My Child was Diagnosed with a Mental Health Disorder! Now What?

My Child was Diagnosed with a Mental Health
Disorder! Now What?
by Ron Huxley

When a child is diagnosed with a mental health
disorder, it is a frightening and confusing experience both
for the child and his or her parents. By the time the child
has received a clinical identification of an emotional or
mental problem, there has been a time of confusion,
frustration, and anger that has already occurred prior to the
new label. Parents can be both relieved, to have a name for
their child’s problem, and upset, to hear that their child has
a disorder.

This can become more complicated when mental health
professionals use large, undefined words to describe a
child's problem. This use of psychological and diagnostic
terminology can make parents feel stupid or foolish, so
much so, that they may be afraid to ask what it all means.
The result is parents who feel as if they are a failure. They
may also feel powerless to cope with their child's mental
health disorder.

Child Development and Diagnosis

Understanding the role that child development plays in
childhood mental health disorder will help parents
understand how it is diagnosed. Child development
provides a standard that the parent and the professional
can use to assess and diagnose a childhood mental health
disorder. Although child development differs from one child
to the next, all children go through similar stages.

Children grow at unique rates: physically, emotionally,
socially, and mentally. One child may excel in the area of
social skills and lack physical grace. Another child may
have superior coordination but poor academic proficiency.
Development is a fluid process, carrying the child along at
different paces. The magic of this fluidity is that children will
"catch-up" to other children if they have minor delays.
Usually, no outside help is needed in these cases. Another
child, with larger discrepancies, will need interventions to
"catch-up" to their peers. On the ladder of child
development, these latter children will need a "leg up" in
order to reach the next step of development. That is where
parents and professionals, working together, come in.

Another developmental issue occurs when a disorder, in
one area of a child's development, affects other areas of
functioning, in the child's development. For example, a child
experiencing depression (an emotional developmental
area) may have physical complaints (i.e., headaches,
stomachaches, or fatigue), academic difficulties (poor
grades, no motivation) and social skills deficits (few friends,
withdrawn, antisocial). It is important that the mental health
professional pays attention to developmental variations and
helps the parent understand how one area can affect
another.

Finally, child development is dynamic and purposeful.
Children have a natural curiosity and an even wider
capacity for growth and change. This is good news for
parents. This capacity allows children to regenerate and
heal from childhood traumas that lead to disorders. It is the
ally parents and professionals count on to make effective
interventions and allow the child to have a normal, healthy
life. What this means, in the area of childhood mental
health disorders, is that children and their disorder, can
change over time. In fact, they are developmentally driven
to change. It is the parents' and the professional's job to
help steer children in the right directions.

A "Tangled Ball of String"

The origins of childhood mental health disorders are
complex. In some cases, such as Post-Traumatic Stress
Disorder, cause is fairly straightforward. A child is a victim
or witness of a crime or severe accident, shows signs of
sleep disturbances, nightmares, and flashbacks, and is
given the proper diagnosis (in this case PTSD). Other
disorders are not so clear. They are clouded by biological,
familial, cultural, interpersonal, and socioeconomic factors,
all of which might play a part in the child's diagnoses. A
good metaphor for this complexity is a large, tangled ball of
string. It is hard to know on which part of the string to pick
at to untangle the ball. It might require that you work on
various parts of the string, at multiple angles, to unravel the
problem.

One important string, connected to the well being of the
child, is his or her family. Disorders affect members of the
family and are affected by those same members. This is
why professionals will say that the family is a system and
that the treatment for the disorder may require that all
members of that family system be involved, even if they do
not have the disorder. As such, the family system may
increase or decrease the symptoms of the childhood mental
health disorder; much the way a heating system's
thermostat regulates the room’s temperature. Too hot and
the heat shuts off. Too cold and the heat turns on.

Conversely, family members can be affected by another
member's mental health disorder. A common example
occurs when one child in a home takes a large chunk of a
parent’s time and energy (not to mention finances) to help
the child cope with his of her disorder, leaving the other
children in the home feeling ignored. Resentment, anger,
and aggressive behaviors are typical in siblings of children
with mental health disorders and often, must be addressed
by the professional working with the family.

