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American children visit the emergency room as often as 825,000 times a year -- not for broken bones or bellyaches -- but to urgently see a psychiatrist. Yet, aside from the select few who are suicidal, a threat to others or severely debilitated, most are discharged and sent home.
It turns out that a surprising number of ER patients are being seen for behavioral issues or a minor psychiatric crisis. A review of 2,900 records of ER patients ages 17 and younger showed the majority were brought to the hospital because of issues such as disruptive classroom behavior, verbal altercations and running away, according to a 2011 John Hopkins study.
Experts question whether these children need to visit the ER at all and whether they are unnecessarily taxing an already overstretched emergency care system.
“If somebody comes in with pneumonia, we give antibiotics and they’re fine,” said Dr. Muhammad Waseem, pediatric emergency physician at Lincoln Medical and Mental Health Center in Bronx, NY. “But, with mental health, they require significant resources, time, and services.”
Several reports confirm that pediatric ER visits for psychiatric complaints have risen over the last decade and continue to increase. National data presented last fall found that visits over an eight-year period -- from 1999 to 2007 -- had increased by 20 percent.
“[Parents] don’t know what to do,” says Dr. Gary M. Blau, clinical psychologist and chief of the Child, Adolescent and Family Branch of the U.S. Center for Mental Health Services. “They’re not sure what mental health conditions are and whether to be concerned about them or not.”
Dr. Tyeese Gaines
“Often the parents themselves feel unsafe, or the home situation is unsafe, such as for a younger sibling,” says emergency medicine doctor Dr. Audrey Paul. “They are in a state of crisis.”
The ER, however, is not the best location for pediatric mental health concerns, according to child and adolescent psychiatrist Dr. Jacqueline Smith at University of North Carolina Hospitals.
“The emergency department can be traumatizing for a child,” she says. “Also, appropriate staff may not be readily available for assessments or recommendations, leading to very long waits for these children.”
Paul agrees. “It’s loud. It’s overcrowded. And, privacy is an issue.”
Given the limited amount of available mental health beds for admitted children, Paul -- who is a pediatric ER physician and an associate professor of emergency medicine at Mount Sinai School of Medicine -- shares that these children can sometimes stay in the emergency department for over 24 hours.
Similarly, nationwide, children with mental health complaints are twice as likely to wait four hours or more than those with other ER complaints, subsequently contributing to ER overcrowding and limiting care to the other children waiting to be seen.
Some studies suggest that the increase in visits do not actually correlate to an increase in psychiatric illnesses among children.
“Unruly behavior can be the result of a psychiatric or medical illness, but it can also be the result of parents having difficulty setting limits,” Smith says. “If behavior is simply unruly, it should be addressed, but perhaps not in an emergency room.”
Tanya Haney-Miller, a school counselor in New Jersey, says that it sometimes comes down to discipline.
“A lot of parents are fearful of [child protective services], and parents don’t want anyone in their business,” she says. “They’d rather avoid disciplining their child because they think that the main way of disciplining is hitting. Some don’t know another way.”
Waseem acknowledges that parents have it rough, making it hard to give troubled children the type of attention and support needed to defuse such issues.
“Parents are living in a high-stress situation,” he says. “They don’t have adequate time. With economic issues, both parents are forced to work in order to sustain, and there is no one to adequately supervise the child.”
Children are exposed to these same high-stress environments which can lead to psychological outbursts after just a minor exposure to emotional trauma, Waseem adds.
He also points out that just because many of these children are discharged doesn’t mean the visit wasn’t warranted. At times, the complaints are issues that can be solved in the emergency department during a long ER stay.
Blau, too, says not to discount the demand for ER psychiatric care. The rates of mental health among children are significant: the U.S. Department of Health and Human Services reports that one in five adolescents has a diagnosable mental health disorder.
All of those interviewed felt that the lack of outpatient resources was a key factor in the increase in ER mental health visits. The most at-risk and economically disadvantaged patients make up a large amount of the visits.
Delinquent behavior: Criminalized rather than diagnosed
“There are simply not enough child and adolescent mental health providers, particularly psychiatrists,” Smith says. “As more parents lose insurance coverage, so do their children. This increases the number of children requiring community mental health services, straining that system. Out of frustration, parents turn to the emergency department.”
In some cases, even the outpatient resources that do exist, such as counselors and schools, still refer patients to the ER for behavioral issues rather than solely psychiatric ones.
“If the schools had programs in place to deal with these things, many of these visits could be avoided,” Paul says. “But, a lot of after school and community based programs have been cut.”
Haney-Miller says that despite her opinion that ER psychiatric evaluations often fall short of expectations, there are protocols to follow.
“Sometimes, it’s not even a thorough evaluation,” she says. “But, we still have to send them. It’s policy.” Haney-Miller adds that with certain mental health crises, the children can’t attend school until a psychiatrist evaluates them.
“They can opt to go to their private physician,” she says. “But, if they don’t have insurance or they have Medicaid, there may be a huge wait for the clinic, and they’re not allowed to return to school.”
Several schools near Lincoln Medical and Mental Health Center have mental health services embedded into their programs, according to Waseem. He says in six months, his ER only received three children from those schools.
“They are not referring their psychiatric children to the ER,” he says. “They are managing themselves.”
However, Blau cautions against broadly discouraging parents from bringing their children to the ER for evaluation.
“While there is truth to the overuse of the ER,” he says, “that one time a parent doesn’t go, there’s a tragedy.”
Dr. Tyeese Gaines is a physician-journalist with over 10 years of print and broadcast experience, now serving as health editor for theGrio.com (NBC News). Dr. Ty is also a practicing emergency medicine physician in New Jersey. Follow her on twitter at @doctorty or on Facebook.
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Black girls who cut themselves, and the pain of self-injury
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I have a child like this, and its not easy. He would get so angry he would punch holes in walls and froth at the mouth like an animal. His diagnosis was ADHD with anger issues, now controlled by medication, but not totally successful. Can someone explain to me though why this type of behavior is becoming more prevalent in today's society? Answer.... lack of discipline for fear of being turned in for child abuse by your own children! What about parental abuse! Today's society is so sick, a little spanking never hurt anyone!
Too Many bleeding hearts that don't want parents to displine the kids Go back to the days of spare the rod and spoil the child.... The laws of CPA's have started this don't spank it makes them hurt and they can get away with the bad stuff because they can call the child protective agency and get the parents in trouble..
ER's are now dealing with what teachers have had to deal with for 20 years. Parents don't want to parent, so let's make someone else do it. After all, parenting is harrrrrdd <sniff>. I agree that there are definitely children with genuine psychiatric disorders who need treatment, but not the high numbers ERs are having to deal with. They're just the after-school dumping ground for parents.
