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National Research and Trends
• There are an estimated 4.5 to 6.3 million children and
youth with mental health challenges in the United States.
• About two-thirds of these young people do not receive the
mental health services they need.
• In many communities, services for youth with mental
health challenges are unavailable, unaffordable, or may
not be sufficient to address their needs, leaving these
youth at risk for difficulties in school and/or the
community.
(http://store.samhsa.gov/shin/content//SMA08-4351/SMA08-4351.pdf)
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Consequences of not addressing Mental
Health Needs
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Increase risk for school failure
Social isolation
Violence
Substance abuse
Unsafe sexual behavior
Incarceration
Poor Health
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Most Common Child and Adolescent
Diagnosis
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Depression
Anxiety
ADHD/ ADD
Trauma
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Check yourself
• Remember we all have some symptoms of
anxiety and depression.
• When assessing and diagnosing mental illness
we look at duration, multiple symptomology,
and impact on life functions.
• NO Medical Student Syndrome Today!!
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Depression
• Younger youth 1 in 33
• Older youth 1 in 8
• Ages 10-19, an average of 430 youth a year were
treated inpatient setting for an attempt for selfinflected injury between 2007-2011 in Indiana
(Indiana State Department of Health, suicide in Indiana Report, 2013)
• Indiana ’s suicide rate has been slightly higher
than the national average for nearly a decade.
• In recent years, suicide among Hoosiers ages 1519 has wavered between the 2nd and 3rd leading
cause of death.
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Depression Symptoms
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Frequent sadness, tearfulness, crying
Increase in irritability and anger
Decrease in activities
Persistent boredom/ low energy
Isolation
Low self-esteem
Extreme sensitivity to rejection/ failure
Difficulty with relationships
Frequent physically complaints
Frequent absences' from school/ poor grades
Poor concentration
Major changes in eating and or sleeping
Talk of running away
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Most At Risk Youths
(www.nimh.nih.gov, 2005; Reynolds, W.M., 1988)
• Starting antidepressants
• Family history
• After being released from
a psychiatric inpatient
hospital stay
• Friend committed suicide
• Real or perceived distress
or “hassles”
– Peers
– Family
– School
• Diagnosis of
depression/anxiety/
bipolar disorders
• Little Family/Social
supports
• Few coping skills
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Anxiety
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Restlessness
Poor concentration
Feels tense
Reoccurring thoughts that interfere with activity
Gets upset when separated from parent
Nightmares
Fears of being alone
Stomach aches/ nausea
Fatigued easily
Excessive worry about: grades, family, relationships,
performance with sports
• Tend to be harder on themselves and strive for
perfection
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Multiple Anxiety Disorders
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General Anxiety Disorder
Panic Disorder
OCD
Separation Anxiety
Social Anxiety
Specific Phobias
Selective Mutism
PTSD
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ADHD/ ADD
• An estimated 7% of U.S. children are diagnosed
with ADD/ ADHD
• Any misbehaving child can be diagnosed with
ADD/ADHD. 10 million child have been
diagnosed with it, and ninety percent of Ritalin
is sold in the U.S. Many believe that the real
problem is cultural. Life has become so stressful
that most adult feel overwhelmed by normal
children.
• Rate of ADHD children in traumatized children
is between 28- 30 %
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(Everything Parent’s Gide to Children with ADD/ ADHD, 2005)
(Putnam 1998)
ADHD/ ADD Symptoms
• Inattention:
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Difficulties listening, even when being directly addressed
Difficulties continuing to pay attention to activities involving either work or play
Difficulties paying attention to details and avoiding carless mistakes
Difficulties completing tasks, chores, and assignments
Difficulties organizing activities and task
Difficulties doing task that require sustained mental effort
Difficulties keeping track of possessions and materials
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Squirming and fidgeting even when seated
Getting up when expected to remain seated
Running excessively and climbing in inappropriate situation
Difficulty playing quietly
Being always on the go
Talking excessively
Blurting out answers
Not waiting his or her turn
Hyperactivity/ Impulsivity:
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Trauma
• Trauma occurs when a child experiences an intense event that
threatens or causes harm to his or her emotional and physical
well-being.
▫ Can be the result of exposure to a natural disaster
 Tornado
 Flood
 Hurricane
▫ Medical Trauma
▫ Terrorism
▫ Abuse
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Sexual
Physical
Domestic Violence
Extreme Neglect
▫ Other
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Trauma and Triggers
• After Trauma
▫ Youth is on Constant Alert
▫ Youth may over interpret signs of danger
▫ Youth overreacts to normal situations
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Traumatized Youth’s Responses
• Fight/ Flight
▫ Hyper vigilant
▫ Easily Offended
▫ Over reactive
▫ Violent
• Freeze
▫ Dissociation
▫ Nonresponsive
▫ Self-Mutilation
▫ Self-Medication
How to Access Services
• You can call your local Community Mental
Health Center or provide the number to the
patient. To access who your local Community
Mental Health Center is:
▫ Access the Indiana Council of Community Mental
Health Centers:
 http//www.iccmhc.org
 Or Call 317-684-3683
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Questions ??
Tara Elsner, LMHC
Amanda Stropes, LCSW
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