Transcription:
Mental Health Matters in Children

Scott Webb (Host):  Rachel Reynolds is the Program Manager for the Cameron K. Gallagher Mental Health Resource Center at Children’s Hospital of Richmond at VCU and she’s here to talk about why mental health matters. Stigma and lack of access to mental healthcare are critical problems that are experienced on a national level across our country. Rachel is here today to talk about how her team is addressing these barriers in Virginia.

This is Healthy with VCU Health. I’m Scott Webb. Rachel, thanks so much for joining me today to discuss this all-important topic. Like all parents, I worry about the mental health of my kids. Let’s start today with a full review of children’s mental health.

Rachel Reynolds, CCC-SLP, BCaBA, LABA (Guest):  There’s some important things to know about children’s mental health. One in five kids have a serious mental illness and that’s often a surprise for people to hear that statistic. Not only that, but 75% of those children will not get the care that they need and there’s a lot of reasons for that. Primarily stigma and access to care. And so, it’s important to be aware that children’s mental health is something that should take priority in a family’s life. But it’s also important to know that it’s okay to reach out and get that support when your family needs it.

When we talk about things like stigma; we’re thinking about the fact that a lot of times in our culture, we don’t think of mental illness the same way we think of physical illness. If a child breaks their arm or is diagnosed with cancer or something like that; a lot of times the community just surrounds the family and provides them with the resources that they need whether it’s bringing them a meal or getting that moral support, financial support that they need, and we don’t see families get that same support around mental healthcare.

Some of that is because the families themselves feel ashamed or like they are not supposed to talk about concerns like depression or anxiety or even ADHD in their children. They see it as something that’s a failure or that’s shameful. When, we think that these are the kinds of things that should be talked about just like a cancer diagnosis or diabetes or any other chronic condition that a child may experience. And so, when we talk about it; it makes it more normalizing to go to therapy once a week or to see a psychiatrist for the medications that they might need.

Host:  Thank you so much for that. I’ve got a 16 year old son and like most 16 year old boys; he can be moody and sort of stays to himself and my wife and I wonder like how much of that is normal for a 16 year old boy and at what level should parents then become concerned. So, what are the signs that your child might need some mental health support?

Rachel:  Yeah, that is a great question and we do hear that question a lot because like you said, adolescent behavior can be erratic and there’s a normal erratic nature to that behavior. One day they are moody, another day they are engaged but what we are usually talking about when we see children that need more mental health support is very dramatic changes in their behavior. Either they are isolating themselves, often from their friends or from activities that they previously really enjoyed like a sport or a hobby. You don’t see them reaching out particularly to their peer groups more often. They won’t always reach out to adults in general, but they will reach out to their peers when things are going well.

So, when you see that they are not even reaching out to their peer group for those kinds of activities; then that is a red flag and a cause to get concerned. Anytime that there may be signs of secretive behaviors going on. They may be sneaking around, or they may be trying to do things in their room without involving others. That can be a concern as well. And one of the things that we see in younger children that often gets overlooked is a lot of physical symptoms that they’ll report that we don’t typically associate with mental health.

So, a kid may not tell you I’m feeling anxious; or I’m feeling depressed; but they might tell you I have a stomachache all the time or they may be extremely negative about themselves and their perspective. If they specifically say – mention things about hurting themselves or wanting to kill themselves or not wanting to live; those are big concerns and they should be listened to and acknowledged and not really written off as just them being kids or being silly.

Host:  Which I think is the tendency. I’ll just give you an example. So, my daughter is a really good basketball player and a couple of years ago, she was on a team where everything was being asked of her and she started reporting to my wife and I on like practice days and game days that she had a stomachache and what we came to realize was that she was having anxiety. And I wanted to ask you about the importance of early intervention and not dismissing things as oh, well they are just ten.

Rachel:  The first important piece about early intervention is that we know that it really makes a difference. The earlier we can identify some of those things and I think you used a wonderful example of being very queued into your daughter’s physical statements about having a stomachache and she didn’t say I’m feeling anxious but you were very queued into that and then you were able to have that conversation with her and I think what we find is when parents or caregivers, teachers feel comfortable talking with kids; then sometimes it’s just that conversation that they need that won’t result in later something that could turn into a hospitalization or a need for long-term counseling.