Diet and displine would be a good places to start. I hear all the time people running for pills to control their child and then they fill them up with processed junk food. Displine to make the child understand that behavior is not acceptable. Sadly so many children have been allowed to get away with doing what ever they want, they have no self control.
It is not illegal to spank your kids as long as you don't physically injure them (I used to work for CPS, so I know). Parents need to get a backbone. You have to start putting limits on kids (and there are lots of options besides spanking) starting around the time they walk-you can't wait until they are already in school, or, worse, a teenager and expect them to be well behaved. Most parents today are too lazy to be consistent in their discipline or to follow through with consequences. And don't tell me parents are too busy or too stressed. I was a single parent after my divorce when my child was almost two. Her dad was a deadbeat parent and I had no financial or other help from him-I had my child 24/7. I worked full time in a stressful job and had a second job on Sundays. I had to sacrifice a lot of personal time and my social life, but my child came first. She is 21 now attending one of the best universities in our state and she holds down a job. She has never been a significant discipline problem. Oh, and I rarely spanked.
A major issue is that mental health coverage (even with supposed parity) is minimal at best. Health insurance deductibles for mental health can be $500 to $3500. Few psychologists or mental health professionals take medicaid, as the reimbursement rates are so low that the time/paperwork would result in a loss of money. Renting office space costs more than medicaid pays in many states. In many states psychologists also can't even file medicaid. So the option is for a parent with low income to go to the ER and file it under their medical care vs. mental health care. That's why pushing more people onto medicaid does little to solve the healthcare crisis.
Guess you can blame the parents..they are the ones bringing them to ER instead of seeing a head shrink.
Medicare is easy to get..up to a limit only.
But Medicaid is hard to get..need to have the lowest of wealth..like $2000 tops!
The ER is being abused by people who do not have health insurance. It is not just these children with behavioral issues clogging the ERs, it is adults with the common cold or other non-emergency issues. Instead of waiting and going to a clinic or to a doctor they go to the ER. They give a fake name and address and then skip out on the bill. The last time I was in an ER it took hours for me to be seen because of all of these non-emergency cases clogging up the system. The problem is that this abuse has also affected the triage nurses in the ER. Certain cases that might have previously been given a certain priority are now looked at as being someone just trying to game the system. The triage nurses are making judgements about whether or not the person's symptoms that they are reporting are real or just an attempt to get quicker treatment. This means that people with legitimate serious issues are being pushed down the list and waiting longer to be seen.
I find the following statement in the article to be a little absurd:
The idea that one in five children has a mental health disorder is absolutely absurd. There is no way that this number is anywhere near reality. Part of the reason for this inflated number is the new attitudes that any kid who does not conform to some arbitrary definition of normal has a problem. The kid is a little shyer than most then they must be on the autism spectrum, the kid is a little more active than others then he must have ADHD, etc. There seems to be this need lately to place some type of label on everyone who is even a little bit different. Instead of accepting these differences as part of who we are they try and call it a disorder and push pills to make them conform to the way everyone thinks they should be. This is doing immense amounts of harm to these children. There is nothing wrong with some kids being shy and some being more outgoing, it is part of the natural variations in our personalities, not a disorder. There is nothing wrong with some kids having a little more energy than others, it is natural. These psychologists and psychiatrists need to stop trying to label everyone to increase their patient base and simply allow people to be who they are.
Maybe High Schools should offer courses in parenting because the parents aren't capable anymore. With all the conflicting information on raising children it's no wonder we have a confused society and getting worse. Many people are isolated from their extended family because of moblilty and thus you don't have Aunts, Uncles, Grandparents watching what goes on anymore. With all the illegitimate children with only one parent, things are much worse. Thousands more in foster care don't help.
Americans eat genetically engineered modified food every day... it is in milk, meat, grains, vegetable, fruits, peanut butter, and how many americans care about this ??? how about your food and water supply laced with hormones, antibiotics, PESTICIDES, and other poisonned chemicals, and no one question why are so many kids having mental illnesses, allergies, autism and other diseases !
LOOK NO FARTHER, YOUR FOOD SUPPLY IS POISONNING YOU AND YOUR KIDS ! and the FDA let it happen !
This is a real important issues that is not talked about by any of your politicians ! IT SHOULD BE TALKED ABOUT because it impact your lives and health !
I actually had 2 cops visit my house 2 days in a row because I told my 18 year old senior son that if he wanted to live there, he'd have to help out a little (~1 hour a day) with cleaning and yard work. He didn't think he had to (without getting paid )so he came home to his clothes out on the front lawn for him to pick up and go where ever.
What are parents supposed to do?
I am no expert in this issue but this is my take as I do have a kid who behaves good and is a model student in his class. But my way is to spend time as much as I can with him. We play sports together, he plays in a travel team and I take him everywhere he plays a game and while we drive we discuss things happening in his life to what a "Gay Marriage" is. I believe we cannot demand what is happening in their life but with time and doing things together they are closer and open up eventually.
But like I said I am also not an expert and this is what is working for me, hopefully helps others too.
Other thing I believe is there needs to be a role model set, and a goal. It can be something which motivates them and is positive. My son loves sports so one of the sports figure is his role model and there are countless times he has said to himself this will not be good for me to reach my goal and stops it. Even something like sleeping late. All this takes time and now a days I see parents do not spend time with kids and let TV and some Lady gaga to Nikki Manage take care of them.
JS in SD - Abusing the ER? Where do you expect these people to go?
Bear with me, my explanation is a bit long.
I lost my insurance a year ago when I lost my job due to disability. The COBRA payments were greater than my current income. I have been waiting a year and a half for disability payments to kick in - either Social Security or private LTD insurance. I may get it after the first of the year. In the meantime, I am required to visit the doctor quarterly for treatment of my disability or I break the terms of the LTD/SSDI. My doctor accepts cash payments up front of $75/visit. 20% of my monthly income just for the visit, not to mention medication, blood tests, etc.
Community clinics are full and a patient can wait all day because they don't take appointments. What working person, especially one in a minimum wage job, can afford to take a whole day off? I do not qualify for Medicaid because I do not have children. I don't qualify for Welfare either - same reason. The most aid I can get is food stamps.
I need to be in treatment because of severe depression, mostly caused by my disability and money problems. The psychologist I was seeing will also take $75 up front payments and I'm supposed to see her weekly. I stopped going because I don't have the cash to go. I still take the anti-depressants, but can barely afford those.
