Myths About Children’s Mental Health

May 6th, 2010

Today is Children’s Mental Health Awareness Day; a day to raise awareness about mental disorders affecting children along with effective mental health treatment plans available for children and adolescents.  

There are many myths regarding mental illness in children, the most common three myths are listed below.

Myth 1: Mental illness in children is caused by poor parenting.

Mental health disorders, similar to diabetes or high blood pressure, are legitimate medical illnesses. Research indicates that a combination of biological and environmental factors contribute to mental illnesses in children.

Examples of biological factors include: genetic contributions, neuro-chemical imbalances, and damage to the central nervous system due to exposure to toxins or as a result of head injury.

Examples of environmental factors include: common stressors such as divorce, death of a parent, exposure to violence or abusive situations, academic difficulties, bullying episodes and social alienation.

Myth 2: Children or adolescents do not suffer from depression or anxiety disorders. Any problems they have are simply a part of “growing up.”

Just like adults, children and adolescents can develop a severe mental illness. One in ten children in the US have a mental illness that is severe enough to cause impairment.  However, only 20% of the children diagnosed receive the necessary mental health treatment.

Myth 3: If children tried hard enough, they will “snap out” of depression or anxiety related symptoms. However, anger outbursts and opposition in children are character flaws that need to be addressed in a disciplinary manner.

Experiencing severe depression or anxiety has nothing to do with being weak. These symptoms result from changes in the child’s brain chemistry, which is secondary to biological or environmental stressors.

Many biologically based illnesses in children, like: autism, depression, anxiety disorders, ADHD, and bipolar disorder are associated with anger outburts, oppositional behaviors, and meltdowns. It would be detrimental to a child’s treatment to categorize such behavior as a “character flaw” when medical treatments are readily available to help regulate mood swings and reduce anger and opposition.

If such symptoms are present in a child, a psychiatric evaluation is strongly recommended in ruling out treatable mental illnesses. If the child is diagnosed with a mental disorder, a broad range of services are available and sometimes necessary to provide adequate treatment so the child can be productive in life.

Apex Behavioral Health has several child psychiatrists and numerous child therapists available to help make life more enjoyable for you and your child.

Research found that nearly one-third of caregivers of young children with mental health challenges reported less train 6 months after their children entered services in a system of care.  Caregivers reported less strain in feeling sad, unhappy, or isolated, as well as  less disruption of family routine and missed work due to their child’s emotional problems.

“The earlier we recognize a child’s mental health needs, the sooner we can help,” said SAMHSA Administrator Pamela S. Hyde, J.D. “Early recognition and intervention can prevent years of disability and help children and families thrive. All parents should learn to recognize the signs and symptoms of mental health problems in early childhood; furthermore, they should seek help for their child’s mental health problems with the same urgency as any other health condition.”  

Troubling Increase in Suicide Rate in Prosperous South Korea

April 29th, 2010

Choi Jin-young hanged himself last month with an electrical cord. The 39-year-old actor wasn’t getting any work in local TV, police said, and he had been depressed since the suicide of his famous older sister.

The sister, Choi Jin-sil, was known as the “nation’s actress.” When she hanged herself in her bathroom in October 2008, a wave of sympathetic suicides swept South Korea and 1,700 people took their lives the following month.

Seven months later, former president Roh Moo-hyun jumped off a cliff to his death. “I can’t begin to fathom the countless agonies down the road,” he wrote in a note.

Daul Kim

Daul Kim

Then 20-year-old Chanel model, Daul Kim, killed herself, posting a blog entry that said: “Mad depressed and overworked.” Another said: “The more I gain, the more lonely it is.”

In 2008, there were 35 suicides per day; which is a suicide roughly every 40 minutes. The suicide rate in a nation of 50 million people has doubled in the past decade and is now the highest in the industrialized world.

The suicide rate in 1982 was 6.8 per 100,000 people, similar to rates reported in Spain, Greece and Italy. The countries did not see their suicide rate spike during periods of economic difficulty like Korea did in 1997.  The rate of suicide peaked in the 1980s for other wealthy countries, but the numbers in South Korea continue to climb. Twenty-six people per 100,000 committed suicide in 2008 (the most recent year for which data are available); 2 1/2 times the rate in the United States and significantly higher than in nearby Japan, where suicide is deeply embedded in the culture.

The government is hoping to decrease the rate to below 20 per 100,000 people by 2013, but there has been little progress. Korean society considers suicide and depression personal matters.

