WBEZ | Out of the Shadows http://www.wbez.org/series/out-shadows Latest from WBEZ Chicago Public Radio en Out of the Shadows: Preventing Child Suicide http://www.wbez.org/blog/city-room-blog/2011-10-28/out-shadows-preventing-child-suicide-93574 <p><p>According to the<a href="http://www.nimh.nih.gov/health/publications/suicide-in-the-us-statistics-and-prevention/index.shtml#children" onclick="window.open(this.href, '', 'resizable=no,status=no,location=no,toolbar=no,menubar=no,fullscreen=no,scrollbars=no,dependent=no'); return false;"> National Institute of Mental Health</a> (NAMI), about eight in 100,000 children commit suicide every year. The families of these children who are left behind often find themselves in a tragic bind to figure out what “went wrong.”</p><p>Most parents fall on the spectrum between surprise and confusion; all are in shock.&nbsp; And unfortunately, the symptoms of suicidal behavior are often right in front of us, even if they seem ambiguous.</p><p>Changes in a child’s behavior should always be investigated, especially if the cause for the change isn’t clear.</p><p>Dr. Adelita Segovia is a child psychiatrist. “The biggest regret I see in some parents happens when they have mistaken symptomatic behavior for ‘acting out,’” she said.</p><p>Symptomatic behaviors can be difficult to identify. The following is a list of indicators to help parents clue-in to suicidal behavior.</p><ul><li>A child may become more withdrawn or isolate themselves.</li><li>History of depression or previous attempts.</li><li>Cutting; hurting themselves or others.</li><li>Slowly overdosing: take notice if your child, who takes their own medicine, may be taking more than the recommended dose</li><li>Children who are particularly violent; violence can easily stem from depression. Violent children are also more likely to do something impulsive.</li><li>If a parent finds drawings, letters, or writing that contains thoughts of suicide, depression, or hurting themselves or others.</li></ul><p>The first thing a parent should do if they feel their child is displaying symptomatic behavior is talk to their child. Parents aren’t always as tuned-in to their child’s life as they think. Ask direct questions to get a sense of what’s really happening.</p><p>The second thing a parent needs to do is get help. There are many resources for information about suicide prevention and medical professionals who can help with the struggle that comes with depression. A full assessment of a child suspected of being mentally ill in any capacity is always recommended.</p><p>For immediate help, contact the <a href="http://www.suicidepreventionlifeline.org/" onclick="window.open(this.href, '', 'resizable=no,status=no,location=no,toolbar=no,menubar=no,fullscreen=no,scrollbars=no,dependent=no'); return false;">suicide prevention hotline</a>. More information, as well as a resource list, can be found at Suicide Voices of Awareness Education <a href="http://www.save.org/" onclick="window.open(this.href, '', 'resizable=no,status=no,location=no,toolbar=no,menubar=no,fullscreen=no,scrollbars=no,dependent=no'); return false;">website</a>.</p><p>More resources:</p><p><a href="http://www.afsp.org/" onclick="window.open(this.href, '', 'resizable=no,status=no,location=no,toolbar=no,menubar=no,fullscreen=no,scrollbars=no,dependent=no'); return false;">American Foundation for Suicide Prevention</a></p><p><a href="http://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml" onclick="window.open(this.href, '', 'resizable=no,status=no,location=no,toolbar=no,menubar=no,fullscreen=no,scrollbars=no,dependent=no'); return false;">National Institute for Mental Health</a></p><p><a href="http://www.spsamerica.org/" onclick="window.open(this.href, '', 'resizable=no,status=no,location=no,toolbar=no,menubar=no,fullscreen=no,scrollbars=no,dependent=no'); return false;">Suicide Prevention Services of America</a></p><p><a href="http://www.sprc.org/" onclick="window.open(this.href, '', 'resizable=no,status=no,location=no,toolbar=no,menubar=no,fullscreen=no,scrollbars=no,dependent=no'); return false;">Suicide Prevention Resource Center</a></p><p><a href="http://www.nasponline.org/resources/crisis_safety/suicidept1_general.aspx" onclick="window.open(this.href, '', 'resizable=no,status=no,location=no,toolbar=no,menubar=no,fullscreen=no,scrollbars=no,dependent=no'); return false;">National Association of School Psychiatrists: Preventing Youth Suicide</a></p></p> Fri, 28 Oct 2011 16:27:00 -0500 http://www.wbez.org/blog/city-room-blog/2011-10-28/out-shadows-preventing-child-suicide-93574 Out of the Shadows: Mental health experts discuss getting help for mentally ill youth http://www.wbez.org/episode-segments/2011-10-28/out-shadows-mental-health-experts-discuss-getting-help-mentally-ill-yout <img typeof="foaf:Image" src="http://llnw.wbez.org//segment/photo/2011-October/2011-10-28/out of the darkness walk flickr.jpg" alt="" /><p><p>For the past few weeks, <a href="http://www.wbez.org/series/out-shadows"><em>Out of the Shadows</em></a> explored the numerous obstacles that surround mental illness. In the series' last conversation, <em>Eight Forty-Eight</em> explored what could be done to break down those barriers. Three experts spoke about the medical, legal and very personal issues involved in treating mentally ill children.