Then the long-term disability insurance that was supposed to be an additional safety net denies payment twice because they can and tells me that dropping psychiatric care due to a lack of funds is not an acceptable reason for stopping and adds another nail to my coffin with them. Their profits are more important to them than treating me fairly.
If I get horribly ill or even a minor infection outside of my quarterly visits, I have to go to the ER. I don't even have to use a fake name because the hospitals in the area have charity care and my emergency care would be "free". If I get bad enough depressed to be suicidal, I will be admitted for psychiatric care. It's the only way I can get it. Community mental health is unavailable to me because I do not qualify for Medicaid.
Most people who have no insurance are not in my dire straits. My roommate is working full-time, but his income is not high enough for him to buy health insurance, keep a roof over his head, a car for work and food on the table. Insurance rates have been skyrocketing for years - though not as high since some of the provisions of Obamacare have taken effect. His income is low enough that he also qualifies for charity care at the ER. He is relatively healthy though, but will not go to the doctor for relatively minor ailments like a sinus infection or bronchitis because of a lack of funds - he just suffers through it. If he gets something major by his definition, he will go to the ER to get treated and the insured people in this country will pay for it.
I realize that this is a discussion on using the ER for psychiatric problems, but general use of the ER is part of that. Without universal health care that includes mental health, this "abuse" of the ER will continue.
Republicans have a place for mental ill people, it's called a jail. They do not have the time or care for people with disabilities, as Mitt has claimed about the 47%, time and again.
Tell me Lightstar - how hard would we have to hit your son to make his ADHD go away?
I need to know because my son has autism and definitely has behavior issues. If I can fix that thru beatings then I better get started....
This to Light Star! Yeah I'll explain why it's more common!Because all they're doing is shoving pills down these kid's mouths.He's controlling his anger with them now,but wait and see what happens in the long run!
Your kid is ADD? He's on medication also.That's one of Your Problems right there,or is going to be.
It's seems now whenever a kid acts up now a days there's something wrong with them,so shove a pill in their mouths, and slap a label on them.
The meds are one thing screwing up your kid,plus the fact do you have Fluoride in your water?Type in Harvard Study and Fluoridated Water,surprise surprsise! How about all the foods with GMOS.What do you think thats doing to adults and kids brains,besides giving them cancer and all the other exploding diseases out there.
First thing you better do if your kid's on meds is GRADUALLY get him off,because I'll guarantee you it'll screw him up for life.When i say gradually,to do all at once will really mess him up more,again start gradually if you go that route.Then switch him to organic foods,a little more expensive,but worth every penny.Quit drinking tap water!
If school officials say anything,tell them to go screw themselves, and I guarantee your kid will be just fine.You'll see the anger issues go bye bye! Oh and whatever you do, don't hit him
Try it and prove me wrong! Been where you are and done that!
Having dealt with the responses of the POLICE & ER personnel, a few words of advice...
1. The system will remove the victim from the source of suspected abuse...
2. Usually taking the parents or spouse out of the picture. This means the victim is placed in the states care and charges could be brought against the suspected source of abuse...
3. While under the states care, the victim and suspect have no contact. If suicide was attempted, the victim is 'involuntarily committed' and parents/spouse are restricted access or even knowledge of where they are...
4, When ER Doctors are faced with medical issues (stomach pain, etc) they prescribe drugs first. Few question if it is a mental issue, even if it is a repeat visit, just change medications and/or up the dosage...
When a Mental issue is finally suspected the ER Doctors, will deny any responsibility. Even when the Psychiatrist states the suicide attempt was induced by 'Over Medication & misdiagnosis'...
BTY - Most Lawyers will not touch the case...
BTY - When someone passes out in a parked car or @ your home or laying on the floor clutching their stomach, the people called are the POLICE & EMS. Not the Mental Health services...
most of the parents should not hve children.
Max, I think this is the crux of the problem. Being too stupid to work simple birth control does not necessarily lead to great parenting.
Oh please.
My brother is severely bipolar-depressive, ADHD, OCD with paranoia, and he was raised in a loving middle-class, non-violent, insured, 2-sibling 2-parent household. Neither of my parents had disorders that would be warning signs, and neither do I.
And while I won't deny that some disorders can stem from a bad home life, many do not. Often, it's just a roll of the dice - gambling with brain chemistry. If mental disorders are more prevalent among that group, it's only because the stress of living that way makes it worse.
What we have learned in the course of treating my brother's severe disabilities is that there are not enough mental health services - public or private - to go around even for those kids who are lucky enough to have families who care. People go to the ER because they have nowhere else to go, either because they have no money or because there's just nothing available. Some clinics require that the patient had been admitted to a hospital before being transferred to them. It's ludicrous.
These places are so strapped for cash because they're often some of the first services to get cut from state budgets. Private facilities often only take private insurance, and most private insurance has a yearly limit on how long they'll pay for treatment, regardless of whether or not the patient is ready for release. It's the glory [-sarc-] of the for-profit health system.
Lightstar, you bring up a good point about there seeming to be more kids with behavioral problems now.
One thing to remember is that the school day in most places is longer than in the past, and in many places kids have very long bus rides. PE classes have been reduced or cut, recess is shorter, there is less "down time" in the day. The homework load is heavier. Plus behavior tolerated or not considered so serious in the past (i.e., two boys having a fist fight) is now a big deal.
So kids now have less outlet for frustrations, their time is more structured and more demands are placed on them. So perhaps at least some of today's "problem" kids would have been ok in the past since the school environment has changed so.
We require a license for driving, owning a gun, hunting fish and game, broadcasting on public airwaves, etc.
We should require a license to reproduce ! Of course, I'm still working on the enforcement policy - turns out that's a toughie...
Man I must of been the meanest mom in the world. I didnt let my kids have a TV or a computer in thier room because I wanted to monitor what they did. I did not buy them nike sneekers or designer clothes, i told them to get a job and buy that stuff thier selves. When my son got busted for pot and called me to get him out of jail I told him I had to go to work call a lawyer. When my daughter went out on a date and did not return at the desinated time I called the police. They got over it. grew up went to college and moved out and got jobs. Parents are not here to give kids everything they want. We are here to teach our kids to how to live in society. Just like a cat teaches its kittens to hunt and a bird teaches it young to fly, giving our kids survival skills is our biggest responsibility. Kids will make mistake after mistake that is what childhood is for, as a parent we need to be there to show them how to get up dust themselves off and go on,
We had a neighbor that had a daughter, who at 9 could pass for a 18+year old...
While in Middle School the girls BF (18) would check her out of school and they would go to his parents house. Even after a court order, the school say they could not stop the girl from leaving the school with an adult...
