Childrens Treatment for Mental Health Issues
And welcome to the psych central caused went each episode features guest experts discussing psychology and mental health in everyday plain language his you host gay pallid hello and welcome to this week's episode of psych central podcast before we get started. I want to give a big shout out to our sponsor. Better help online therapy where you can get one week of free convenient affordable private online counseling anytime anywhere just by visiting better help dot com slash psych central they help keep the show free so please check them out and speaking of shows calling in today. We have a perot rice the c._e._o. Of tanger- tanger- place of cedar rapids iowa apar- welcome hake thanks gave is great to be with you today. We're really glad to discuss children in and mental illness children and mental health. Nobody wants to talk about children. I mean people just aren't talking about mental illness at all and children are vulnerable so i really appreciate all you you do and being willing to have this discussion. The first question that i want to ask you is what is tanisha place well yeah we're e central iowa pretty much and we are a behavioral health organization tation and and we serve about five thousand kids a year and we have a large outpatient mental health clinic impatient services and home services. We also do a great deal of training on trauma and resilience billion. We hosted a symposium every year and really you know our mission is to inspire empower and he'll that's really the three things that we are trying to do with kids and our state the other thing though that i'm really involved in a lot of advocacy both on the state level the national level. I'm also involved in some international work as well and so this discussion around children's mental health and what is is proper mental health for children has been something. I've been working with really since the last few years. I think it's a conversation that's finally starting to kind of hit the national media i think people superstar pay a little bit more attention. I think even when you look at what's happening right now at the border and what's happened with those kids. People are talking about the trauma of c._n._n. Somebody was talking about the trauma of two. They're facing and i said oh okay. We're finally starting to get it other countries so it is a good conversation have and and because really it's about where we're going to pull resources for the future so the future that literally the truth but it's a hard thing to do one of the things that i think that's interesting is is you're saying that trauma is part of mental health and and it's sad mental health a lot of people when they think of mental health and you know unfortunately we use that word wrong all the time you know. He has mental health. Everybody has mental health. They're really speaking of mental so illness but when we're speaking of negative mental health you see the trauma scale is being very valuable. Can you explain that a little bit because so many people don't see trauma as mental illness or mental health at all yeah because i think we're trying to do. I think what has happened in movies and other things. I think people have had this vision. What is somebody who is mentally ill and then what if somebody who is struggling with mental health what if somebody who isn't struggling with mental health challenges and what we learn what we really know that all of us at some point have had some type of challenge right and some of us have had different redoing factors and different invinci- helped us over those humps and i think that we are starting to to know more at least speak to and i think the people are like oh yeah you know. I think i'm gonna go get some help or your child is looking a little bit more sad than i than i remember or or they're not talking as much. Maybe we should get some consultation. I think what we've known the discussion around trauma and acis the adverse childhood experiences that the kaiser is a permanent had done had really kind of pushed across the nation and people start to think like god how many what were those things that kids have been exposed to that could affect their physical outcomes later in life and that's where the discussion has changed over the last few years people are making a connection with these events and they don't have to be you witnessed the shooting they could be things like people hollering hollering and your house or bullying situations that happened at school or divorce may be a multitude of things that are traumatic to a child so there's no one like you no major traumatic event it could be a small little things that added up but he rolled the child sense of self over the years and so one of those things that help to trial built themselves back up one of those things that helps trial feel strong one of those supports the community has to to to fossils resumes factors in children. That's what we're talking more about. That's the part that's exciting. We kinda knows eldest dead. They're really deteriorates. Child resilience factors but we have to do is invest in the things that actually help build those resilience factors and when it comes to children they're vulnerable honorable for a couple of reasons one their children but to they're completely dependent on the adult who are around them for example. If if i feel that i am in harm's way as an adult. I am empowered to do something about it but children don't have that. They're stuck with whomever their parents are and that it can be positive but it could also be very negative. You know absolutely i mean but when you think about it all children have to go to school right so we know oh and we we as a country. No where kids are going to be mainly especially during the school months. We have to build on supports there. We can't parents. They are doing the best job they can. Some parents are better another parents right depending on how you look at what what parenting is some days. I have two sons. I feel like i'm a really good parent and somebody's i feel like i'm really struggle to handle that situation well so parents onto also a tremendous amount of pressure and i think when we look at the complex issues that our society almost seems factor in however however parents still need backup right you know we need to make sure that the school systems in that are also a trauma informed resilience focused solutions focused and to help kids who may be struggling and what we find is that more and more resources have been pulled out of schools for mental health and for positive mental health than than have been in in years past is everybody's trying to do the best account the budgets they have. We also need to make sure enough community support. I grew up in chicago and i remember spending my summers. Basically away almost unsupervised on the streets kogyo run with my friends. You know