</p><p>Lawyer <a href="http://www.law.uchicago.edu/faculty/heyrman" target="_blank">Mark Heyrman</a>, who specializes in the rights of the mentally disabled, <a href="http://www.iit.edu/psych/people/profiles/terrence_koller.shtml" target="_blank">Dr. Terry Koller</a>, a licensed child psychologist and the executive director of the Illinois Psychological Association and <a href="http://www.afsp.org/index.cfm?fuseaction=home.viewpage&amp;page_id=6A71D16C-915E-6926-704E5A9C15C3D6AF" target="_blank">Stanley Lewy</a>, who founded the Midwest Chapter of the <a href="http://www.afsp.org/index.cfm?fuseaction=home.viewPage&amp;page_id=1" target="_blank">American Foundation for Suicide Prevention</a> and the <a href="http://www.spassoc.org/" target="_blank">Suicide Prevention Association</a> after losing his son, all weighed in.</p></p> Fri, 28 Oct 2011 16:15:00 -0500 http://www.wbez.org/episode-segments/2011-10-28/out-shadows-mental-health-experts-discuss-getting-help-mentally-ill-yout Out of the Shadows: A mother's account of her daughter's suicide http://www.wbez.org/story/out-shadows-mothers-account-her-daughters-suicide-93562 <img typeof="foaf:Image" src="http://llnw.wbez.org//story/photo/2011-October/2011-10-28/flickrrosemary.jpg" alt="" /><p><p><em>Over the past few weeks, <a href="http://www.wbez.org/series/out-shadows" target="_blank">Out of the Shadows</a> has brought you in-depth reports of children and their families suffering from mental illness. Our series concludes with a mother's personal account of a most devastating outcome: suicide. </em></p><p><em>Barely two months ago, Maria's daughter, Alicia, took her own life, just days before she was to return to her sophomore year at college. Alicia's suicide was shocking, not because the family wasn't aware of her depression, but precisely because they were aware of it. They'd treated and supported her condition for years and felt very close as a family. Her death has left an unbearable pain - and many unanswered questions.&nbsp;</em></p><p><em>Here's Maria's story.</em></p><p><em>(</em><em>Note: The names of the participants have been changed to protect their privacy.</em>)</p><p>[Alicia] was very passionate. She would open her heart with no reservations—maybe expecting others to do the same. The saddest part is, she was able to help others and not help herself. You don’t know it—you can’t see that pain. It’s not one that is bleeding. But it’s bleeding internally. And you don’t see that blood coming through.</p><p>I will ask my daughter, are you happy? She will say “No, I haven’t gotten there.” Was she telling me the truth? I don’t know, I don’t know. I never saw it. She never made an attempt. The fact that taking an anti-depressant can give you suicidal thoughts—how can a medication give you suicidal thoughts? That’s what you wanted to avoid. It doesn’t make any sense</p><p>I remember filling her papers for college, and in the papers it said, “Are there any concerns you would like us to know about your child?” And I took the time to write out “my child has depression.”<br> It was not until her cat—or, our cat—died that she went to a counselor; it wasn’t the right fit. She didn’t like it, she never went back.</p><p>Another parent has told me recently that she has a daughter with depression and that was part of her contract with her—if you want us to pay for your room and board and your tuition, and your support, in return, you need to see a therapist every week and you need to call us once a week. Not an e-mail, not a text, we want to hear your voice. Wow, I wish somebody would have told me that.</p><p>She finished both semesters with great grades and she came home, she went out, she was not super busy—kind of relaxing, spending a lot of time on the computer, especially on a site called Tumblr, describing depression as “the monsters in the dark.”</p><p>The nights were the worst for her. I was never a big fan of Facebook, Tumbler, Myspace, or any of them. I tell my kids I said, “Did you really have 800 friends? A 1000 friends? I don’t see them coming through this door. What’s the fictitious world you’re creating out there?&nbsp; When you see these friends having fun, how do you feel as a child? It might be lonely. You might be depressed.