The mother was the local EMS director and when her daughter refused to do something and threatened to call the school supplied social services #. The mother handed her, a EMS card and told her to call there first. Because the daughter was going to need medical attention...
BTY - The daughter had her second child by her 17th birthday, no husband/father in sight. The kids are being raised by the now grandmother and doing great, even the children's mother has settled down...
Well, perhaps instead of just telling parents that it isn't necessary to bring them to the ER, it might be more helpful to suggest some alternatives. Our region's mental health care is not very good, and if you say your child needs urgent help you get put on a waiting list or seen by a person who doesn't have much clue and isn't even skilled at working with adults, much less kids.
Yes, the school counselors are good in my kids' school I think, but I wouldn't want them to see anyone in our area...it's forever to get in and when you do you see pretty quickly the system is a mess. And yes, I do have training in the subject, so I'm not just saying it as a parent. It's known around here that if you go to our local mental health center good luck on that, and the inpatient at our "regional" hospital is a seriously scary place. I even know someone who was there and told (I was visiting her and saw this with my own eyes) by a supposedly psychiatric nurse that, "Yes, I see on your chart that you are trying to get out of an abusive marriage and feeling depressed. I really think if you would work more on your marriage your husband might treat you better and you might not feel so down". WTF? I guess throwing her into the headboard and knocking her out was okay? What exactly was she supposed to do to "work on" that marriage besides getting to safety?
And that isn't even kids, either. I know a group of kids from a few years ago who were on low doses of anxiety meds and in therapy. The center suddenly decided that no children should get any psychiatric meds unless they were displaying "psychotic or injurious behavior to the point of other or self-harm" and immediately took the whole set of patients off anxiety meds cold turkey. Every single one of the kids ended up in alternative school and two ended up house bound from that anxiety. Most quit therapy because they felt abandoned and that no one cared or had a clue, and no matter what any parents said, the center didn't seem to get how inadvisable it is to stop those meds suddenly, especially when most of the group were doing pretty well, functioning at school, and progressing in therapy and not having serious side effects or on inappropriate doses. I would bet those kids aren't going to trust the mental health system in the future, either, and they may be the ones who need to reach out for help the most.
So my point is that if you want less kids (or adults) in the ER for psychiatric issues, one part of the solution is to have a great mental health network in the schools and community. Unfortunately that is one of the first things cut and unless a person has been exposed to the need for these services in one way or another s/he has no idea how essential the services are for the safety and health of the community.
LightStar, I think you answered your own guestion...."Can someone explain to me though why this type of behavior is becoming more prevalent in today's society?"
Many kids these days are simply spoiled. The result of a lack of parenting. Seems discipline with children is nonexistent these days. Parents simply don't have time with both spouses working and the kids get dumped off at a childcare center where they're interest is in money not the kids. I'm not buying the ADHD excuse we always get from the teachers, psychologists and psychiatrists. They might be hyper but the behavior they show still leads me to believe it's a major lack of discipline. But then the right of parents, relatives and teachers to discipline their children has pretty much been made illegal....... your kids can sue you in some cases.
A child is taught in school from pre K on that their parents can't spank , or discipline them . I have had teachers tell my child that and me I didn't know anything I was just a parent. The child protective service and schools need to back off and let the parents discipline their child and teach them respect and morals. I am not for abuse of any kind but isn't it abuse when a child has no direction from anyone . Parents are lost at what to do because the parents of today are the result of this . They were the first to be taught that you can't discipline and they don't know how.
You, like many others are confused about the word "discipline"
Discipline=dicere=to learn
Punish=punier=penalty, to give pain
I work in Child Welfare. A lot of my time is teaching parents the difference between punishment and discipline. Effective and consistent discipline eliminates the need for punishment.
Discipline is instilled in children
Punishment is imposed on children
Discipline fosters self-control and self-responsibility
Punishment relies on the parent to control behavior and be responsible for changing it. Those are the child's responsibilities.
Discipline encourages the child to be capable and responsible for making decisions.
Discipline encourages the desired behavior.
Punishment encourages desired behavior only when parents are around to enforce it.
Discipline encourages children to rely on their inner controls or rules for conduct.
Punishment implies that responsible behavior is expected only in the presence of authority figures.
Punishment may be effective now and then as a reminder of the consequences of rule breaking. It should never be the main ingredient of effective discipline.
Discipline is harder for the parent. It is a continual process that requires the adult to model disciplined behavior and not just preach it.
Punishment is easier for the parent. It's reactive, emotional, and requires much less effort and time than consistent discipline.
No one can ever tellyou that you, as a parent, cannot or should not discipline you child(ren).
The USA has the highest incarceration rate in the world, but put less than 45+people to death in 2010...
China put over 470 to10,000+people to death in 2010 (depending on your source), more than the entire world put together, but have a very low incarceration rate...
"Every year China has nearly 10,000 cases of the death penalty that result in immediate execution. This is about five times more than all the other death penalty cases from other nations combined," said Chen Zhonglin, a National People's Congress (NPC) delegate from Chongqing municipality.
Which country has the lower crime rates??? see http://www.infographicsinsights.com/2011/06/crime-infographic-china-vs-usa.html
Human nature recognizes, results of bad decisions...
BTY - I fly a lot, the Asian children are great to fly with, it is the western children that should be caged & muzzled. Usually their parents should join them, also...
Parents taking their kids to ERs for emotional/behavior problems! Really. Seems like children raising children. Some old fashioned attitude adjustment needs to be applied to these misbehaving kids.
So your suggestion for parents who can't afford medical services is to beat their emotionally afflicted children until they get better.
Thanks! Helpful ! And to think I was favoring a comprehensive single-payer health-care system like modern nations have that would provide pyschological and mental health screenings for all Americans in need.
I won't make THAT mistake again ! Beating the troubled children until the problem is gone is WAY better.
Easily fixable. We need universal health care so that people don't go to ERs for everything from common colds to therapy. I waited 8 hours at my hospital ER for an x-ray which turns out to be cracked ribs when the fast majority of people there were the uninsured and would not be turned away. To boot the vast majority of those were not emergencies at all; mostly flu and cold symptoms. I pay healthy premiums for that service. And secondly, it's called parenting. What the hell happened to people raising children with common sense? If your children have psychological problems, take them to a psychologist or therapist. We have become so selfish and self-centered in American society people just do whatever they please no matter how it affects others. It's really getting to be B.S. and I'm tired of it.
Wow you started strong, then you lost me when you told Americans to just take thier troubled kid to a thrapist or psychologist instead of the ER.
