is it like having pneumonia? Can you make a diagnosis and
treat one of these diseases and that’s the end of it? – Some of them you can. That’s the optimist in
all of us who deal with behavioral and developmental
issues in kids. We really believe that
many of these issues can be fixed if you can. Unfortunately, some can’t. And I let my developmental
pediatrician expert and psychiatry expert
speak to those, but a lot of issues that
you’re talking about can be treated and can
have very good outcomes with proper
evidence-based treatment. Medical and psychological. And so we really are
seeing great advances. For the past probably 100
years there’s been no path or mnemonic markers for
psychiatrists psychology. You can’t take a blood sample
and tell if somebody has anxiety versus
depression versus ADHD. We’ve gotten much better
at diagnosing these things with measures
and with reports and much better at
using good treatments to get kids the help they
need in a timely manner. (slow music) – [Melissa] Statistics show
the state of mental health in Mississippi is not good. According to the National
Center for Children in Poverty, One in five children
in Mississippi, approximately 131,000
have a mental disorder or health problem. Half of all lifetime
mental health disorders start by age 14. – You have your
kids that are having minor symptoms of depression, anxiety, which of course, may
run through the family. Family genetics always
plays a toll as well. Then you’ve got
the kids that on the severe end
of the continuum that are receiving
services from multiple
agencies, but even before that
had risk factors that put them in place to have mental
health problems issues anyway and those
types of things are low income
poverty levels, the family dynamics,
single parent households, child abuse, domestic violence, neglect. – [Melissa] According to
Mental Health America, when compared to other states
and the District of Columbia, Mississippi is near
the bottom of the list with the highest rates
of mental illness and lowest access to care. According to the Kaiser
Family Foundation, 32% of adults report
poor mental health with slightly more
women than men and more blacks than
whites reporting poor mental health. Experts say there are varying
degrees of mental disorders and that early
detection and treatment are extremely important. – We asked families
of young children, what are you experiencing and it was children at-risk
for mental health challenges, and they were saying
that their children had some really
significant problems and they wanted
to get them help, but first of all no one believed
that children that young could have problems and
then they had a lot of fear that by saying that, my child’s having
these problems, I don’t know what to do
when he won’t go to bed, and he’s staying up all night, and he’s throwing things
in stores all over, that their child was gonna
get taken away from them because people’ll
look at them and say, well you’re just a bad parent
and that’s the problem. And in reality, what
they were needing was help that would really
address that child’s needs. It’s not about labeling
a child at that age. It’s about identifying symptoms
that we know if we treat them early, they’re going
to go down a better path than they otherwise would have. (slow music) – [Melissa] Where can you
access mental health care? Coming up on Southern Remedy. – Well, one of
the things that quite honestly
breaks my heart is seeing how many kids
end up in emergency rooms having never
had anything really done for them from
a brain health standpoint who end up getting
picked up by the law for drug
or substance abuse, fights, acting out. All kinds of
behavioral disorders and then they go right
to the psychiatrist if they can get
to see one. Is that frequent
in your practice? – Well it is. The majority of young people that I
see are referred by criminal justice system. Depending on the
ethnic cultural group, that has a big influence
on whether or not someone goes to
the emergency room for treatment or whether
or not they go to their primary care physician,
or whether or not they seek
psychiatric help. Young people, by the
time they get to me because of drugs
and violence and not functioning
in school, if a child has a
learning disability or they’re not able to read
or understand very well, then they go to
school and they don’t let anyone know that they’re
having these problems, so rather than allow
themselves to be identified as someone who’s slow, then they’ll act
out and act bad, so it’s more
acceptable to be bad than to be slow, so
those children frequently fall through
the cracks. Their behavior
becomes so intolerable that they get
suspended from school, subsequently
expelled from school and then they’re
on the streets with other children with
the same type problems. Then they continue
to use more drugs. Continue to create more
crimes and then it becomes a vicious cycle and if
we’re not able to intervene early enough
then they end up in the criminal
justice system. (slow music) – Fortunate for us
in our community, we have Alliance Health Center who has been a partner
from the very beginning with our program as well. They have services
for adolescents and they are our
single point of entry for a juvenile. The same type
of process occurs where they’re
assessed, a determination is
made as to what to do to help them next. – [Melissa] Chief
Deputy Ward Calhoun of the Lauderdale County
Sheriff’s Department says his department gets
calls on a daily basis about people in a
