Mental disorders in children and the importance of early detection

Less than half of children with mental illness get the treatment they need, says Roy Boorady, MD, child psychiatrist. He explains that early identification and treatment could help kids live a more normal life.

Transcript

00:00

ROY BOORADY: Newspapers such as New York Times or the Wall Street Journal have been presenting articles that write about some alarming statistics about the use

00:07

of medications with children or the use of medications for things like attention-deficit hyperactivity disorder. And I think reading some of those articles

00:16

puts parents and even doctors in a situation that they're very scared to prescribe because

00:22

of the hysteria behind a lot of the information presented.

00:31

There's a high percentage of mental illness, and the reality is less than 50% of those get the actual treatment or help they need.

00:39

And if we could identify things earlier and sooner, we could help people have more of a normal life.

00:46

I think few and other fields of medicine would argue not to treat something. For example, if I was a neurologist

00:52

and you came to see me and you had a seizure disorder, of course, I would give you medication to treat that. I'm not sure why that cannot apply to psychiatry as well,

00:59

that if we see something and you identify it early, that we should get treatment early. We have the psychiatric disorders

01:06

that actually start in childhood, and they tend to be ones that occur with children because of probably developmental.

01:13

And they involve things like either processing or control. So you have attention deficit hyperactivity disorder.

01:20

You have autism. You have ticks and Tourette's, and you have a whole host of learning disabilities

01:26

that could also present with emotional difficulties. After that, I think as children mature and become adolescents and adults, one also has

01:33

to be concerned and be on the lookout for things like anxiety disorder and depression. They each require their specific therapies.

01:42

They may not always require medications. It's more than, here's a medication and everything is better. And depending on the severity of the symptoms

01:50

or how impairing they are, a lot of children can get better, and families can get better with non-medication therapies that

01:57

might include either behavioral therapies, cognitive behavioral therapies. It might involve coordinating treatment with schools

02:04

and school personnel. It may not always require medications. I think the deciding rule or deciding

02:11

factor that goes into that is, what's the level of the impairment? How much are the symptoms getting in the way?

02:18

And how much are they impairing? We have much better identification. And because of that, we have much earlier identification.

02:26

And I think, as anything else in medicine, if we're going to use that as an analogy and parallel, is

02:33

that, clearly, the earlier we could identify, the sooner we could get treatment and the better the outcome. The question I always tell parents, if they come in

02:41

and they're worried about the side effects of medication, I'll throw it back and say, well, what are the side effects of not treating something?

02:48

And there are now some sophisticated brain studies and brain imaging work in which children

02:55

are followed on medications via brain scanning, showing that a year into a medication treatment

03:02

or more, the brain is starting to look like sort of what we would consider a normal brains. So again, earlier treatment, you could

03:10

reverse the course sometimes of a particular illness to help a child develop more normally and have a normal life.

03:16

A big part of the treatment for the children is actually working with the parents. And a lot of times, parents don't know what to do, or parents may be quite exhausted

03:25

from trying to do what they're doing to help the child. So a lot of the treatment is also supporting the parents,

03:31

giving them the strategies and the skills and also the understanding of what to expect over the years.

03:38

Things do get better. We can help them make changes. Their child can get better. And the family gets better.