Sure ! Just DO it ! Come on - what do you think is holding them back?
Look - in modern countries, when a citizen gets sick they call their doctor and go. In America when we get sick we call our bank to see if we can afford it.
Until that changes our health care system is broken capitalist garbage.
Wow, I am glad I am past those days. I raised a son who had symptoms of serious mental illness from early childhood. You bet I used emergency rooms at times. We live in a town which has a psychiatric hospital for children (sorry, miracles do not occur in those places but sometimes it is the only solution). The place had walk-in emergency assessment but sometimes it was not possible to safely get my son there. The options were to go thru the ER (occasionally via ambulance) or police transport, meaning handcuffs and the potential of something happening that could result in charges, not to mention the neighborhood specter of police transport (although police would respond along with the ambulance, the paramedics would take charge and handle things better). Occasionally we used the ER as a place to go to to arrange for on-call staff from the state mental health center (again, we were lucky to live in the town where these facilities existed), and I will forever be grateful to the psych nurse from the MH center who met us at the ER in the middle of the night and spoke with kindness to my son, who was also forever grateful to her and who did not go into the hospital that night.
I'm pretty sure people are are just "bad parents" pretty much avoid bringing their issues to the ER or other health providers. I was involved in MH advocacy for many years and knew families who were--and others who were not--involved with MH systems. It was not "bad parenting" that drove parents to seek help and to keep seeking help.
Another factor in ER visits had to do with my son's MH issues combined with physical issues. There was a stretch of many ER visits over a period of time. Either he was injuring himself in connection with out of control behavior, or he would have a physical illness which did not warrant ER treatment but severe OCD/anxiety over his symptoms would lead to an ER visit. I would call the nurse help line with the notion of getting an official explanation why my position of waiting for urgent care to be open or letting a virus run its courser--but the darned help line nurses would support seeing a doctor right away (as if I had not seen our way through stomach virus bouts over the years). Once my son called the nurse line himself, then when I said "no, you do not need the ER, the ER is not going to make your symptoms go away instantly" he called the nurse line back to claim I was denying medical care--and then I DID worry about CPS. I thought the frequent ER visits should trigger working together between the pediatrician and the psychiatrist/psychologist, but I guess that concept was beyond them!
I should add that kids with MH health issues can often have symptoms that worsen on Sundays with the school week approaching, if they are experiencing bullying (by peers or staff) in the school environment. There seem to be seasonal components as well (Feb was a peak month for my son's hospitalizations, and when it was hardest to get "partial" treatment in the hospital--which sometimes led to inpatient hospitalizations as the symptoms continued to escalate).
Our state MH center now has walk-in assessment (used to be if you called intake, it would be a wait of several weeks to see a mental health professional). With physical illnesses, there is a range of options (assuming the means to access them!)--schedule an appt and wait, go to a walk-in clinic, go to the ER. There ought to be a similar range of options for mental health issues.
BTW my son is an adult now, is not on any medication, is self-employed with skills that are in high, high demand (network installations and high-tech hardware servicing--he occasionally services the computerized drug-dispensing machines at the very hospital where he used to show up in the ER repeatedly). He is not totally symptom-free, but he has pretty much learned to live productively in spite of his symptoms.
Dealing with the MH system (I hate to even call it a "system", which implies something that is organized to work well!). Funny how hospitals can position and market themselves in areas such as birthing centers, sports medicine, etc (you bet they do) but seem to really struggle to put together good quality MH services.
Re: healthcare costs. A major local provider recently announced its long range building plan--to the tune of a half billion dollars in one city. This was before the SC upheld Obamacare, but they were somehow not worried about having the revenue to pay for all this. And everything they build looks like it was designed by high-end hotel designers. They put a steinway grand piano in their brand-new lobby along with indoor waterfalls and pricey artwork just before they shipped half their medical transcription jobs to Mumbai. Seems crazy to me.
SRMcMahon,
Glad things worked out, for you and your son. The system is stacked against parents and spouses of people with MH issues, in the USA...
I moved my wife back to her home country, where we now both live. After months of purging the drugs that the ER and MH facility had prescribed, from her system. She is back to her old self, no medical issues or medications...
The Thai Doctors, stated she was 'Home Sick' resulting in the stomach pain and the supposed Modern Medicines of the USA caused the MH issues...
Speaking with other Thai's, this seems to be a common problem, when they move out of their country. And not live in a Asian community in the foreign country...
This is what happens when disciplining children is looked on as a crime. I don't think 5% of these children actually have some serious mental disorder. I think they have been undisciplined and basically running their households (instead of the parents) and when they don't get their own way they learn a tantrum of some kind will get it for them. As they get older, the tantrums get bigger.
Children need definite boundaries, and predictable consequences for misbehavior. This discipline can, and should, include mild physical punishment if necessary. If you reel in their need to run things when they are 2 or 3, the need for a swat on the behind drops substantially. I'm not talking about being brutal. I'm talking about being controlled, having thought it out previously, and implementing a plan. "Time out" is effective, and I'm not putting it down. It is thought out and planned. So can a carefully measured swat on the butt. If you don't think disciplining them is a good idea, you may as well get them their own chair in the emergency room. Sparing them a red mark on the butt in excxhange for a lifetime of mental issues is NOT kindness.
I know of a couple of occasions years ago whe "parents" of some rotten spoiled brats would dump they're kids at a Psych ward for 72 hour observations. They had platinum health insurance through they're employer and it was covered. Then they could go off and have a couple of days off from the problem they created. Them and the kids needed a whipping.
I dont know what "platinum health insurance" is but for kids, or anyone, to get into observation they would have had to have been admitted by the social worker on duty or a doctor. People get turned away/discharged from ER's all the time when they come in with supposed mental health issues if they don't meet the criteria of actually needing psychiatric care.
Because mental health units are usually a revenue loser for a hospital, many psych beds have been reduced or eliminated completely. Google it up for yourself if you don't believe me.
The largest population of the mentally ill is now found in jails and prisons, not mental health care facilities.
As I said in my above post this was "Years ago" about 25.
mac1183--you're right, except the sw would not have the power to admit. Typically a psychiatric SW does a structured assessment, takes the info to the psychiatrist on call, who approves or disapproves admission. As for the person who claimed a 72-hour observation is a parent vacation?--actually, it's typically set as a 23-hour observation (72 hours, or 96, has more to do with adults who are admitted against their will and is the time limit before they have to be discharged or a court hearing set--the amount of time depends on state laws). While the kid is in the hospital, you--the parent(s)--is spending hours with the intake staff, contacting the school, and reeling from the stress of the whole situation--plus visiting your kid, who is freaked out (and may deteriorate more during the first 24 hours), meeting with some kind of therapist, meeting--hopefully, but not always easy to arrange, the psychiatrist. No more a vacation than having your kid in a regular hospital.
