Welcome to Childhood Made Crazy, an interview series that takes a critical look at the current “mental disorders of childhood” model. This series is comprised of interviews with practitioners, parents, and other children’s advocates as well as pieces that investigate fundamental questions in the mental health field. Visit the following page to learn more about the series, to see which interviews are coming, and to learn about the topics under discussion:
Yana Jacobs, LMFT is currently chief development officer at the Foundation for Excellence in Mental Health Care, www.mentalhealthexcellence.org a private community foundation with a mission to bring alternatives into the mainstream public and private sectors. She began her work at Soteria House in the mid 70s and has spent over 30 years working both in private practice as a therapist and in the public sector at Santa Cruz County Mental Health in California.
For more information: www.mentalhealthexcellence.org
EM: How would you suggest a parent think about being told that his or her child meets the criteria for a mental disorder or a mental illness diagnosis?
YJ: First and most important is for parents to know that there is actually no science supporting mental disorders and therefore when faced with a doctor or licensed practitioner who is telling you that your loved one has a diagnosis be aware that you are now in a very subjective part of the health care system!
There are no blood tests or brain imaging to verify these diagnoses. They are labels that describe clusters of behaviors and symptoms, not an “illness” per se.
EM: What should you as the parent do?
YJ: Most of these symptoms are triggered by life challenges, adjusting to adulthood, going off to college, leaving home, all can be traumatic for some young people. Don’t fall into the “mental illness trap,” instead find someone to work with who is curious to learn “what happened”? When did the “symptoms” begin? Learn about what circumstances might have triggered psychosis. Is there any substance use, drinking, marijuana, or hallucinogens? Staying up late studying, partying, breaking up with a significant other, feeling lonely…all can trigger psychosis.
EM: How should you as a parent understand psychosis?
YJ: I think of psychosis as our body’s natural response to a trauma, something we aren’t able to hold, manage, etc. We all have defense systems to protect us, psychosis is another form of defense when the “threat” is just too much to manage. Young people are particularly vulnerable as crossing that bridge into adulthood is packed full of challenges!
EM: What should we do while our loved one is in a psychotic state?
YJ: Try to help them get some sleep even if it means getting a prescription for a sleeping pill (assuming they aren’t sleeping). If your loved one won’t talk with you, try to find other family members, friends or professionals for he/she to talk with or be with. Sometimes a change of environment can be helpful.
EM: How would you suggest a parent think about being told that his or her child ought to go on one or more than one psychiatric medication for his or her diagnosed mental disorder or mental illness?
YJ: I would strongly recommend if you child has been prescribed a psychiatric medication to hold off as long as possible and only use it as a “major tranquilizer” for a short time period, then stop and see how they are doing without the medication. I would never take more than one medication at a time as these are strong drugs and no one knows how they interact together when on multiple drugs. Some medications when stopped can have strong withdrawal symptoms which may mimic psychosis, don’t be fooled and remember to always titrate off slowly!
EM: What if a parent currently has a child in treatment for a mental disorder? How should he or she monitor the treatment regimen and/or communicate with mental health professionals involved?
YJ: If your child is under the age of 18 you will have access to records and open communication with the provider. However, if over 18 your child needs to consent to sharing records and allowing the practitioner to share information with you. Try to maintain close ties with health professionals.
EM: What if a parent has a child who is taking psychiatric drugs and the child appears to be having adverse effects to those drugs or whose situation appears to worsening? What would you suggest the parent do?
YJ: Let the prescribing professional know that they are not doing well on the medication. I would hope that the professional would advise you to stop the medications, be wary that the side effects of the medications may be causing “symptoms” and don’t agree to increase the dose! Rather stop that medication and maybe try another. Sometimes the health professionals are not savvy to these side effects and thus will prescribe more! This is the time you should advocate to stop the medication that’s not working first and then try another if so inclined.
Always monitor your child for depression and suicidal ideation or intent as these are serious and not uncommon side effects particularly when giving a young person an anti-depressant. Studies have shown, particularly with younger people, an increase in suicide while on anti-depressants.
YJ: Sometimes, even in the most loving of homes the child needs a change of scene. See if they might stay with another relative or friend who understands the difficulties and is available to provide a retreat/safe place to be. Go to the mountains, nature, get out of highly stimulating surroundings. Look for practitioners who aren’t advocating for medications as the first line of treatment but rather want to get to know the person. Bringing the family together, friends and others who are part of your child’s life can be a show of love and support and also provides a larger safety net.
EM: What would you like to say to a parent whose child is in difficulty and who would like to put her trust in the current mental health system?
YJ: The current mental health system is broken and underfunded. There is a heavy reliance on medications as the first line of treatment. This should be a last resort. If possible, seek private help and only with those providers who are familiar and comfortable with psychosis or acute depression.
To better understand the mental health system and the history, read THE ANATOMY OF AN EPIDEMIC by Robert Whitaker
Directory of Providers: www.mentalhealthexcellence.org and click on the provider button and explore this website!
This post was previously published on Psychologytoday.com.
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