</p><p>I found that she searched for painless suicide. How do they have a legislation for invading your home if you’re searching for making bombs and if there’s suspicion of any terrorist attack? There has to be a connection between 911 and making an attempt for suicide. There has to be a 911 call.</p><p>She was texting with someone across the nation that night. Somebody that she met through Tumblr. And it seems to me for the evidence I have found later, that this girl also had depression. She said to the girl in her last text&nbsp; that she was thinking about doing this. And the girl says back to her, “Please don’t do this. Don’t pay attention to the assholes out there. You’re a great person, I know it’s gonna get better. Please, don’t.”&nbsp; My daughter said back to her, in a text, “It’s not about the assholes out there. It’s about my own mind.”</p><p>If it would have been an adult she was talking to, or somebody with the right state of mind, they have the phone number.&nbsp; All they have to do is contact 911 and say, please find the address for this phone number, because this person is about to do this.</p><p>We went to her college for a celebration of her life and we were told by the President that in his experience of all the years that he’s been president of various colleges that the summer between freshman and sophomore when a kid comes home is one of the most difficult ones. My husband and I looked at each other and we said , “Wow—really?”</p><p>We have a son, he said to me—mommy, I’m your son, I’m alive, I’m here, I’m your son, I’m alive, I’m here. And I need you here. Please don’t leave me. That’s my who sister left me, please don’t leave me too.</p><p>He immediately tried to get busy with everything. It was a sign for me that he didn’t want to think about it. And my biggest concern is that I hope that he can heal and grieve in his own way and that this tragedy doesn’t explode later on in his life.</p><p>She really underestimated her condition and the capacity of her brain to go to the darkest place. The guilt that we have—we question our skills as parents. Everybody tells us you guys were great parents. However, do you need to be an expert to save the life of a child? Be aware? Have eyes in your back, in your front, in your side? Don’t underestimate. But don’t also project those fears to your kid. This very talented, beautiful, intelligent, compassionate, full of life girl is gone. And now we are survivors. How are we supposed to go on?</p><p>I’m hoping that together we can learn to ease the pain.<br> &nbsp;</p></p> Fri, 28 Oct 2011 13:47:00 -0500 http://www.wbez.org/story/out-shadows-mothers-account-her-daughters-suicide-93562 How mental illness affects intimacy http://www.wbez.org/story/out-shadows-how-mental-illness-affects-intimacy-93539 <img typeof="foaf:Image" src="http://llnw.wbez.org//story/photo/2011-October/2011-10-27/holdinghands.jpg" alt="" /><p><p><em>As <a href="http://www.wbez.org/series/out-shadows" target="_blank">Out of the Shadows</a> neared its close, the series explored another end – the transition between adolescence and adulthood. Mentally ill youth face big decisions and challenges as they get older; one of which is dating.</em></p><p><em>Listeners met Shakena at the beginning of Out of the Shadows. Shakena’s often embarrassed to talk about her mental illness; she's been through a lot. She witnessed a murder when she was nine and she was molested as a child.</em></p><p><em>Older now, 18, Shakena started dating a classmate from college but only just recently told her boyfriend about her depression. So now she must navigate the highs of falling in love in tandem with the lows associated with trauma and illness - ones that previously prevented her from getting too close to boys. WBEZ's Aurora Aguilar helped Shakena share her experience.</em></p><p>The things I suffered through I was by myself. When I was molested, I was by myself--no one to turn to. When someone died in front of me I was outside, by myself. And I don’t like being by myself.</p><p>We were just friends first you know talkin’, textin’, seein’ each other when we can since we were at the same school. I was coming home from school and he took me out to dinner. He was carrying my bag and we were talking and he was actually telling me about how he was telling his friends all about me. I was like “Oh yeah?”</p><p>He was like “Yeah, I was telling them like how you were gonna be my girlfriend soon.”</p><p>"Oh soon to be? So when you gonna ask me?"</p><p>He was like, “I don’t know, when will you be ready?” And so while we were leaving he grabbed my hand while we were in the street and he kissed me.</p><p>He’s shorter than me; he has dark hair. I don’t know--he has dimples and tan skin he’s just cute. I don’t think he likes that I say that about him because he’s like, “I’m a man—I’m not supposed to be cute and adorable!" He’s really cute!