Young kids battling mental health issues are on the rise

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The need for mental health services is on the rise for elementary-aged children, according to Pamela Brown, executive director of the Anne Arundel County Partnership for Children, Youth and Families.

In kindergarten classes around Anne Arundel County, more teachers are dealing with students who bite, throw chairs, can't relate socially and can't focus on their work.

In emergency rooms, nurses are shocked at the increasing number of children arriving with mental health issues — and the number of parents who don’t know how to help.

Mental healthWBrown recently wrote the county’s Community Health Needs Assessment, which found public mental health services for children ages 6 to 12 increased by 14.5 percent from 2012 to 2014. The assessment was a joint undertaking led by the Anne Arundel County Department of Health, Anne Arundel Medical Center and University of Maryland Baltimore Washington Medical Center.

“It runs the gamut from the behavioral issues all the way up to things for which you really need intervention from a mental health expert,” Brown says.

Mental health professionals say they’re seeing a similar trend across central Maryland, with children as young as age 2 receiving services.

“We are seeing children, even younger and younger children, needing mental health services,” says Susan Perkins-Parks, director of the behavior management clinic at Kennedy Krieger Institute in Baltimore. “We get referrals from day care centers and preschool programs where people aren’t able to manage those kids.”

Experts say potential reasons range from improved awareness of mental health and access to services to issues like bullying, family stress, and academic and social pressures.

To address the increase, local and state leaders are working to fund additional mental health services. But for parents, experts say the first steps are identifying early warning signs and discovering where to go for help.

Recognizing a problem

Bryce Greenberg was a “perfect” baby, says his mother, Tracy Greenberg. Yet when he turned 18 months old, his behavior started to change.

“He began having night terrors,” says Greenberg, of Potomac. “They’re basically like nightmares on steroids.”

When Greenberg enrolled her son in music and “Mommy and Me” classes, she noticed the differences even more.

“He never would sit in the circles. He didn’t really want to participate in a lot of the activities,” she says. “He would just kind of do his own thing.”

Still, plenty of toddlers don’t like to sit, and many can be oppositional, Greenberg says. In the following years, Bryce stopped napping, became hard to soothe and began displaying violent behaviors. When kindergarten hit, that’s when Greenberg knew Bryce needed help.

“Kindergarten I can remember vividly,” Greenberg says. “At that age, things that were not typical — throwing chairs, refusal and not doing any work.”

As Bryce aged, the violence progressed. At times, he would bang his head against the wall for an hour. Doctors diagnosed him with attention deficit hyperactivity disorder (ADHD) and eventually with bipolar disorder and anxiety.

Less stigma

Mental illness is defined by the National Alliance on Mental Illness as a condition affecting a person’s thinking, feeling or mood. About half of all mental health conditions begin by age 14, the alliance says.

One of the main reasons more people are seeking mental health care for young children is the stigma around it has declined, says Dr. Meena Vimalananda, medical director of Sheppard Pratt’s child and adolescent services in Towson and Ellicott City.

“There is a greater awareness of mental health services in recent years,” she says. “These are legitimate illnesses. This is not something to be ashamed of, and it can be treated.”

Passage of the Affordable Care Act also boosted access to mental health clinicians, experts say.
But just what are the issues driving more parents to seek mental health care for their kids?

“The truth is, we don’t really know,” Brown says. “We’ve got a whole lot of educated guesses.”

Rising stress levels

Stress may be one possible reason for the increase in mental health needs.

“You get more and more families where two parents are working, and they’re working very long hours,” Brown says. “There’s stress in the household.”

That stress can be compounded by children’s pressures, both in and out of school, says Gina Richman, director of the child and family therapy clinic at Kennedy Krieger Institute.

“Kids have a lot of needs,” she says. “If something doesn’t go well, kids really take that very seriously, very personally — if they don’t have the right friends at school, if they don’t get invited to birthday parties, if they don’t get on a sports team. There’s a lot of pressure on these kids, and I think there’s a lot of pressure on parents. There’s not a lot of flexibility for them to work out a lot of these kinds of things when they come up in a very busy household.”

Military families often face added stress, such as parents being deployed or families having to move every few years, says Jennifer Crockett, director of training at Kennedy Krieger Institute’s Department of Behavioral Psychology.

“Children express that in different ways,” she says. “A 6-year-old is going to be really noncompliant and oppositional. A 12-year-old, you may see it more with how they’re interacting with their peers and forming social bonds. It’s not as if the children are necessarily showing signs of PTSD (post-traumatic stress disorder). They’re showing signs of disruption in their world.”

The recent recession may have also had an impact on the rising need, Brown says.

“Children were babies during that stress and during the anxiety and during that depression,” she says. “What we do know is that 0 to 5 is the most important time in terms of brain development, in terms of social and emotional learning.”

When a parent loses a job or can’t afford to pay the mortgage and the family home goes into foreclosure, adults aren’t the only ones affected, Brown says.

“If you think of the stress people were under during the recession ... stress is never just [on] the parents,” she says. “Stress feeds the children, too.”

Other possible culprits

Bullying is another potential reason mental health experts say they are seeing more young children.

“There was a time when kids were being bullied at school, and that was considered the norm,” Vimalananda says. “Not so much anymore. People are realizing the deep wounds and scars and that they should seek help.”

Technology may even play a role, as children are not learning the same social and emotional cues through human interaction as they did before smartphones and tablet devices were invented, Brown says.

“Young children learn to self-calm by a whole lot of touch and cues from mothers and others,” Brown says. “They weren’t getting that.”

Parents and children are not engaging each other in play and eye contact when their focus is on their phones, she says.

While reasons for the increase may vary, the sum result is the same for this age group, Brown says.

“Children cannot settle down at school,” she says. “So they go to school, and they’re not ready to learn. They’re not ready to sit in a classroom.”

Click next below for warning signs of mental health issues.

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