Posted by Caryn Bailey
As a new mom, I worried about all of the “normal” things like safety, illness, whether my daughter would talk by a year and a half or when my son would finally stop wearing diapers. Despite my background in nursing and my training in psychology, mental illness was at the bottom of my parental concerns. But with 1 in 5 young people in the US diagnosed with a mental health disorder, and symptoms of some illnesses presenting as early as 5 years of age, I should have been proactive about educating myself. Pediatric Mental Illness is real, the best thing we as a community can do to combat the stigma associated with it is to talk about it.
Childhood Depression, ADHD, and an array of mental illnesses are treatable, particularly in children. There can be many positive outcomes if we diagnose mental illness early, remarks Dr. Heather Huszti, chief psychologist at CHOC Children’s. At best, only one-third of children who require treatment for a mental illness receive it, which is why education, support, funding, and access to mental health resources is so vital.
Last week, I spoke with Dr. Huszti, who provided a wealth of information on finding the support you need for families of children with mental health issues. She provided a wealth of local resources, many of which are free to families. Additionally, she discussed how families can work with their public schools to gain support for their children and talked about how to reduce the stigma associated with mental illness.
For the family who has just received a mental health diagnosis, what immediate support can they find?
One of the best resources in Orange County, California is the National Association for Mental Illness (NAMI). The organization provides education classes for the individual who has been diagnosed and these classes are taught by at least one person who has had a mental illness. These classes, aimed towards children, families, and health professionals, have been tremendously helpful for providing education and support.
For families in search of a provider, OC Links can provide resources either online or by calling their phone number (855-OC-LINKS). Dr. Huszti also provided the following resources for families:
American Academy of Child and Adolescent Psychiatry: Offers a Facts For Families Guide
Saddleback Church: Offers a large ministry with pastors, support groups and other programs.
Jewish Federation and Family Services: Each Catholic Church organizes educational events and methods of support
CHOC has been working specifically with the above religious groups as part of their overall mental health initiative.
While there is a wealth of information online, Dr. Huszti cautions families to opt for a trusted source. Not only can the information found online frighten families, it can offer promises and solutions that are unrealistic. It should also be noted that the above resources (minus cost for treatment, provider fees or workshops) are free.
How can a family involve their public school in gaining support when a mental health condition is diagnosed?
According to Dr. Huszti, including the school as a partner is a good idea. Many families are hesitant to involve their school, but when the school does not know what is going on with a child, it can be difficult, if not impossible to provide the services that the child needs to be successful. Additionally, parents should know that it is within their rights to request an Individualized Education Program (IEP) meeting which develops a plan for each public school child eligible for special education or accommodations within the regular classroom for children with medical or mental health diagnoses. Families can invite whomever they wish to attend that meeting, either in-person or via phone. If a family is working with a therapist, he/she can call into the meeting or provide a written letter detailing the accommodations a child needs to be educated in the least restrictive environment possible. Schools are required to provide resources (as able) that will help keep children in a regular school setting if at all possible. If a child attends a private school, that school is bound by the federal government guidelines, provided they are receiving federal funding.
Parents should also seek support and assistance from their school’s nurse and/or counselor, who can provide information about mental health issues and develop a program to support them in school. Some of those accommodations might include things like omitting timed tests.
If you find that you’ve hit a roadblock, TASK is a parent group that advocates for kids with special needs. Their website is an invaluable resources for information and workshops which can help parents with topics like “What is a Section 504 Accommodation?”, “Bullying Prevention,” “IEP Tips,” and more.
What resources are available for families who have children with a chronic mental health condition?
When a child is diagnosed with a chronic or long-term mental illness, Dr. Huszti recommends involving a qualified pediatric psychiatrist. This will ensure that a proper assessment is completed to determine if medication is appropriate. While parents may have concerns about introducing medication into their child’s treatment regimen, they should know that a child/adolescent psychiatrist is less likely to recommend medication when compared to a pediatrician or a primary care provider. “We try to avoid medicating kids when possible, because their brains are developing,” said Dr. Huszti.
Families can also benefit from getting involved with a local support group. These groups are beneficial because they include parents who have walked their pathway. Information and advice on topics such as how to continue advocating for your child, can be invaluable.
If as a parent, you find your child with a severe mental illness approaching the age of 18, Dr. Huszti recommends talking to a professional about conservatorship, which involves identification of the person/s who will make medical decisions for your child.
What resources are available to help a family financially in the event of a chronic mental health condition?
Several county-based resources that are part of the Mental Health Services Act provide services for free or at a reduced rate. If you have commercial insurance, Dr. Huszti recommends calling your insurance provider to request a case manager for chronic and/or severe mental health conditions. A case manager can help with access to additional resources or facilitate entry into programs that have a lower cost.
The majority of children whose families are without health insurance will qualify for county-based insurance. As a provider, Dr. Huszti can often get more resources for children with county-based insurance when compared to commercial insurance. Families are encouraged to visit OC Links to find out about county-based programs which include therapists and psychiatrists associated with contracted clinics. Additionally, Full Service Partnerships (FSP), wrap around services, and in-home services can be accessed in severe cases where the family needs support to help the child succeed.
What can families do to receive support regarding the stigma associated with having a child with a mental health condition?
The stigma surrounding mental illness can cause a delay in seeking treatment with resultant negative outcomes. NAMI and Saddleback Church are active in this arena, aiming to provide education to combat stigma through classes and materials. Additionally, the Mental Health Services Act provides a stigma-reducing campaign (Talk About It) as part of their prevention and early intervention program.
“Stigma lives in lack of understanding” remarks Dr. Huszti. CHOC is also working to help families talk about mental illness through their initiative “Let’s Talk About It.” This online resource for adults and children provides questions and methods for talking about mental illness. Each Mind Matters, Reach Out Here and Walk In Our Shoes are additional resources Dr. Huszti recommends for helping families overcome the stigma associated with mental illness. These resources seek to debunk myths surrounding mental health and encourage kids and families to seek help.
“Myths live and proliferate in darkness. When we provide information and are willing to talk about it, that is how we break down stigma,” said Dr. Huszti.
What resources does CHOC provide and how can families obtain support and assistance specifically from CHOC?
In Orange County alone, there are 75,000-150,000 kids who require mental health services. This number is astounding, and no one facility can treat each of these children. Among the children CHOC serves is a specific population who have both a chronic medical condition and a mental illness. Because the chronically sick child is at higher risk for mental illness, CHOC specializes in this area and can treat, for example, depression in a child with epilepsy.
In spring 2018, CHOC will open a psychiatric unit for children ages 3-17 years of age. When the unit opens, these beds will be the first for kids in Orange County who require mental health care under the age of 12. At present, these children have to leave the county for treatment.
CHOC will also open an intensive outpatient program in the coming months, which will provide services for adolescents who require more than weekly therapy, but do not need to be hospitalized in a psychiatric facility. CHOC is working in collaboration with Hoag and Mission Hospital on this project.
In Orange County, mental health resources are fragmented, leaving families in need of access. CHOC is working to help families find the right place of expertise, develop a better system of care, and provide resources in collaboration with the Child and Adolescent Program at UCI Department of Psychiatry and Orange County Children and Youth Behavioral Health, among other community programs.
If you or a family member is in need of mental health treatment, don’t wait. Contact one of the above resources provided by Dr. Huszti or visit CHOC.org for additional support and information.