</p><p>He’s 27. In a way that’s a good thing for me because I need a certain level of maturity. I feel like he can understand because he has years of experience and also with similar troubles that I’ve experienced as well.</p><p>I’ve told all my friends about him. They were like “Ohhh Shakena! What are you doing? He’s so old, he has kids, what’s going on?”</p><p>I’m black, he’s Mexican, and it was like, “Oh! You’re going with a Mexican!” I was like, “Yeah! " And he’s always speaking Spanish to me, and I don’t know what he’s saying but he sounds so sexy so I’m like "OK, whatever, sure!”</p><p>We tell each other everything; even if it’s something the other person doesn’t want to hear; that’s something I always value in a relationship. Also, he takes into consideration my moods. If I don’t want to talk he sets back, he doesn’t push me to speak about what’s going on with me, y’know?</p><p>And I want to share things with him. I’ve told him things that I haven’t told my best friends that I’ve known like basically all my life. It’s good to have that sort of comfort level—level of trust.</p><p>When we talked on the phone I was like, “Babe, before we go any further… I have to tell you something.” He was like “OK babe what do you have to tell me?”</p><p>I was like “I don’t want to say it over the phone.” I don’t think that’s a good idea because it’s really important to me and it’s a part of Shakena, you know?</p><p>So, the next time I saw him, he was like, “OK, what’d you have to tell me?”</p><p>I have this thing: I don’t like when people look me in the eye, especially when I’m telling them something so serious ‘cause I feel like they’re judging me and what I say so he was like, “Would you feel better if I didn’t look at you?” and I said, “Yeah, it would.” So he closed his eyes, he grabbed my hand, he said, “OK, so tell me what you have to tell me.”</p><p>So then I told him, and he was listening. He was really understanding; not how I expected him to be. I kind of expected him to be like, “Oh she’s depressed is she’s gonna be a downer?”—that’s what I expected him to say.</p><p>When I get into those moods where I want to be alone, I lock myself in my room, cut off my cell phone, if someone knocks on my door I act like I’m asleep—like I didn’t hear it. Total isolation from everybody and everything.</p><p>I honestly don’t know if I can be able to “stop it” so to speak. I think I can help it from progressing to such a large state, but stop it completely? I’m not sure.</p><p>He just said that if I feel like, at any point in time, we’re moving too fast, he said “OK, we can stop talking, whatever,” as long as I tell him first. He doesn’t want me to just like ignore him. He was just like, “Listen babe, if you have a problem, just let me know, and I’ll give you anything you need.”</p><p>I think I fell in love with him and it’s creeping me out! Especially since we haven’t known each other that long you know it’s been three-four months and first it’s that serious and for my mind and body to react like that to him is pretty scary. It’s almost too perfect, too fast, something’s gonna go wrong. You know I tell my best friend that and she’s like, “Oh you’re looking for trouble—and you’re gonna cause it.”&nbsp; I was like, "I’m not trying to, but when something seems too right, it usually is." Something’s gonna break apart at some point in time.</p><p>The worst thing he can do is leave; and the best thing I can do is be honest. So, I’d rather tell him earlier in the relationship than later.</p></p> Thu, 27 Oct 2011 14:57:00 -0500 http://www.wbez.org/story/out-shadows-how-mental-illness-affects-intimacy-93539 The tricky transition to adulthood http://www.wbez.org/story/tricky-transition-adulthood-93294 <img typeof="foaf:Image" src="http://llnw.wbez.org//story/photo/2011-October/2011-10-19/Ana Thresholds FInal.jpg" alt="" /><p><p>People between the ages of 18 and 25 are the most likely&nbsp;of any age group&nbsp;to experience mental illness. They’re also&nbsp;the least likely&nbsp;age group to get adequate services, and often have difficulty navigating the complex transformation into adulthood known as “the transition cliff.”</p><p>Ana lives in one of those unassuming buildings peppered throughout Chicago that don’t quite look like the homes and apartments surrounding them. These are assisted living facilities.&nbsp;She’s been living here with her cat, Snowball, and a handful of other adults with mental illness for a few years.&nbsp;</p><p>ANA: I turned 21 on a Sunday, and that Friday I was emancipated from DCFS. I had no guardian; I was my own guardian. I knew I wasn’t going to have anymore help. I was scared when I was put into my own apartment because thought I was going to end up doing something really bad to myself.