SRMcMahon,
In NC the ER Doctor can involuntarily commit a patient. At the same time bar the relatives/spouse from contact...
The Hospital Director informed me I would have to file a missing persons report, to find where my wife was. I was escorted off the hospital grounds after I threatened Legal Action. By this time the ER had prescribed almost two pages of different medications, Xrays, & 2-CAT scans...
The POLICE would only state she was under medical care, they could not say where. No grounds for any legal action and they were the ones that had transported her...
Three days later she called me and supplied the needed access/contact information, 90+miles away. Using a phone supplied by an attendant who could have lost his job, by doing this. It took almost two months to detox her from the prescribed medications and stabilize her...
Imagine yourself in a foreign country, with poor language skills and being removed from any contact with; relatives, souse, or legal/Embassy support and having NO access to Money or phones. In Thailand the hospitals encourage the family to be present all the time...
BTY- Next month is our 9th anniversary, this happen 3+years ago, and she has no intention of ever returning to the US...
I would not take a dog to that hospital, the largest in the area. I Lawer told me, I should not expect quality care from the local hospital, I should go to a bigger city...
It is extremely difficult for a mother and father together to provide a loving and disciplined home life for children, considering the financial stresses society places on families today. But what makes the problem much worse is the reality that nearly half of all children today live in single parent homes. The children recieve insufficient attention (discipline) at home and therefore our schools (and medical facilities) receive the fruits of the destruction of the family in America. We are a society of blamers, and no matter what the situation, it is now the exception to find someone willing to stand up and take responsibility for their own lot in life and take responsibility for the consequences of their decisions. We all make choices every day which determine what happens to us. IT IS NOT ALWAYS SOMEONE ELSES FAULT. The story above demonstrates our societies problem ... instead of attention to the root cause of the problem (a lack of parenting), we focus on our emergency rooms and the lack of mental health workers. America does not need a bunch of new mental health workers, we need parents willing to take responsibility for the children they create.
yet you are blaming as well. You are blaming parents you don't know for things they may not have total control over. Not all single parents do the things you listed, and you are just as much of a blamer as the people you accuse. It isn't always lack of parenting, although sometimes it is. Lack of health care coverage for mental health hurts us all, bot one thing, and yes, educated and skilled workers make a huge difference, as do adequate facilities. You are wrong that it is an exception to find people who take responsibility. You are right that parents need to be responsible, but you are leaving out huge chunks of this picture and sticking all the blame on parents when there are many factors at work here.
Mental health services in this country suck, period. I was in Washington state, they sucked there; in New Mexico, sucked there. Currently in Maryland, suck here. Many psychiatrists are opting out of Medicare/insurance entirely and just taking cash for their services. Same thing goes with psychologists. They just are tired of dealing with the insurance bull@!$%#. I can't say I blame them.
@RacknStack (you must be Chiropractor, right?)
Mental health services 'sucked' in ALL those places?? Is it possible this may say something more about YOU, and how you relate to the world around you?? I understand people with depression or other issues can be miserable, don't give up, continue to try various options and keep your expectations realistic.
Many mental health programs suck in one or several ways. I don't find that to be an unreasonable statement. But yes, just because one person/place doesn't work it isn't a reason to give up.
My 5 yr old upset the coffee table. I spanked him last night (nothing excessive just a spank on the butt). He is telling his teacher. I am expecting a call or visit tomorrow. I have never been in trouble before. Not sure what will happen. I don't think he will flip the coffee table any more.
There is an actual valid reason some of these parents are going to the ER, it's not bad parenting or spoiled children - it's to get MEDICAL treatment for the cause of the psychiatric symptoms. The National Insitute of Health and National Institute of Mental Health have been leading the way in making the connection between infection and neuropsychiatric symptoms. PANDAS/PANS is an immune response to infection that affects the brain - causing OCD, anger, agression, anorexia, ADHD, tourettes, and other pshyciatric symptoms. Treating these children with pscyh meds has no impact because the underlying immune response/infection is not being treated. Ignoring the medical cause of sudden onset mental illness is inexcusable in the medical community. Boston Children's Hospital is currently attempting to remove a child with PANDAS from her family when they were transferred to BCH for help with the eating component of her disorder. It's inexcuseable.
My daughter was becoming violent and nasty to everyone and was miserable...totally unlike her. After several weeks of it I started looking online and found many, many parental complaints about kids on the antihistamine Zyrtec. The descriptions matched my daughter's behavior exactly, and we took her off of it immediately. Within a few days she was back to her sweet, smart, funny, and loving old self, and although she has an occasional foot stamp she is NOTHING like she was over the time she had problems. We were about to get her an appointment with a psychologist, but fortunately I happened to think of the Zyrtec.
So fast toward to a few weeks ago when her twin started having tantrums, depression, and anger issues. We were confused and she was miserable, and then one night I remembered her sister's reaction to medicine and thought of her Singulair. When I researched it I found another long list of parents describing just how she was behaving and we stopped it. She is almost completely back to her old self and we are so happy for her. She giggles and bounces around now as she used to!
So my point is that one of my kids gets crazy on candy with dye...seriously wild and aggressive, but if we limit that she is fine, and that you never know what can be causing acting out unless you look at the whole picture. While I definitely agree that parents do cause many problems they see in their kids, and have had to take my child out of Walmart more than once when she was smaller, it isn't always the whole picture. It's too simplistic and inadequate to blame parents for all behaviors until one takes many factors into consideration.
We also need to stop paying the parents for having kids with "ADHD". I have seen parents go to great lengths to get that diagnosis so that they may receive SSDI for the child. One lady, had 3 kids ALL diagnosed with it. WTH? She was a lazy, no good parent who took the SSDI checks to the casino. Stop paying people for crappy parenting. If the child truly has these issues, which I believe there are legitimate cases out there, then give them state medical coverage to assist financially with therapy, medications, etc. There is no reason to double dip by paying the parents $700 a month for the kid. There are too many SSDI checks going out to the wrong people, while some with real disablities, have to fight for years to get it, if they get it at all.
How true, how true...I have talked to kids who tell me that their mamas tell them how to act crazy. Sad but true. Yes, there are some legitimate cases out there, and the kids do need and deserve the help but far too many are like you pointed out, sorry mamas living off the kids to support habits. There is one who goes down to Biloxi to feed her habit of gambling and uses her kids' crazy head checks to support it.