there were no community centers. There were no real <hes> organize activities in my neighborhood and so how can we invest and our community especially our community are more risk and we know that there are higher traumatic event and lower socioeconomic status to make sure that those kids are still getting positive positive influences that were still intervening in a positive way preventing kids from having further mental health crises later on in life and also strengthen their resilient. There are a lot of things that we have to do at the community and it's not a and again i don't mean to be cliche but we have to look at it the whole village <hes> and that we have to care about what's happening all kids regardless of who lives in my neighborhood who doesn't love a my neighborhood. These are things that we need to have. An interesting concept that you raise a are that there are things that we can do to give kids a better chance and improve their mental health. The children won't even see as preventative medicine for for lack of a better word. You take a child to a doctor and you give them a physical cooler. You give them vaccines that the child knows that it's preventative medicine but having structured activities having supervision getting them involved in sports theatre or music or things like this it improves their mental health and i would say that the average child is is completely unaware that this is improving their mental health. Absolutely absolutely they're building. Blocks of life is that this is what we know kids need. This is what kids know. It's that holistic view of a child and we also have to and you said we have to care as much about the mental health their physical health. That is s crucial. I have said something controversial at a at a meeting. Then maybe a year ago right up to the park went shooting and that tragedy the about that young man and all those children die this also child who committed this act was this young man who had gone through therapy and had been in therapy and therapy is not a magic bullet. Medication is not a magic bullet and sometimes i think what gets portrayed that these things are like so magical no at the journey to the journey that we need to start as early as possible for children and and to make sure we're intervening as early as we possibly can and hopefully preventing tragedies like that but there are many many children who struggle with mental health issues who never become mm violent. There are many people who have struggled have issues as children who've grown up to be very successful adults what it is that you find those things that helps center you finals thing to help oh you recover. When you have crises you find those supportive adults though supportive community around you helps you when you have in some of those low points they use of psychopharmacology has also been something on that <hes> we have gotten much better at knowing that the types of medications that might help childen when children's shouldn't be on medication as a field. We have gotten much more sophisticated. We tend not to focus on the positive things that are happening to and the many many programs around the country that are doing positive things that for whatever reason the things that always hit the paper or things we always for the most about other negative things that are happening. That's something i think is really really unfortunate and we've got to have portrayals out there people who are getting healthy. It's okay to have set back this okay to have challenges. We all have that and that's the part we have to realize. None of us has gone through life and i haven't some type of mental health challenge or issues a low self esteem or issues depression or issues of self doubt or doubt about the world. You know these are things that we just have to come to acknowledge. I think that helps reduce the stigma and a lot of ways because because you know what it can be any one of each of us has such different unique creatures. We all have different zillions factors. We'll have different lives with live and and then that journey has taught us how to deal with different stresses and so i am very much glass half full about this because i think that there are so many amazing people out there trying to do work with kids that it it does my heart. Well and i know a tender. That's one of the things that we do and i can see that work every day. We're going to step away to hear from our sponsor. This episode is sponsored by better help. Dot com secure secure convenient and affordable online counseling. All counsellors are licensed accredited professionals anything you share is confidential schedule secure video or phone sessions plus plus chat and text with your therapist whenever you feel it's needed a month of online therapy often cost less than a single traditional face to face session go to better help dot com forward slash psych like central and experienced seven days of free therapy to see if online counseling is right for you better help dot com forward slash psych central and we're back speaking with a paro rice the the c._e._o. Of teenager place let's talk about some controversy for a moment because something that you said there is we need everything we need. Psychopharmacology which is medication and we need therapy european and we need community supports and we need. We need lots of things that you use the cliche which is one that i really like that. It really does take a village but like you you said the controversy hits the news and one of the big ones that people talk about all the time is oh. You have a hyper child or a child whose hard to handle. Let's medicate them and make it easier on the parents. What do you have to say about that from your viewpoint as the ceo of tanner place who works with a lot of children who are in crisis yeah i. I think that that's a fallacy. I think that sometimes we think that appeal can solve everything. Psychopharmacology is is just a part of treatment. They usually tied to therapy and other interventions. It's just a part of the treatment process. It is not meant for every child. It is not the most appropriate thing for every child <hes> but there are a large segment of kids where it is. We are very lucky here. We have two psychiatrists to psychiatric nurse practitioner psychologist. We have a great medical team here and i see them and the work they do every day. Parents are not coming in saying. Hey just give me some medication. My child just needs to calm down. That is not what's happening. We don't do that type of work. We're not operating isolation that way. You need to really first of all understand. The diagnosis of that child was happening with them at school and at the home and their social interactions and then you you're making a treatment plan liam psychopharmacology maybe part of that treatment plan or may not or maybe four small amount of time. The thing is that we are doing the