</p><p>Ana’s diagnosis is borderline personality disorder, depression, chronic PTSD and schizoaffective disorder. Since she was 13, she’s bounced between dozens of hospitals and nursing homes. Ana has family in Chicago, but none she could turn to for help.</p><p>ANA: Unfortunately my dad doesn’t believe in mental illness so it’s kind of hard to talk to him. He doesn’t believe I need medication. He has a thing about throwing my pills in the garbage and I have to go scavenge hunting after them. It’s hard to make him comprehend I can’t help it – he thinks I do it on purpose.&nbsp;</p><p><img alt="" class="caption" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-19/Marc Fagan Thresholds Final.jpg" style="width: 300px; height: 568px; float: right; margin: 8px;" title="Dr. Marc Fagan leads a training on crisis management for young adults with mental health issues to adolescent and youth service providers. (Photo courtesy of Thresholds)">Ana says her dad didn’t believe her mom’s mental illness was legitimate, either. Her mom is schizophrenic.</p><p>ANA: Unfortunately she jumped off 7th floor building, and crushed her leg. She’s permanently in a wheelchair. I just learned this last year. My&nbsp;family kept that from me. Before that I thought my mom was dead.</p><p>Her mother is now living in an assisted care facility in Texas. Ana arrived at her facility with the help of Thresholds. Her supplemental security income – or SSI – pays the rent. She’s been doing well here, even holding down part time jobs at Radio Shack and Target. But she wants more.</p><p>ANA: I don’t want to be here such a long time, you know? There are people here who’ve been here 10 years, 13 years, you know? And I don’t want to do that. I don’t want to be here the rest of my life.</p><p>Mark Fagan is the associate director of youth programs at Thresholds. The non-profit mental health agency provides treatment and housing.</p><p>FAGAN: With our state in Illinois, we know that it’s increasingly very seriously difficult to get any kind of mental health services if you don’t have really good insurance or if you don’t have Medicaid.&nbsp;</p><p>He says even though the law says adulthood starts at 18, insurance and Medicaid coverage don’t necessary follow that marker.&nbsp;So Fagan says that young adults experiencing a mental health condition tend not to qualify for those services at exactly when they need it the most.</p><p>Adding to that problem is the fact that the mental healthcare system is designed for independent adults or for dependent children. There’s not much out there for those who fall in between.&nbsp;</p><p>Vanessa Vorhies is a researcher who works with young adults at Thresholds. She says that research shows that true adulthood actually starts around 30 years old.</p><p>VORHIES: You know if we think about any other developmental phase across a lifespan - this one is what I find is most interesting - is the amount of change. The young people tend to move a lot, they tend to be under a lot of stress because they have to pick college or a career or something. And you can become a parent. Also young people are most likely to get or develop serious mental health conditions during this time.</p><p>Because hormonal changes affect brain development, many disorders don’t physiologically show up until these in between ages. By the time these symptoms are identified, Fagan says the services that match with them don’t follow along, and that’s where we get into what we call a “transition cliff.”</p><p><img alt="" class="caption" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-27/RS4487_Marco and Corey Final-scr.jpg" style="width: 397px; height: 250px; margin: 8px; float: left;" title="Marco (left) and Corey both receive assistance from C4 Chicago - a behavioral health and social service provider. (Photo courtesy of C4 Chicago)">COREY: Being honest you know, independence is hard.</p><p>Corey is&nbsp;21 years old. He suffers from schizophrenia and lives with his family in Roscoe Village.</p><p>COREY: My family thought that it was like a phase or a funk - that it would go away eventually. But unfortunately it didn't happen and they decided I needed professional help.</p><p>Corey is lucky to have parents that recognized his illness and who still want him to keep living with them. Because many parents, after years of incredible difficulty raising a child with illness, are overwhelmed to the point of saying, “You know what? You’re 18 – you’re on your own.”</p><div><p>COREY: One of my pills was $400. Another was $200. Two of them were over $100. Pills are very expensive, that's why people need health insurance.</p><p>While his family offers emotional support, he says they’re not in a position to fully support him financially. Corey’s monthly cost of medication comes to nearly $1,000. And like so many navigating insurance beaurocracy, he had a lapse in services.