Tag Archive for 'mental illness'

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Mothers agree on helping children with mental illness and their families

Liza Long is the author of the post, “I am Adam Lanza’s Mother,” that has gone viral in the few days following the mass murder that Mr. Lanza apparently committed at Sandy Hook Elementary School 14 December 2012. In it, Ms. Long—who obviously is not the deceased mother of Mr. Lanza—makes an important, impassioned, and strong case for focusing on mental health issues among children and youth. Here’s the beginning of that post.

In the wake of another horrific national tragedy, it’s easy to talk about guns. But it’s time to talk about mental illness.
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Cog mod for PTSD

In the Journal of Behavior Therapy and Experimental Psychiatry, Joanna Kowalik and colleagues reported that their review of studies on the use of cognitivie behavioral therapy for treating posttraumatic stress disorder (PTSD) revealed that cog-mod appears effective in changing raters’ responses on some of the widely used scales of the Child Behavior Checklist. However, the results of their literature review are not as powerful as one might hope, given the small number of studies and substantial variability in the studies themselves.

Abstract

Background and objectives There is no clear gold standard treatment for childhood posttraumatic stress disorder (PTSD). An annotated bibliography and meta-analysis were used to examine the efficacy of cognitive behavioral therapy (CBT) in the treatment of pediatric PTSD as measured by outcome data from the Child Behavior Checklist (CBCL).

Method A literature search produced 21 studies; of these, 10 utilized the CBCL but only eight were both 1) randomized; and 2) reported pre- and post-intervention scores.

Results The annotated bibliography revealed efficacy in general of CBT for pediatric PTSD. Using four indices of the CBCL, the meta-analysis identified statistically significant effect sizes for three of the four scales: Total Problems (TP; ?.327; p = .003), Internalizing (INT; ?.314; p = .001), and Externalizing (EXT; ?.192; p = .040). The results for TP and INT were reliable as indicated by the fail-safe N and rank correlation tests. The effect size for the Total Competence (TCOMP; ?.054; p = .620) index did not reach statistical significance.

Limitations Limitations included methodological inconsistencies across studies and lack of a randomized control group design, yielding few studies for meta-analysis.

Conclusions The efficacy of CBT in the treatment of pediatric PTSD was supported by the annotated bibliography and meta-analysis, contributing to best practices data. CBT addressed internalizing signs and symptoms (as measured by the CBCL) such as anxiety and depression more robustly than it did externalizing symptoms such as aggression and rule-breaking behavior, consistent with its purpose as a therapeutic intervention.

Because they are integrating so few studies it is very difficult to have a sensitive meta-analysis in this case. However, that Professor Kowalik and her collaborators found differences at all is encouraging. I hope they’ll continue to follow this literature. Also, I hope researchers will be using other measures of outcomes and that those other measures will be examined in future integrative literature reviews, too.

Kowalik, J., Weller, J., Venter, J., & Drachman, D. (2011). Cognitive behavioral therapy for the treatment of pediatric posttraumatic stress disorder: A review and meta-analysis. Journal of Behavior Therapy and Experimental Psychiatry, 42, 405-413. doi:10.1016/j.jbtep.2011.02.002

Counselling explained. You can find counselling services in your local private hospital in Nottingham, UK.

Virginia campaign promotes action agenda

The Campaign for Children’s Mental Health outlined an agenda for improving mental health policy for children and youths in the US commonwealth of Virginia on 14 June 2011. The “Action Agenda” expresses the need for Govenor Bob McDonnell to exert leadership in three policy areas so that the problems of 100,000 minors with mental health issues are addressed:

  • Children with mental health disorders and their families need to have a full array of high quality treatment and support services in their own communities, no matter where in Virginia they reside.
  • Children with serious mental health disorders who require public sector services need to have access to the same array of services regardless of payment source or custody status in order to maximize the impact of and curb inappropriate use of public dollars in the treatment system.
  • Children with mental health disorders and their families should be recognized and included as experts on their own and their children’s treatment needs.