DSM-IV: The Diagnosis Bible

When professionals diagnose a child, they use a book
called the Diagnostic and Statistical Manual of Mental
Disorders (or DSM). The book is divided into sections for
adult mental health disorders and "disorders usually first
evident in infancy, childhood, or adolescence."
Professionals use this book to communicate with one
another (and insurance companies) about childhood mental
health disorders. It is a classification system for
understanding and labeling the defining features of
childhood mental health disorders.

The DSM defines a mental health disorder "as a clinically
significant behavioral and psychological syndrome or
pattern that occurs in an individual and that is associated
with present distress (e.g., a painful symptom) or disability
(i.e., impairment in one of more important areas of
functioning) or with a significantly increased risk of suffering
death, pain, disability, or an important loss of freedom."

Stated simply, a mental health disorder is a problem that
affects a child's ability to function in his or her world. An
important note, made by the DSM, is that a classification is
not about classifying the person or child by his or her
mental health disorder. This clarification can have profound
effects on the self-image of the child. Being a problem and
having a problem are very different things and create very
different reactions from others.

Mental health professionals make a diagnosis, based on
the classifications listed in the DSM, on five axes or levels
of diagnoses. Axis I is used for Clinical Disorders or Other
Conditions That May Be a Focus of Clinical Attention. Axis II
is used for the listing of Personality Disorders and Mental
Retardation. Axis III describes the General Medical
Conditions. Axis IV is used for Psychosocial and
Environmental Problems. And Axis V is the Global
Assessment of Functioning. This multiaxial system provides
for a comprehensive format for organizing and describing a
child's disorder.

Information and Support

Perhaps the most important thing a parent can do when
their child has been diagnosed with a mental health
disorder is to get as much information on the topic as
possible and find a support group for parents of children
with this diagnosis. This will reduce a lot of the anxiety and
myths about the diagnosis.

Parents can find information by taking a ride to their local
library, searching their local bookstores, and browsing the
Internet. At first, parents will feel overwhelmed or even
refuse to look at the information. This is normal and will
usually pass with time. If a parent chronically refuses to look
at any information on the topic they may need the help and
support of other parents to deal with this frightening change
in their lives. Don’t try to force or guilt a parent into
researching their child’s diagnosis. Compassion and
patience is needed at this time.

Support groups are helpful to parents of children
diagnosed with a mental health disorder. These groups can
help normalize the diagnosis by parents who “have already
been there and done that” with the diagnosis. They can
help the new parent advocate for their child’s rights with the
schools and health agencies. They are available to hold up
and sustain the parent when the emotional burden
becomes too great to bear on their own.

Working with a Professional

Most likely a parent will work with the professional that
diagnosed his or her child. But when this is not the case, for
instance when the child has been diagnosed by a school
psychologist or general family physician, the parent will
have to find a qualified professional that they feel
comfortable with.

Parents should ask the referring professional for
recommendations on who can help treat the child and the
family. Parents can also talk to members of their support
groups and review the materials they have gathered online
and offline as to the most appropriate type of interventions
and therapists for their child’s diagnosis. If parents have no
particular names to contact, look in the local listings for
professionals in the parents' living area and contact two or
three likely candidates. Ask to interview one or two that
appear knowledgeable and experienced with the child’s
disorder. The decision of a professional working with a child
is not an easy one and should be considered patiently and
wisely. Take time to research location, price, availability,
and background. Feel free to ask for references. This
involves a child’s well being and should be handled
carefully. Once a professional has been chosen, work
closely with that person on the needs of the child. Every
professional has a different way of handling parent/child
interaction and consultations in therapy. Some will meet
individually with parent and child. Others will want to meet
together. Talk about the reasoning behind both
approaches. Either way, parents need to be involved as
they are the central agents in their child’s life.

Having a child diagnosed with a mental health disorder is a
crushing experience, even in the best of circumstances and
with the best of medical and therapeutic help. Parents will
need to understand all of the issues that are involved with
the child’s disorder, including development, diagnosis, and
treatment techniques. Finding information, support, and a
qualified professional will be helpful as parents navigate the
stormy waters of diagnosis and treatment. With this help,
they should be able to find calmer and safer times in their
lives.

Reference:

* Diagnostic And Statistical Manual Of Mental Disorders -
Fourth Edition (1994). American Psychological Association,
Washington, D.C.

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