</p><p>COREY: We have Medicaid, and then they sent me a notice in the mail that at 19 they cut me off my insurance, but they never gave me a chance to apply for my own medical card. I didn’t have insurance for a month and a half. I had to pay for my medications completely and medications are so expensive. I completely broke the bank, I had no money in my account whatsoever.</p></div><p>Shannon Garrison is a therapist working with Corey and many other young adults at C4 Chicago. She says she sees gaps in services like his all the time.</p><p><img alt="" class="caption" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-27/RS4488_Shannon Garrison Final-scr.jpg" style="width: 395px; height: 287px; margin: 8px; float: right;" title="Shannon Garrison, a therapist at C4 Chicago (Photo courtesy of C4 Chicago)">GARRISON: I’m still trying to figure out how this process works because there doesn't seem to be rhyme or reason. I have quite a few clients that have the same mental health diagnosis, the same kind of delays or deficits in functioning and one has gotten approved for a medical card, and has gotten approved for SSI, but a kid in a similar situation can't get either one.</p><p>With this lack of medication and therapy, Garrison says young adults end up back in the hospital, or worse.</p><p>GARRISON: So it actually ends up costing more without these services because you're going to see a lot higher rates in psychiatric institutions and in unfortunately the criminal justice system.</p><p>Garrison’s program, just like the other rare programs like it across the state,&nbsp;lost a $100,000 dollar grant to fund their young adult services. They had been teaching scores of struggling youth everything from balancing a checkbook to job readiness. And it’s dealing with some of that daily grind that makes life so hard for people like Corey.</p><p>COREY: Ever since my mental disorder, when I’m stressed out, I get under pressure I do have little breakdowns. I get angry, I cry. I just feel like if I still went back to school I’m afraid I couldn’t finish because to this day I still crack down under pressure. &nbsp;</p><p>Both Corey and Ana have had it rough. But in a way, they’re fortunate – because they found help. Studies show that about one out of every five youth has a diagnosable mental health disorder. And of those – 70 percent never get treatment.&nbsp;Consider this: If one in five Chicago public school students had an undiagnosed mental disorder, there would be more than 57,000 ill children without mental health care in this city alone.</p><p>Corey and Ana’s lives illustrate just a few ways in which this phase of life is treacherous. Despite advances in medicine and therapy, the immense social stigma of mental health conditions remain immune to science. In considering everything, it’s easy to feel hopeless. But Mark Fagan, who we heard from a while back, says the very instability of this period is actually where there’s hope, too.</p><p><img alt="" class="caption" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-27/RS4485_Vanessa and Ana Final.jpg" style="width: 388px; height: 244px; float: left; margin: 8px;" title="Researcher Vanessa Vorhies meets with Ana. (Photo courtesy of Thresholds)">FAGAN: Young adulthood is also a time where we’re able to have some pretty serious influence. &nbsp;You know often times their brains are not fully developed and that’s what’s great. Because we still have that opportunity to provide some influence in terms of both their biological structure as well as their social and emotional structure. So even though it’s an incredibly difficult time, it also provides us with a lot of opportunity for hope and support and for the ability to create healthy transitions along their lifetime.</p><div><p>What are your hopes for the future?&nbsp;</p><p>ANA: I want to become a social worker or therapist. I want to be someone that helps other people.</p><p>COREY: I don't want to throw my life away - I have dreams for myself.</p></div></p> Thu, 27 Oct 2011 11:00:00 -0500 http://www.wbez.org/story/tricky-transition-adulthood-93294 Teaching mentally ill children: A delicate balance for children and teachers http://www.wbez.org/content/teaching-mentally-ill-children-delicate-balance-children-and-teachers <img typeof="foaf:Image" src="http://llnw.wbez.org//story/photo/2011-October/2011-10-26/lakeshorehospital.jpg" alt="" /><p><p>Katie Osgood made her way down Lawrence Avenue; she was on her way to work. An ambulance passed and she wondered if it was one of her students. Hers is not a typical classroom: There are no desks, the kids wear scrubs and she’s careful about what supplies she uses.</p><p><img alt="" class="caption" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-26/lakeshorehospital-crop.jpg" style="margin-right: 15px; margin-top: 15px; margin-bottom: 15px; float: left; width: 325px; height: 411px; " title="(Flickr/Zol87)">"Count out my pencils, you know. And then other things, I just can’t use—you know, staples, paper clips. I mean markers aren’t dangerous, but you do have to kind of watch them," Osgood said.