Good point. I have met several people over the years that collect SSDI and are using their SSDI money to gambel, drink and buy drugs. I know there are some legitimate cases but far too many people are working the system to get this free cash. The doctors are in on it too because they get a guarantee flow of income for doctor visits that go on and on and never end. The patient never gets better and the government pays financial support until they die. I know of one person that likes to get herself baker acted every so often because it guarantees that the free money will continue. We live in a society that rewards people with attention and money for acting crazy. If I had a kid that was acting up real bad, I would just take him or her to the cops and ask to take a tour of the jail to show them what their future would be like if they don't shape up. Tough love can work if applied appropriately.
As an ER physician myself, I can tell you that this article is right on as far as seeing many "troubled" children vs truly "psychiatric-laden" children. Keep in mind, every ER is legally obligated by the federal government (see the "EMTALA " law) to see everyone who walks through their doors and it IS really frustrating when the child's problem ends up being what most would consider a non-emergency. The law does not require that we see them immediately but rather is based on a well-established triage system. Some of the parents and caregivers who bring those types of kids in, usually just need some hefty reassurance from a healthcare professional, and everyone is on their way. The problem is when they come in over and over (and OVER!) again for the same innocuous types of complaints every week (and sometimes every day!). That is when the best treatment for them is to have an attentive social worker talk to them about how to manage these situations. We try our best to have our staff help them find the appropriate people to talk to when these types of needs arise. Unfortunately, there are some who refuse to (or just can't!) "get with the program" and continue gumming up the ER.
I'm not complaining...I'm happy to see anyone who feels they have an emergency. I also feel part of my job is to educate the patients and the public on the proper use of the ER. I can't tell you how often I see the same patients on a "too-regular" basis or how often I see patients who have a simple sore throat - these are NOT emergencies!
And finally, one more point, the ER doctors see patients based on a triage system - the more medically unstable you are, the sooner you are seen (i.e. if you were in a high-speed roll-over car crash and came by ambulance you're seen faster than someone with the "sniffles" - even if the person with the sniffles came in by ambulance - yes, it happens regularly, I swear! They think if they come by ambulance it makes it MORE of an emergency when if fact many community EMS teams just feel obligated to transport ALL of their patients regardless of severity (as a matter of keeping good public relations and ongoing community support for the EMS). When the person with the sniffles comes in by ambulance to our ER, they are quickly evaluated by a triage nurse and then sent out to the waiting room to wait their turn according to the traige system, after they are determined to be stable by the way!
Contrary to what many seem to believe, taking an ambulance to the ER does not get you to see a doctor ANY faster, folks!
Amen. Straight from the horse's mouth.
All I can say is "Wow!"
Depending on where you live if you have a child with a true emergency psychiatric problem you first call the child's doctor/psychiatrist. The doctor then assesses the problem. In a true psychiatric emergency they tell you to take the child to the emergency room. Why ? Because they have to go through the emergency room to get transferred to an appropriate mental health facility if there is no room at the Children's hospital psychiatric unit.
Never get your psychiatric or psychological advice from your public school.
First thing any good psychiatrist is going to do is order all of those tests to rule out any organic causes, like PANDAS for example, metal poisoning, etc. as well as a full neurological work up. Then there should be a psychological evaluation. Usually, there should be some outpatient therapy. After assessment in outpatient therapy which could be one visit or many, you may be referred to a psychiatrist for additional care depending on the severity of the problem. The entire process should include family involvement because a true mental health problem involves and effects the entire family.
Almost all psychiatric care should be paired with psychological care. Just taking a pill alone does not help anything. Medication is to care for a physical barrier to making the psychological care work. All of this takes work on the part of the parents and a commitment to the child's care. Key statement in this article......
“Parents are living in a high-stress situation,” he says. “They don’t have adequate time. With economic issues, both parents are forced to work in order to sustain, and there is no one to adequately supervise the child.”
Truly mentally ill children require a parent to be available at all times. That's a family decision and not an easy one.
And spare the rod, spoil the child doesn't mean to spank your children. It means, rule with your right hand and not your left because true justice is tempered with mercy. You hold your staff in you right hand and your rod in your left. Anyone who says otherwise does not understand what they are reading.
Well said!
Good post, and the only thing I would add is that sometimes a good psychiatric isn't available. One of our local ones had a daughter who committed suicide many years ago, and he used to go around insisting that patients newly diagnosed with depression needed ECT right away so they wouldn't kill themselves. Another of our local psychiatrists was totally obnoxious, rude, had pressured speech and acted totally manic one day while another day he would be compassionate, then another so depressed it's a wonder he got out of bed. He never got help and he killed himself.
I'm just saying that sometimes you really have to advocate to make sure your loved ones are cared for appropriately. If no one does that workup for toxins or the neuo/psychologist exams or you do feel your child (or adult, for that matter) urgently needs care s/he isn't getting, insist that it is given.
Another reason to provide free birth control.
Down south when I was working in the rural community you would be surprised (no you would not..lol) at the number of kids who told me their mamas told them to "act the fool" so they could get a "crazy head" check like Mama had so the "guv'ment" could take care of them the way it took care of her and grandma. Don't think for a second the kids have problems. They are taught at a very young age to act like are mentally ill and the system falls for it. Oh and btw....the medicine the kids are given for their *problem* is sold on the street or fed to the pigs....people will buy anything, and feed anything to the livestock.
I can confirm this practice is rampant both in personal experience and discussions with peer psychiatrists. Is it really such a stretch of the imagination to think some parents would do this??
I would add that the single greatest predictor of whether someone will go out on disability is not their skin color, religion, or even socioeconomic status.
It IS most correlated with having a first degree relative who is on disability. Hmmmmm, social modeling, perhaps??
Several years ago, I worked as a clinician in a out-patient mental health center, and volunteered to be part of a demonstration grant to seed a General Hospital in a NJ suburb with mental;l health input to their emergency staff. On my assignment which was a Friday evening, and a night I suspect that is now frequented with these pubescents and adolescents, there was a spike in serious Adult problems mostly physical. Indeed if a cop or perpetrator was to be shot, it would usually be on a weekend. The emergency staff was severely understaffed. I would suggest that any parent, whose reality testing is so compromised that they would bring a child management issue to an emergency room, were themselves the ones in need of psychiatry.
As a psychiatrist, I have to say that this seems to be a well written and balanced article. There are no easy choices, and the fears expressed about child protective services, worries about our friends the lawyers, are indeed quite real.