Visit the 1 in 5 Website (see it over in the sidebar, too) and download the full statement of the Action Agenda.

I am very glad to have and I hope others will join me in signing a petition to support this effort. Isn’t it great to have this effort right here in Virginia? Do you have similar efforts in the area where you live?

The Congressional Mental Health Caucus

Sadly, mental health has been in the US news of late. I’m reminded that in the US legislature there is the Congressional Mental Health Caucus, which takes as its goals reducing negativism and stigma, aiding efforts to access mental health services, improving work-related productivity, and protecting veterans who have mental health problems. Although the caucus does not explicitly state child mental health as a focus of concern, it has supported awareness efforts such as National Children’s Mental Health Day.
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Teaching about mental health

Teachers who are concerned about helping students understand mental health issues have at least one sensible places where they can go for teaching resources: Breaking the Silence, a Web resource offered by a local National Alliance on Mental Illness group. BTS, as it calls itself, provides a combination of neighborhood (NY, US) and widely available services (including a downloadable teacher’s “toolkit” with lesson plans, posters, and more).
The BTS folks make the case for teaching about mental health in this way:
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Brain features associated with neonatal risk for schizophrenia

Differences in neonate brains

Writing in the American Journal of Psychiatry, John Gilmore and colleages reported that the size and structure of the brains of newborn boys—but not girls—who are at risk for developing schizophrenia differ from those of their peers. Using multiple scanning methods at different times during gestation and infancy, the researchers compared the brains of offspring of mothers who have schizophrenia to the offspring of mothers who do not have schizophrenia; they found that high-risk boys had larger brains and larger lateral ventricles than baby boys whose mothers did not have psychiatric illness.

Because the risk of developing schizophrenia is much greater for close relatives of schizophrenics, the differences between the groups provides a strong indicator of later potential development of disease. Professor Gilmore wondered “Could it be that enlargement is an early marker of a brain that’s going to be different?”
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Jani’s story updated

In “Hushing the intruders in her brain,” Shari Roan continued her account of childhood-onset schizophrenia as experieinced by January (‘Jani’) Schofield. In the current story, Ms. Roan provided an update about Jani’s and her family’s life and progress. The coverage includes content about changes in Jani’s therapy and medications, the family’s living situation, and other aspects of life with childhood schizophrenia. As previously, there are accompanying multimedia features to the story, including this video by Don Kelsen.


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Virginia Campaign for Children’s Mental Health

Twelve key children’s services for community services boards
  1. specialized children’s emergency services;
  2. crisis stabilization;
  3. evaluations for Comprehensive Services Act services;
  4. psychiatric/medication;
  5. office-based mental health therapy;
  6. office-based substance abuse therapy;
  7. mental health case management;
  8. intellectual disabilities case management;
  9. substance abuse case management;
  10. home-based behavioral treatment and support for families;
  11. school-based day treatment; and
  12. local residential services.

Right here in my home commonwealth of Virginia last week, Mira Signe, Vicki Hardy-Murrell, John Morgan, and Margaret Nimmo Crowe explained why it is important that government and private organizations attend to and address issues in children’s mental health. By explaining that Virginia has inadequate services and that one in every five children or youths experience mental health problems at some time during their lives, they made the point that that there is a tremendous need for public focus on these issues. This was the kick-off event for the Campaign for Children’s Mental Health.

The Campaign for Children’s Mental Health is a 3-year sustained effort to make mental health services more available and accessible to Virginia children in need. It will strongly endorse Governor-elect McDonnell’s call for system improvements; urge the General Assembly and state and local government to work collaboratively with the administration to address system deficiencies; and conduct a high-profile three-year advocacy and education drive to build public and political support for improved mental health services for children.

Only about one in 20 of Virginia’s children have access to the key services listed in the accompanying box. So, four out of five children who need these services do not have access to them.

No, Virginia, this is not an acceptable way to treat our children. Let’s do better.