right intervention at the right time and the right dose. That's what the most critical thing and medical providers that help but we do it in a very interdisciplinary team environment so you have a psychiatrist. You have the therapist you have. The caseworker work all talking about with the parent. This isn't lockstep with the parents. I think that sometimes it was society. We think oh yeah kill for that. That'd be then that's fine. That's not really reality and most medical providers. They're not trying to do that either. Um in all fairness doing in psychiatry. I've known around the country and people i talk to people. Take that very seriously because what we know that some of these cases are very strong and they're out long-term studied around the how they may impact children's physical health years down the road so people are very careful about what they prescribe. It's interesting to hear your perspective on a par because you say things like psychopharmacology and interdisciplinary team and wrap around around services and that's a very medical approach and i think that is what's happening in the field. I think that is the average way that a child old is prescribed medication and services etc but it doesn't quite have the f- of over just medicating annoying kids and i think that that's why that information kinda goes out there because that's kind of a fascinating conversation like hager. Your your child is a pain. Let's give him drugs like that. That has that hook only impression that the medical model. I should say much more holistic model. I mean because the other pieces that we do and it's part of our conversation how we look at kids as you're looking at all the social should determines of hell that the c._d._c. put out so you understand housing you understand employment you understand all of the societal factors that go into what happens in that household what happens with those adult also then happens to that child some speaking from a professional standpoint that using the big words or whatever but the reality is i'm also a dad of a thirteen year old and a nine year old and when i think about if my children are having challenges what would i want them to have and the fact that their dad is a c._e._o. Should not matter we want kids who whose his parents not c._e._o.'s whose parents are single parents whoever could be able to get the same quality of care and that same holistic view of that child so there's no shortcut to proper treatment amount and that's all we have as a society i think i think we're starting to get there. I am hopeful. We're getting together. We see the the holistic of whether child again communication is not a cure. All it's gotta be part of a treatment continuum that involves therapy that may involve physical health and there's a lot of other pieces that go along with it but we after look at the child holistically otherwise we're not really doing a service because children are not they don't operate in isolation so if you're not looking at all those pieces you're not going to be effective and then no medication aged only effective when we're not trying to have kids who are zoned out you know walking around both the city that's not. That's not productive as healthy. There's an interesting thing that you said there. Were you said said the things that are happening to the adults in the household are happening to the children in the household and i want to touch on that for a moment because adults really have this idea that children are you know the bulletproof from the ways of the world they don't have mortgages and jobs and children and all of these things but i think if we all reflect back back when when mom and dad are stressed out about money that is fell and reverberated throughout the household and absolutely impacts the children now it may impact them in a different way in fact act. I think it's reasonable to say that it absolutely impact children in a different way. Can you sort of speak on that idea that oh you're just a kid. Don't worry about it and how that needs to evolve volve because the kids are worried about it but because you told them not to worry about it that means you're not a source of supports right and i'll say a couple of things you know. One first of all anybody has been around. Any type of child knows children pick on everything first of all. There's nothing seems to get past him which is remarkable but i must take my own experience a little bit. You know i grew up in a household. My father was a drug got. My mom was very clinically depressed and i know for a fact when i look back on my wife the effect that those two things had on me and what happened when you are wondering if you're going to have a home the next day all right. We're almost for a little bit. You know what that's like. You don't know what's happening with your next meal or your mom can't get out of bed for two days because she doesn't have the strength to do that. You know so. I know what those things did to me. Made me think about throughout my life i mean those are extreme and i would hope nobody has ever had to experience that i know their children who experienced that every single day and that's the extreme but there are small just the pressures of maintaining the household depression around making sure that gifts at christmas time that's one of the things that in my role and all all the roads i've had that's always so important because guess what are the parents i know when he gets the christmas time and how expensive toys r. and people want to give the kids thing and that's stressing that pressure trying to make that happen but god you pay this bill. You go get this toy right. You know we try to make sure all our kids who are programs. Get some christmas gifts. Families get gifts so that's one less thing that they have to worry about but all those pressures of course filter down to the child they can feel that tension and again each child responds to that tension in a different way but we have to acknowledge the attention there is they're not they're not oblivious as a matter of fact they're picking up on way more than than you think and sometimes it's good to have a conversation. You're trying to push the old enough to to have a dialogue to make them feel reassured that hey things are okay. We're gonna be fine. This may be tight right now but this is what we're doing. You know you don't have to talk to him like an adult but acknowledged that the tension is there. That's going to help them. I'm still safer. Let's move onto when everything goes wrong. The worst case scenario what people unfortunately think about more often than not when they think about mental wellness and that's crisis you said at tanner place you have inpatient and outpatient services and the crisis treatment. Can you talk about that a little bit how you take somebody from crisis to wellness. Yeah i mean well guinness a journey because each child is different and