A few years back, I was in the ER seeing a 14 year old brought in by the police. Her mom had called them after she told her daughter she couldn't date someone, and the daughter then said "I'll just kill myself". She had no history of self harm, violence, or any other behaviors suggesting actual risk...BUT...even though she admitted to me she did this just to get her mom to relent, the mom refused to take her back, and the ER physician refused to allow discharge because of legal worries. Since insurance companies will NOT reimburse for 'Parent-Child Conflict' diagnosis for a hospital stay...she got admitted as 'Bipolar' instead, despite my objections. This is the law of unintended consequences.
There is no ADHD...there are just bad parents. If you cant handle the responsibility don't have kids.
"Lead Don't Follow"-You are an idiot. I am MORE than responsible with my daughter and she has a severe case of ADHD. My husband and I have sought every treatment option possible since she was in Kindergarten, and we always received the same diagnosis: ADHD. IT IS CAUSED BY A CHEMICAL IMBALANCE IN THE BRAIN. I don't see how bad parenting can relate to that. I would love for you to spend the day with my daughter when she hasn't had her medication. You would deserve every second of the frustration she would provide.
There most certainly is such a thing as ADHD. It's overdiagnosed, but that doesn't mean it isn't a real problem. I've seen a psychiatrist and 2 psychologists, and received the same diagnosis every time. ADHD (inattentive type, what used to just be called ADD).
ADHD doesn't necessarily mean hyperactive, and hyperactive doesn't necessarily mean ADHD. Some of those kids are flat-out undisciplined. Others are sleep deprived - the symptoms for ADHD and sleep deprivation are nearly identical.
Others suffer from the developmental disorder known as ADHD. The root cause of ADHD is that the brain is understimulated by the environment - inattentive types become withdrawn, and pay more attention to the movie going on in their head than what is going on around them, while hyperactive types are overly energetic, lashing out at their environment like a 4 year old who missed nap time, desperately trying to stay awake.
Stimulants bring the understimulated brain up to "normal" levels, and therefore have the opposite of the expected effect. Instead of the child ramping up, the child calms down. They may be given stimulants and depressants at the same time, so that the child is still able to sleep at night - sleep deprivation makes symptoms so much worse!
Most children grow out of this condition - it's a developmental disorder, and sometimes they just need time to catch up - but others do not. There do appear to be hereditary factors, but environment (I strongly suspect exposure to pesticides) also appears to play a role.
Scientific research has already found out that our toxic environment (chemicals in the air, water, food, etc.) is having a devastating effect on the world and its inhabitants. Why do we not have serious discussions on how this is effecting our children, their physical and mental health????
I just retired in May after teaching in inner-city high schools for 24 years. I'm an excellent teacher with a ridiculously strong work ethic, but I just couldn't take the horrible student behaviors anymore.
Society has got to get serious about education partnering more effectively with business and health organizations.
Have to agree with hwilson........that is is OVERDIAGNOSED....I have seen a case where it had been diagnosed to supplement some woman's income. Sad but true. The woman got SSI for her 2 boys. She was a worthless piece of human flesh, hung out on the PC all day, in chat rooms, chatting with men and finally hooked one, moved in with him. When the gal's kids were out of school and the divorcee was able to sink her claws permanantly into the new guy the kids were (like some miracle in a Hollywood movie) *cured* and suddenly the Mom was going around making speeches and telling everyone how a miracle diet she came up with did it. The poor fool of a guy she hooked up with sold everything and moved from his home in Tennessee to be with her in the midwest. Now her boys are gone and the SSI is gone but she doesn't care. She is happy and has a veteran to live off of. No idea what the boys are up to. So much for society getting serious about dealing with health care.
I'm sure if you turned off honey boo boo, fed her a healthy diet and did some studying with your daughter her "disorder" would vanish.
At least those people in the ER's.. have jobs. peace b.
Americans eat genetically engineered modified food every day... it is in milk, meat, grains, vegetable, fruits, peanut butter, and how many americans care about this ??? how about your food and water supply laced with hormones, antibiotics, PESTICIDES, and other poisonned chemicals, and no one question why are so many kids having mental illnesses, allergies, autism and other diseases !
LOOK NO FARTHER, YOUR FOOD SUPPLY IS POISONNING YOU AND YOUR KIDS ! and the FDA let it happen !
This is a real important issues that is not talked about by any of your politicians ! IT SHOULD BE TALKED ABOUT because it impact your lives and health !
The high use of psychiatric drugs in this country, especially on children, doesn't concern us? Really? Why not?
Here is what we have done, been doing and are still doing to our kids:
1. Hardly anyone stays home with their kids anymore. Everybody, it seems, goes to work. Some do it so they can keep 2 BMW's in the garage - seriously, I know these people! More couples divorce than stay married, since we now have no fault divorce. So kids grow up in daycare. What kind of life is that? To be rousted out of your bed or crib when you are a baby and taken to a strange place and left with strangers all day only to be picked up at the end of it by exhausted stressed out parents. It can't work! What part of this do we not get?
2. They also grow up in single parent homes.
3. They are often latchkey.
4. They grow up in poverty. This list is not in order of importance.
5. They often witness domestic violence
6. They often are victims of some kind of abuse. I have a relatively normal job in a relatively normal place and I work with thousands of people and I hardly know anyone who was not abused, or assualted, or a witness to abuse, or the target of a bully when they were a child.
7. They are from dysfunctional families. A majority of people are.
8. Their parents are likely medicating themselves with prescription drugs for depression, or anxiety, or bipolar disorder, or sleep disorder, or worse.
9. If their parents are not medicating themselves with prescription drugs, they are likely using illegal drugs, or drinking alcohol to medicate.
10. Given the above, what chance does any child really have anymore to be okay?
Any Questions?
It's impossible to tell the difference, just by looking, between a child who's able to control his actions, but for whatever reason isn't, and a child who is physically or mentally incapable of controlling his actions.
There are 10 year olds out there with the minds of 1 year olds. With intensive one-on-one therapy, they might get up to a 2 or 3 year old level by adulthood. But they're never going to get better, and they're never going to be normal.
No amount of tough love or discipline will ever change them, or get acceptable behaviors out of them. And their tantrums when they're grown will have the full strength and power of a rampaging adult behind them.
You can't just lock them away and pretend they don't exist. We don't have state-funded mental institutions anymore. Relatives aren't always there to provide care, and if they are, they might not be able to afford it.
It's a real problem.
We see "unruly children" and assume bad parenting. We see "out of control" adults and assume drugs or bad choices.
But sometimes they have the best parents in the world, and sometimes they make all the right choices. And it still happens.