mental health crisis. The majority of them
are adults, but when a parent of a
teenager in crisis calls, a specially trained crisis
intervention officer takes the child to a
mental health facility for an evaluation. Those juveniles would not be in an area with adults. They are separated. The idea is that CIT
officer attempts to build as much rapport
with that individual and help them to understand
that they’re not there to hurt them, that
they’re there to help them to get some help and we then
try to do what we commonly call a warm hand off where
we take that individual that now we have been trying
to build some trust with, they’d been riding in
the car with us there and we’re not in a hurry,
but very calmly introduce them
to the staff. Try to call them
by name. Talk with them. Spend a few minutes there. That little bit of
paperwork to do. Helping them to adjust to
this new place they’re at because many times
they’re scared. Where am I? What exactly
is gonna happen to me? Talk to them a
lot about okay, she’s a nurse,
he’s a nurse. They’re gonna ask
you some questions. They’re gonna
help you. It is an assessment,
a series of questions where they learn about
their medical history. They learn about if they
had any kind of diagnosis, who treats them, that kind of thing and then they make determinations
about what, if any, meds need
to be given to them depending on the
situation, calm them down. Many of the people we deal
with are very anxious or frustrated and so
many times they’re given what they determine is the
appropriate medication to calm them down and
then typically, those individuals
within a couple of days are able to be released
back out to go home for follow up visits
with their doctors. Those kinds of things. – [Melissa] But when
the law is broken, regardless of age, there
are still consequences. – You can’t rob a bank and
run out in the yard and say, out in the street
and say, I’m having a mental health crisis,
and we go, oh okay. Well let’s put the money back
and we’re now gonna carry you for an assessment. That’s not the
way it works. If that juvenile
has violated the law in some form or fashion and
they are ordered to go there by a youth court judge, that’s
just what’s gonna happen. Many times, you
might not always know that there a mental health
aspect to what happened. In the juvenile facilities
that we utilize for the youth in Lauderdale County, part of that introduction to that
location is part of their coming into it is
there’s an evaluation and then there are mental
health services available to that youth
who’s being housed in a juvenile facility. – [Melissa] Children at-risk
with Dr. Rick deShazo. – It seems to me that poverty and culture and race and access to care and food, all of those
social determinants of health feed in not only to developing
developmental disorders, but also in treating them and good mental health. Am I close on that? – You’re absolutely on target. There was a study done
called the A study. The Adverse
Childhood Event Study done by a big healthcare
consortium in California, Kaiser Permanente, and
they looked at adults and what happened to them
when they were children and this was a study
done on middle class working adults and
what they found was that children who
had bad events during their childhood, whether it was a
chronic illness, poverty, if they had a parent
with a chronic illness, or a death, or some sort of other
violence in the home, child abuse,
anything like that the more of those negatives
that these children had when they
were children, the worse the outcome
is for the adults. That’s why it’s
so important not to get these
children to adequate help by the time they get to
Dr. Summers right now, but to get them to
adequate help a lot sooner. – What is most important? Do kids who end
up with these poor brain
health syndromes, what is the origin, or
mixture of all that? – So your question’s
a very good one. How much of it
is genetics? How much of it
is environmental? It’s all. But I will say this. A lot of those things– Human beings
are very resilient. We’re built to
handle tough times. We’re made to
handle things that don’t go our
way often times. We’re made to handle
hurricanes that slam the coast. We’re made to handle trauma. You hear about the times when
people don’t handle it well, what you don’t hear
about are the times when people do
handle it well. However, in that
whole area, again, we’re the optimist here. We want to help people
overcome some of those things that seemingly are
un-overcome-able. Those things that are
so huge like genetics and biology and
neurochemistry. You can tamper with that
through good therapy. That’s not just talk therapy,
it’s medical therapy as well. Medicine and
developmental care. So we really are
seeing changes from the environment, but
also because of the treatments we’re providing
these children. – [Melissa] All
episodes in this series on mental illness
in children are available on the PBS video app or on the MPB Youtube channel. – Go to mpbonline.org
for web extras and more discussion about
children’s mental health. – For all of us here
at Southern Remedy, thanks for watching. (slow music) – [Voiceover] Southern Remedy
is underwritten a grant from the University of
Mississippi Medical Center. – [Voiceover] This production
is part of American Graduate. Let’s make it happen. A public media initiative
made possible by the Corporation for
Public Broadcasting.

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