“This is the dark aspect of our rapid development,” said Ha Kyooseob, a psychiatrist at Seoul National University College of Medicine and head of the Korean Association for Suicide Prevention. “We are unwilling to seek help for depression. We are very afraid of being seen as crazy.”

Many leading hospitals have created departments of “neuro-psychiatry” in hope that the public perceives treatment as a medical condition and not a public admission of “crazy.”

Attempts by the Ministry of Health and Welfare and suicide prevention to interview families of suicide victims has yielded little information. “When we go to the families and ask questions about why it happened, they say to us, ‘Do not kill him twice,’ ” Ha said. “We have tried to interview hundreds of families, but we have only been allowed to talk to a few of them. If one is dead from suicide, everything is a secret.”

Suicide is the leading cause of death among South Koreans in their 20s and 30s, and it is the fourth leading cause of death overall, after cancer, stroke and heart disease.

Incidents of suicide are increasing among the rural elderly that is probably driven from isolation, illness, and poverty. Police investigators say that the long hours young South Koreans spend online provides opportunity for young people to meet and plan group suicides, even if they live in different cities.

Finland was once seen as the suicide capital of the world and was the world’s first country to take a concerted approach for suicide prevention. The suicide rate in Finland rose continuously for 30 years since 1950 but a nationwide program between 1986 and 1996 reduced the rate from 30.3 per 100,000 people in 1990 to 20.4 by 2004. The Korean government is hoping to decrease the rate to below 20 per 100,000 people by 2013.

Korean celebrity suicides have caught the eye of the public and the news media is caught up in a flurry of chain reaction suicides among the famous.

Former President Roh Moo-hyun leaped to his death in May 2009. The former democracy activist whose term had ended in 2008 was said to be under intense pressure and allegations that he and his family had accepted $6 million in bribes when in office. After his death, Justice Minister Kim Kyung-han announced the investigation would end.

Roh Moo-hyn

Roh Moo-hyn

Roh faced police allegations regarding if him or his wife had taken money from a wealthy shoemaker. Roh said they took $1 million, which was to settle a debt and was not a bribe. He said he believed the $5 million given to a relative was a legitimate business investment.

The note of the suicide text, released by the Yonhap news agency, said: “The rest of my life would only be a burden for others. I can’t do anything because I’m not healthy. I can’t read books, nor can I write. Don’t be too sad. Isn’t life and death all part of nature? Don’t be sorry. Don’t blame anybody. It’s fate. Please cremate me. And please leave a small tombstone near home. I’ve long thought about that.”

The soap actor Choi Jin-young’s suicide generated front-page headlines, reminding the public of the suicide of his beloved sister, who killed herself after becoming distressed over Internet rumors that linked her to the suicide of another celebrity, comedian Ahn Jae-hwan.

No studies have found a statistically significant increase in suicide among the nation’s elite. However, the news’ fixation on the suicides worries Ha.

Government data show that suicides can trigger copycat behavior.

Choi Jin-sil’s death triggered a 70 percent increase in the suicide rate. It lasted for about a month, resulting in 700 more deaths during that time than would normally be expected.

“Famous suicides have a really bad influence,” Ha said.

Choi Jin-Sil, Actress

Choi Jin-Sil, the "nation's actress"

Violent Behaviors Involve One in Four Girls

April 29th, 2010

When one thinks of violent behavior among teens, the first image that comes to mind may be a clump of boys fighting in a school hallway or park. Violent behavior among adolescent girls can be a problem as well.

A recent report from SAMHSA’s National Survey on Drug Use and Health shows that among girls age 12 to 17, 18.6% got into a serious fight at school or work in the past 12 months. 14.1% participated in a group-against-group fight and 5.7% attacked others with the intent to hurt them seriously. girls-fighting

More than one-quarter (26.7%) of girls in this age group engaged in one of these types of violent behavior in the past year, based on averages for 2006 through 2008.

Other key findings indicate that the percentage of girls engaging in these violent behaviors varied by family income, substance use, and school-related characteristics.

Family Income. Prevalence of these violent acts in the past year decreased as annual family income increased. Violent behaviors were reported by 36.5% of adolescent females who lived in families with annual incomes of less than $20,000; 30.5% of those in families with annual incomes of $20,000 to $49,999; 22.8% with annual incomes of $50,000 to $74,999; and 20.7% with annual incomes of $75,000 or more.

Substance Use.  Adolescent females who engaged in any of these violent behaviors in the past year were more likely than those who did not to indicate past-month binge alcohol use (15.% vs. 6.9%), marijuana use (11.4% vs. 41.%) and use of illicit drugs other than marijuana (9.2% vs. 3.2%).