</p><p>Osgood’s the only teacher at Chicago Lakeshore Hospital, a psychiatric facility that treats mentally ill patients, including kids. There are 40 beds for youth at Lakeshore but her average class size ranges between eight and 20 kids. She’s a certified teacher, so kids get credit for a half-day of class each day she teaches them. But because of privacy issues, she may not always privy to what they’re learning at their regular schools.</p><p>"I do always tell them, 'You know what? Make sure you’re OK first; if this is going to stress you out, we’re not going to work on it today. You gotta get well with you.' A lot of kids will actually respond with, 'No, I want to do this. I feel like I can.' Whereas if you’re in a regular school,you kind of have to keep pushing them. I mean, today a teacher’s job is on the line if your kids don’t get the grade,” Osgood explained.</p><p>The kids, between the ages of four and 17, come from all over the city. But share one thing in common: They are disoriented and away from their parents or guardians. They’re admitted at all hours—even at 4:00 a.m.</p><div class="inset"><div class="insetContent"><p><a href="http://www.wbez.org/series/out-shadows" target="_blank"><img alt="" src="http://www.wbez.org/sites/default/files/story/insert-image/2011-October/2011-10-12/OutOfShadows-promo.jpg" style="width: 280px; height: 63px;" title=""></a></p><p><span style="font-size: 11px;">Out of the Shadows will explore the fractures in mental health care for children in Illinois and illuminate how it affects our youth.</span></p></div></div><p>Osgood explained, "Some of them are going through the hardest point in their lives. Like it probably won’t get worse than whatever it was that brought them here--whether it’s a suicide attempt, whether it was a moment of rage where they got out of control, whatever it was that brought them here."</p><p>You won’t hear Osgood in action during this story. Heikenen-Weiss wasn’t able to record her with students present because of privacy concerns. And it might not have represented an average day for Katie; there is no such thing. Things are always in flux—her patients, their needs, their interests, their health and capacity to learn. One thing is constant: Every morning, the kids participate in a group therapy session called “community.” The kids state why they’re hospitalized. One kid says he kicked his sister’s door down. Next to his name on a white board up front, the counselor notes that anger is an issue he’s struggling with. Under his goals, she writes: “Build up anger management skills.”</p><p>"A kid starts acting up or something, you can always point to the board—'Oh, you’re supposed to be following directions today, remember?'," said Osgood.</p><p>Osgood looks for signs that might help her teach the kids.</p><p>"It’s almost like cracking a code for all these kids. You know, figuring out what exactly is driving these behaviors? What is going on behind the scenes that’s causing them,‘cause you might just look on and see, oh, the kid threw a chair. There could be a thousand things—someone could have called him a name in the morning, or maybe he didn’t eat anything that day or maybe, you, know, he’s going through being put into the foster care system and he just found out. You know, you don’t know what’s happening," Osgood explained.</p><p><img alt="" class="caption" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-26/shadows-crop.jpg" style="margin-left: 15px; margin-top: 15px; margin-bottom: 15px; float: right; width: 325px; height: 491px; " title="(Photo courtesy of Katie Osgood)">All of the employees that work with Osgood were trained to catch these clues. But Lakeshore was not without its problems. A study out earlier this year, commissioned by the Illinois Department of Children and Family Services,claimed that children had been sexually abused because employees weren’t keeping an eye on them. Hospital officials refuted those claims—and&nbsp; Osgood said she felt supported.</p><p>"One of my biggest things that I love about working at a place like Lakeshore is that I have a team of people with me. I always have a mental health counselor there in the room with me," Osgood said.<br> Every member on staff was also trained to deescalate situations, even the small ones cause those can escalate with these kids. Sometimes, that can mean shutting down the entire ward if kids get too agitated. Osgood said that maybe once or twice a week, a kid has to be restrained by staff. But she looked at every act of discipline as a learning experience.