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6 ways to improve childhood mental illness treatment

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John LaDue makes court appearance.
Waseca Co. Sheriff deputies escort 17-year-old John LaDue into court.
Elizabeth Baier/MPR News

Seventeen-year-old John LaDue, planned a violent attack on his family and school in Waseca earlier this year, but was arrested before he could follow through.

LaDue planned to murder his family and shoot "as many victims as [he] could get" at school, according to transcripts of his interviews with police.

"I think I'm just really mentally ill," LaDue told police officers. "And no one's noticed. I've been trying to hide it."

The case has once again brought to the forefront issues of mental illness in children.

Alan Kazdin, professor of child psychology at Yale University and director of the Yale Parenting Center, said there are more than 300 recognized mental illnesses and they aren't always easy to detect.

"It's not as if they're wearing a red shirt; many of them are just not that visible," he said. "In the case of children and adolescents, consider two broad kinds: those that are mostly depression and withdrawal, and those that are acting out like aggression... Adults, particularly parents and teachers, do not recognize depression, withdrawal and anxiety very well. It's not as if they've failed; they're very hard to recognize in children. It isn't what people missed; not everything is evident."

Kazdin, along with Jarrod Leffler, child and adolescent psychologist at Mayo Clinic, joined The Daily Circuit to talk about ways to detect and improve mental health care for children and adolescents. 

6 ways to improve childhood mental illness treatment

1. Watch for ostracism
Kazdin said one sign of trouble is when a child is excluded from their group of peers. It's natural for someone to try to be accepted into the group and conform to fit in, but when that doesn't work, a child struggling with mental illness can become aggressive. This isolation can lead to thoughts of revenge and violence. 

2. Most children don't recognize they have a condition that deserves treatment.
"It's not as if a child is hiding a cut," Kazdin said. In the United States, 25 percent of the population at any one time have symptoms that meet the criteria for a psychiatric disorder, he said. 

3. Monitor how stress impacts children in your life.
"Children and teenagers experience the stress that the adults bring home," Kazdin said. "So if there's marital or work stress, it spills over to them. Children have two kinds of stressors to be simplistic: their stressors and the family's stressors. It turns out parents don't get the stressors from the children, that is they don't pick up theirs. They're usually not aware of them."

Kazdin recommends starting a firm relationship with open dialogue early with children so you can talk about these stressors when they hit adolescence.

4. Be proactive with your family.
From June, a caller in Minneapolis:

5. Better and regular mental health assessments of all children.
Kazdin says children should receive simple assessments that look at socialization and impairment for early detection. "You don't wait until all your teeth are falling out and go to a dentist," he said. "Along the way, you're having care."

6. Embed mental services into the healthcare system.

Leffler said Mayo Clinic is considering ways to better integrate mental health check ups into regular appointments. 

"One pilot we're looking at here is for any teen coming in for a primary care visit in one of our clinics, they're doing one of these screeners that Dr. Kazdin mentioned," he said. "If you score high enough, then you're enrolled or asked to participate in some kind of follow up. Monitoring these people and keeping our finger on the pulse as they're struggling with whatever it might be... is I think in the future where the money is going to be for helping these families."

We received a lot of great feedback from listeners during the show:

Pat in Duluth on trying to get help for her troubled son:

Kelly:

I think that we need to start teaching kids early on in school that having a mental illness is not something to be ashamed of. Mental illness runs in my family, and I knew in high school that I had a problem. I didn't want to tell my parents or a teacher because I felt that it would make me stand out, look weak, and doing so would everything feel more real, that I really was sick. It forced me to face my problems instead of ignore them. Money was not an issue, resources were not an issue, insurance was not an issue. It was 100% based on my negative stigma towards mental health. If we teach children early on through education in schools, religious institutions, and after school programs to be aware of their feelings, to know the difference between having a bad day and feeling anxious or depressed for a period of time, and that telling a teacher, a parent, a neighbor, or an older sibling what you are feeling then we can start a new generation of children who feel comfortable speaking up for themselves and for their own health.

Deb in Minneapolis:

I worry about how much compassion and attention is given to kids who are bullied, and how little is given to the kids who are labeled as bullies. They are likely in pain too--and acting out because of it. To me, the issue is often seen as good kids/victims vs bad kids/aggressors and this puts those kids further down the road to feeling more ostracized and angry. I think these kids need someone to reach out to them who actually wants to hear what they're feeling and dealing with. 

What options and programs are available? How can we help kids who are reluctant to ask for help? Leave your comments below.