School Attendance. Adolescent females who were not currently enrolled in or attending school were more likely than those who were in school to engage in one of these violent behaviors in the past year (34.3% vs. 26.7%).

Grades. Among those who attended school in the past year, rates of violent behaviors increased as academic grades decreased. About one-sixth of girls who reported having an “A” average (16%) engaged in a past-year violent behavior compared with 26% of those with a “B” average, 38.5% of those with a “C” average, and 52.6% of those with a “D” average or lower.

Despite media attention on high profile accounts of females’ acts of violence, rates of those violent behaviors among adolescent females remained stable when comparing combined data from 2002 to 2004 with those for 2006 to 2008.

San Diego county has also linked adolescent violence to underage drinking but included several other elements, such as: social pressures, jealously, and pride as factors leading teenage girls to fight.

Fallbrook High School principal Adam Dawson believes, “It may be a combination of illicit drug use, family issues, or simply looking for a way to be connected. It can also be social pressure, this is why it is so important to have solid, healthy friends.”

The statistic of one in four girls aged 12 to 17 committing an act of violence at school or work pushes the percentage of girls involved in violent behavior to 26.7%, slightly higher than boys involved with violent behavior, which is 25.4%.

High-school aged girls have other reasons for becoming violent, besides binge drinking.

 “Some girls are just dumb,” said Torrey, a 15-year-old high school student. “They think that they are guys and want to fight like them. I knew this one girl who thought she could fight like a boy, and ended up getting into a fight with them. She was beaten with a stick.”

Statistics from the San Diego Association of Governments (SANDAG) revealed 164 adolescents who were arrested in 2008 were interviewed; 25 percent of those were girls under 17 years of age. The SANDAG report also revealed that a higher percentage of girls were arrested for violent behavior compared to boys; 37 percent versus 31 percent.

“Some girls like to be known as fighters, and the just don’t care,” said Ellie, a high school freshman. “My cousin would punch and push me. She was proud of [being a fighter]. She isn’t even afraid of going to court or being sent to juvenile hall. All she says is that she’ll get out and beat [the person she was fighting with] up again. They do it to just be bullies.”

“Sometimes it’s because of  a boy,” said Lauren, a high school sophomore. “It’s one of the dumbest reasons to get into a fight, but if a guy flirts with another girl, his girlfriend will start something. A lot of it is drama, like a girl thinks someone looks at her weird or talks bad about her. They mad-dog each other and try to start something. They start yelling at each other to watch their backs.”

Previously, boys and girls exhibited different rates of violence but in the last few years arrests for girls has increased higher than arrests for boys.

“These girls like doing it where people can see it, too,” said Lauren. “Last week at Fallbrook High School, a fight broke out in the bowl [the open part of the high school campus] at lunch, so everyone could see the fight.”

According to the high school girls, the fights between teenage girls are not simply a few pushes and slaps.

“Some girls punch, slap and pull hair,” said Tara, a junior who had been in a fight several years ago. “Personally, I punch, but that’s just me. I know of a girl who got a chunk of hair pulled out in a fight, and another girl who bit someone in a fight.”

According to Sheriff’s sergeant Amy Brown, the Fallbrook substation doesn’t get many calls of teenage girl violence. However, when they do occur, Sheriff’s deputies investigate the incident to find the individual at fault and charge them with misdemeanor battery. If there is significant bodily harm, the individual who began the fight is charged with felony battery.

Dawson believes that desensitization to violence places a major role.

“It’s the norm; they see it on TV, at home and online,” he said. “Every high school is battling this, and have strict policies based on the California educational code.”

“We often associate acts of teenage violence with boys; however, the problem is also pervasive among girls,” said Nick Macchione, director of San Diego County’s Health and Human Services Agency. “It’s extremely important to remind girls, and boys, that there are more constructive ways of handling stress and anger. Violence is never the answer.”

Suicide Prevention on Campus

April 29th, 2010

“Our Campus Suicide Prevention grantees are generating critical new ideas for reaching students and helping them lead safe and healthy lives.”                           

  -Richard McKeon, Ph.D., Special Advisor for Suicide Prevention

Innovation in Gatekeeper Training

Avatar - the word is all over the media; but can technology help people learn how to identify someone in distress?

Wii Avatar

Wii Avatar

That’s the strategy Joy Himmel, Psy.D., Director of Health and Wellness at Penn State Altoona, is employing to train campus faculty, staff, and students to recognize when someone needs help.