so for our children are impatient program. They're not able to be in their home home for various reasons so we have kids who come who have severe depression we have kids who may just come out of a psychiatric hospitalization and so that journey for them. It's gonna look different for each family has gone a little gonna look a little bit different. You know i. I don't look necessarily as crisis. I think that they may have had this episodic situation right but it's really about. How do you help them. Avoid that situation going into the future. How do you build their resilience so they don't do any self harm or they don't think about suicidal ideas or contemplate not being on the planet. How do you help young people do that and there's no easy. I wish it was an easy fix but it's not not because each child response to treatment and such different ways and also what we learn now what we learn about what we really acknowledges that you know what if you're not helping the family at the same time a child may be an inpatient care that you're really not doing quality treatment and that is something that absolutely moved across the country and i think people are much much more family engaged family driven because we get that child may be with us for six months eight months. They're going to go back to that home. They're gonna go back to the home community so we not only build the resilience doings factors in that child if we don't do that in that family and then that community then they're not going to be successful going back so i think the what we know again is moving away from the medical model treat the child treat the child. Treat your child to now much more of a systematic holistic view of that family unit. That's what makes for good treatment and it takes time. Unfortunately unfortunately we live in a managed care. Environment and insurance sometimes dictate certain things and each state is very different how that's done and so not only do. We have to have a really quality impatient program ram. We gotta also really quality. Community based supports for that child to and understand it. There may be setbacks along the way that's part of the journey right. Nobody one day is like oh boy. I'm so you know. I'm having this episode of crisis. Perfectly fine doesn't work that way. That's not life but we have to have things in that community where that child may not need that highest level of care that most restrictive the level of care. How do the families respond to this because i i imagine that given our limited knowledge of mental health that exists in society when they knock knock on your door. They probably believe that the issue is entirely with the child and then you're saying no no no. There's there's things that you can do as well as their push back on that. I'll sure i mean there's some but you know it really. A lot of people come in our doors. They just want help. They want help the dawn of parent any parent losing. Their child is terrifying they did they want help. Okay and i'm not saying it's all pines gotta. Everybody comes as so open to the now necessarily true. He's treatment program is different and treatment programs uh-huh unique. Each each family is unique. Some people are ready to engage in and change making process. Some people are ready to do some self reflection and people are not. It just really really depends and that's where i peed. There are other programs that people can find the fifth what their family may need but for the most part honest to god i met with a lot of parents who are in crisis and who feel like it because they don't wanna lose their child and our jobs to help give them hope that we're going to help be part of the journey with you and so a lot of people that it's just hard it's humbling and scary and so again you acknowledge that you validate those feeling but then you set a course of action you set a plan together to help their child in to help their family again if the family isn't healthy part of that or encouraging people to to be healthy then it's not treatment is not gonna be successful. Long term and there are a lot of families. We have who themselves wound up in therapy. We seek seek additional things. We've had events in their passive changed. You know how they parent so again. If you're open and you're engaging with people people come to you for help and that's the most profound thing once adores openness and help us help us family. There are a lot of things you can do. We just have to come with the right spirit philosophy around not victim blaming it. We don't have people say all your your fault. Your child is struggling with your child has thought about committing suicide. That's not what you do. You look at what are those factors that led to that child thinking about that. What does those stresses in my child's life that his way of them to think about that. What can we do whatever supports you can build in. How can we build in supports for that parent as well that even here not about your child is dramatic so those are things that we do. That's the final thing that i want to touch on oprah. So many people believed that mental illness only exists in children that have bad parents more more often than not bad mothers or come from broken homes or there's just a lot of like you said victim blaming that the child would be fine if it wasn't for or they're awful family. We know that that's not true. Absolutely let's just straight. Children's mental health challenges cover every social economic spectrum. I don't care we have kids who come who are seen in our outpatient clinic and are impatient programs whose families are extremely wealthy whose families are extremely poor whose families families are a middle class. It covers every gambit so we have to put that out. We have to just say that's just a myth and you know what even families that are are very very poor. They want the best care for their child too. That's the other meth that we have a society which is a whole different conversation to be imported with me. You don't care about your kids so everybody's everybody's trying to get the best care they can. They have limited resources. They can turn to to get that care. That's where wealth gives you that opportunity but better believe it wealthy poor middle-class. Everybody has the same level of mental health struggles that is excellent. Oh par thank you so much. What's the website for your place if people want to check it out across the country country you gotta w._w._w. Dot tanner place dot org awesome. Thank you so much for being on the show. We really appreciate your time and for enlightening us on all of these subjects. You're just you're just awesome. Thanks so much for having me. I really appreciate it. You're very welcome and hey everybody. Do you want to interact with me on facebook suggest topics comment on the show and be the first to get updates. 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