Kids are extremely resilient by nature and they respond quickly usually to intervention. So, even if kids do need say to see a counselor or a therapist for a short period of time; we find that just a couple of weeks or a couple of months of intervention can be enough to give them the skills and tools that they need so they can move along their way. Whereas if those kinds of concerns don’t get caught early on; often in later adolescence or childhood or even in early adulthood; these challenges are starting to manifest themselves and can become even more serious mental illnesses or kids can go down a path where they start abusing drugs or other substances and the problem compounds itself.

So, early intervention is really, important. It’s also important to know that most people are very responsive to things that don’t involve interventions, but don’t involve medications. So, just because your child needs mental healthcare, it doesn’t automatically mean that they are going to be placed on psychiatric medications or this is something that’s going to impact them for the rest of their lives in a negative way.

Host:  What I think is just so important as you stress, listen to your kids, don’t rush to judgement but don’t dismiss things and understand that the earlier we catch some of these things and deal with them; the better off they may be and I think that that ties in perfectly to what you were talking about originally when you started here today is about the stigma and access to care. So, let’s take these separately. Let’s talk about the stigmas attached to mental health support and how we can break them down.

Rachel:  Like I mentioned before, I think that mental health stigma is something that has been predominant in our culture for a long time. I think it’s only really in the last ten or fifteen years that our culture has been evolving to being more open to talking about mental healthcare. I know that when my parents were growing up, that was never discussed. Nobody talked about going to see a psychiatrist or a psychologist. If you had a mental health challenge; it was a sign of weakness. And it was wrong with you, that you didn’t talk about with other people.

And I think now our culture – I’ve had great conversations even with high school students and they are so much more open to talking about their feelings or talking about their need to take care of themselves and I think that that’s such a welcome shift in our culture. We still need more of it. There’s still a lot of stigma around talking about mental health and talking about the importance of self-care. It’s important that we devote time in our lives just like we do to brushing our teeth and going to get a physical every year that we devote that same amount of attention to our mental health. And whether that’s giving yourself a break and not feeling like you need to do all of it. you were talking about the story with your daughter and feeling the pressure to be the best basketball player. It’s okay to know that we don’t have to be the best at everything.

And our current culture sometimes celebrates being the best at everything particularly with access to social media and showing only the best of our world on those social media connections. And so, it’s important to normalize that sometimes we’re sad and sometimes we have bad days and it’s not always sunshine and roses but there’s ways to work through that.

Host:  Definitely are ways to work through that and places to work through that. So, let’s talk lastly today about the resources that are available through the CMHRC.

Rachel:  We have a couple of different ways that families can access support and I think one of the things that we’ve been talking about here is about that stigma but also knowing what to do and where to go. And the resource center was designed to really help with that issue. So, we have family navigators who work directly with families either over the phone or in person at our Virginia Treatment Center and what the navigators’ role – they are a nonclinical provider. So, their role is to listen to the family, find out what kinds of services may have been recommended or that they think their child needs and then direct them to the right supports that will benefit them. That could be anything from a support group or a play group for their kids all the way up to finding psychiatric or counseling care or inpatient services for their child.

We are not a crisis service. And we’re available basically 9-5 Monday through Friday but we can be available to kind of guide the family along the way because it’s a very confusing process dealing with different insurances and providers that aren’t taking new patients. So, we can guide the family and after that initial call, we even follow up with the families to make sure that they’re getting to the resources that they need in a timely manner.

Host:  Rachel, thanks for joining me today. Such an important topic and your expertise is so helpful. That’s Rachel Reynolds, the Program Manager for the Cameron K. Gallagher Mental Health Resource Center at children’s Hospital of Richmond at VCU. Listeners can learn more about the mental health resources that are available at www.chrichmond.org. And thanks for checking out this episode of Healthy with VCU Health. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library at www.vcuhealth.org/podcasts for topics of interest to you. Thanks, and we’ll talk next time.