In 2008, Penn State Altoona received a Campus Suicide Prevention Grant from SAMHSA and is using the funds to set up an innovative Web-based gatekeeper trainings for faculty and staff. Next on the list is reaching the 4,100 students who live on campus.

Dr. Himmel plans to use a gaming plan to reach them. Similar to the online world of Second Life and video game consoles like the Nintendo Wii, students will use an avatar. But they won’t be playing a game - they’ll be learning to communicate with at-risk students.

Using a product developed by Penn State University Park, Dr. Himmel adapted a faculty and staff gatekeeper training for the Altoona Campus; the product went live in fall 2009.

“Worrisome Student Behaviors: Minimizing Risk,” features three vignettes that focus on school violence, trouble between classmates, and a student’s erratic behavior, as well as commentary from Penn State counselors.  Faculty and staff can visit the Web site whenever it’s convenient for them - 24 hours per day. The program takes under an hour to complete.

Also included are links to campus-based resources as well as information on how to refer a student to the Health and Wellness Center. More than 100 people have taken the training since October 2009. “We’ve seen great success in terms of university involvement,” Dr. Himmel said.

Currently in development and set for launch in May 2010 is a pilot program that allows students to enter a virtual environment of peers via the technology of avatars.

Two out of five students in the virtual space are identified as having difficulties in academic progress, attitudes, or behavior. Users can communicate to these students and learn skills in identifying students at risk, approaching them, and referring them to resources. “It’s very interactive,” said Dr. Himmel. “If you ask one question, the student will give a certain answer, and then you have to decide how to respond.

If users chose an answer that may not be the best thing to say in a given situation,  the program will give cues for better options.

Students especially are familiar with these types of online environments, Dr. Himmel said. “And critical information is brought directly to them, eliminating the need to carve out several hours for in-person training. I think this kind of technology is where we need to be.”

Cultural Competency Matteres

When they applied for a SAMHSA Campus Suicide Prevention Grant for Tufts University, Michelle Bowdler, M.S.P.H., and Bonnie Lipton, M.P.H., already had cultural competency on their minds.

“As an institution, Tufts really values diversity,” said Ms. Bowdler, Senior Director of Health and Wellness Services. The university operate six culture centers: Asian American, LGBTQ, Latino, Women’s, Africana, and International.
Tufts University

Tufts University

“When we wrote the grant proposal, we informed the center directors about our plans for cultural competency focus groups,” said Ms. Lipton, Program Coordinator and Evaluator for Tufts Community Cares. “We asked them what mental health topic would resonate with their students.”

In spring 2009, Tufts held focus groups with each center, speaking to more than 50 students in total.

“We wanted to learn more about what mental health issues students are facing, how they cope, who they turn to for help, and what else the university can do to help,” Ms. Lipton said.

Focus group questions related to five different areas:

  1. Perceptions regarding student mental health problems on campus
  2. Attitudes about informal help-seeking
  3. Attitudes about counseling services
  4. Beliefs about helping peers
  5. Ideas for enhancing help-seeking behavior for mental health problems.

All six groups discussed how much stress students experience. “Tufts is a rigorous school, so the students are under a lot of academic stress,” Ms. Lipton said. “They also may feel they need to compete with their classmates.”

As a result of this feedback, Tufts Community Cares sponsored stress management sessions at the Africana Center during finals in fall 2009. More sessions are planned, focusing on ways students can take better care of themselves.

“The focus groups allowed us to talk to students about what their culture, race, ethnicity, or religion might lead them to think about mental health care. That information is helping us to create programs and products that will be effective for suicide prevention,” said Ms. Bowdler.

For example, the Latino Center will hold a discussion with first-generation students about their experiences. Planning is under way for discussions open to all first-generation students at Tufts.

In addition, some members of the Asian American focus group expressed concern about how positive and negative stereotypes affect them. A general presentation and another focusing on women’s mental health will be held in spring 2010.

The focus groups had another positive effect on the students. In their evaluations, many students indicated that the discussion helped make them more willing to talk to someone.

Ms. Bowdler feels that Tufts is on the right track. “The simple act of inquiring how to respond to the needs of a specific community helps people feel more comfortable asking for help.”

 

Sexual Paraphilias

April 29th, 2010

In 2005, the Seattle Times wrote a report on an Enumclaw, Washington man who died from intimate activity with a horse. The article was the year’s most read article on the Times’ website in highly educated Seattle. Four follow-up stories continued to enroll in the newspaper’s top 20 list and when a columnist wrote about the popularity of this story, his article shot to the top of the most read list.

In April 2010, a similar story occurred and by the morning it was the most read story. In the most recent article, Douglas Spink allegedly provided animals for sex acts on a bestiality farm in Washington. There is a suggested connection between Spink and the man that died in the Enumclaw horse sex case, Kenneth Pinyan. Bestiality was not considered a crime in Washington when Pinyan died. After his death, it was made a Class C felony, punishable by 5 years in prison.

 The Associated Press reported that Spink repeatedly contacted jail authorities in Tennessee regarding James Michael Tait, an inmate jailed on bestiality charges. Tait has previously confessed to authorities that he videotaped sexual acts executed by the man in the Enumclaw horse sex case.

Authorities raided Spink’s animal farm on April 14, 2010 on suspicion of Spink violating his federal probation stemming from drug related charges, and arrested Spink and an English tourist, Stephen Clark, whom was later charged with three counts of cruelty to animals, a first degree felony. The raid was conducted by the County Sheriff’s Office in assistance with the U.S. Marshals office and the FBI.  Authorities seized large dogs, horses, and mice. Thirteen mice had to be euthanized. Thousands of child pornography and bestiality images were allegedly found on the property as well.

Bestiality, or zoophilia, is one of several sexual paraphilias. The porn industry has a section devoted to zoophilia; so while the majority of people  are aware zoophilia occurs, very few people have met an actual zoophilie who is open about their paraphilia.  

A sexual paraphilia is intrusive to the point that it affects a person’s day to day activity, the normal functions of a person, and causes emotional, physical or mental distress. As previously stated, there are several different sexual paraphilias.

  • Exhibitionism is the most commonly arrested paraphilia. It involves a man exposing his genitals to an unexpecting stranger, most likely a woman or child.  The individual exposing himself may need the look of surprise on the stranger’s face in order to get aroused. Commonly, this occurs when the perpetrator is driving in their car, so they can easily expose themselves to a group of people and drive away without being identified.
  • Fetishism is characterized by intense sexual fantasies or behaviors involving inanimate objects. The individual uses a nonliving object (wigs, women’s stocking) in a sexual manner. The individual most likely can not become sexually aroused without the object present. Fetishes can range from shoes to underwear to wigs.  
  • Frotteurism is the intentional touching or rubbing of genitals against an unsuspecting person. This often occurs in an inconspicuous environment, such as a crowded bus, subway, or elevator where the brushing against can easily appear accidental. When college aged males partook in a sexual survey, frotteurism is the paraphilia most men admitted to doing at some point in their life.
  • Voyeurism is most commonly known as the peeping tom syndrome; spying or observing an unsuspecting stranger who is undressing or naked. People may not be aware that they are being observed, but voyeurism is easily prevented by closing one’s blinds.
  • Sexual sadism involves inflicting pain, humiliation, or suffering on another human being. In the porn industry, sexual sadists are referred to as a dominatrix. CEOs or powerful executives are often clients of dominatrixes.
  • Sexual masochism refers to the person receiving the pain inflicted by the sexual sadist. The individual may be humiliated, beaten, bound, or made to suffer in some way.
  • Pedophilia is the sexual attraction to children before they have gone through puberty, typically age 13 years or younger. The perpetrator should be 16 years of age or older. High school student - teacher relationships, like Mary Kay Letourneau’s relationship with her student, are  not considered pedophilia because the male student is post pubescent.

Many people ponder what causes pedophilia. Psychologists are not certain if the individual, who is generally male, has a brain that is wired differently or if it is learned behavior.

If  sexual paraphilias are learned behavior, psychologists theorize how it happens. Initially, the male feels a sense of heightened arousal when he sees a specific stimulus. It is important to note that this is not sexual arousal, the arousal could be attributed to anxiety. It is an arousal of the senses, not the genitals. However, the individual mistakes this feeling of anxiety as sexual arousal and strengthens and reinforces the arousal through masturbation.

Some people who fantasize about deviant behavior may never act on it. For those that do, the internet serves as a meeting ground for people with deviant sexual behaviors to swap stories and create a sense of community. Talking to other individuals who share the same sexual paraphilia will only strengthen the attractions and create a false sense of security regarding the legality and justification of their (illegal) actions.

As evident by the popularity of the man/horse story from Emunclaw county, people are disgusted yet intrigued by certain sexual paraphilias. Perhaps this is due to the taboo nature of the subject and the rarity of it in an advertising world where sex sells. Sexual paraphilias are intrusive in one’s everyday life and treatment is available at Apex.

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