</p><p>"After you give a time out to a child, you need to process and say, 'Well, why did you get this timeout? What can you do differently next time?'" Osgood said.</p><p>With a patient’s doctor nearby, Osgood could input on how medications were working out.</p><p>"Some of these mental health issues are brain-related. You know what? It’s a chemical imbalance, and if you regulate that, then guess what? You see amazing results. We always remind the kids that medication alone is not going to…you have to do your part, you have to use your coping skills," Osgood remarked.</p><p>Osgood gets to know some of the kids—some have a hard time leaving, even after they’ve been medically cleared. Those are usually wards of the state who have no place to go. They often stay up to six months’ other students plunge back into the outside world.</p><p>Osgood explained, "A lot of times, we’re discharging these kids straight back into school, like the very next day. And half the time, the teacher won’t even know that the child has been hospitalized for psychiatric issues. You know, it’s protected health information, you know, and if the family chooses not to share that, the teacher has no idea."</p><p>Osgood said that she sees a lot of kids return to the hospital.<br> "My objective is kind of to show these kids that they can do it. I want the kids to experience some kind of success, especially the ones who have experienced a lot of school failure. You can rope them in a lot easier in terms of getting them engaged," she said.<br> Osgood knows she’s not teaching her kids to test, or to pass a grade, or to build on the lessons of a previous teacher. She’s hoping to plant a kernel—something that might pop up later in life.</p><p><br> &nbsp;</p><p><br> &nbsp;</p></p> Wed, 26 Oct 2011 15:05:00 -0500 http://www.wbez.org/content/teaching-mentally-ill-children-delicate-balance-children-and-teachers State guardianship's role in caring for mentally ill kids http://www.wbez.org/episode-segments/2011-10-26/state-guardianships-role-caring-mentally-ill-kids-93502 <img typeof="foaf:Image" src="http://llnw.wbez.org//segment/photo/2011-October/2011-10-26/flickr San Jose LibraryUSED.jpg" alt="" /><p><p>Some wards of the state end up in psychiatric hospitals like <a href="http://www.chicagolakeshorehospital.com/" target="_blank">Chicago Lakeshore Hospital</a>. Over the years, the <a href="http://www.state.il.us/dcfs/index.shtml">Illinois Department of Children and Family Services</a> has made great strides in finding homes for abandoned, neglected and traumatized kids. Some families, like the one profiled in <a href="http://www.wbez.org/story/adopting-fight-93364" target="_blank">Rehman Tungekar's piece</a>, choose to give up custody of their adopted children because they can't afford treatment for mental illness; but DCFS has little power of supervision once children leave the agency. When the <a href="http://www.uic.edu/uic/" target="_blank">University of Illinois at Chicago</a> issued reports that were highly critical of some of the region’s private psychiatric hospitals this year, DCFS was limited in what actions it could take. To learn more about the challenges facing the agency and its charges, <em>Eight Forty-Eight</em> was joined by the deputy director for the Division of Clinical Services at DCFS, <a href="http://www.state.il.us/dcfs/library/management_bio.htm" target="_blank">Cynthia Tate</a>.</p></p> Wed, 26 Oct 2011 15:01:00 -0500 http://www.wbez.org/episode-segments/2011-10-26/state-guardianships-role-caring-mentally-ill-kids-93502 Adopting the fight: A family's effort to provide for their mentally ill child turns into a custody battle http://www.wbez.org/content/adopting-fight-familys-effort-provide-their-mentally-ill-child-turns-custody-battle <img typeof="foaf:Image" src="http://llnw.wbez.org//story/photo/2011-October/2011-10-21/Daniel Hoy 2.JPG" alt="" /><p><p>From their modest home in Ingleside, Ill., Toni and Jim Hoy draft a letter to their son, Dan. He last lived with them three and a half years ago.</p><p>Dan and his brother Christian are adopted. They joined the Hoys and their two biological children 15 years ago.</p><p>The adoption decision had been risky, especially given the children's troubled history.</p><p><img alt="" class="caption" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-25/custody-crop.jpg" style="border-width: initial; border-color: initial; margin-right: 15px; margin-top: 15px; margin-bottom: 15px; float: left; width: 325px; height: 421px; " title=""></p><p>"It was very chaotic," Toni explained, citing the boys' young birth mother. "There was prenatal substance abuse: alcohol and drugs. And there was post-natal physical abuse. Severe neglect where the children did not have food to eat. The neglect was probably worse than the abuse."</p><p>It didn't take long for Toni and Jim to see the childhood abuse manifest in the kids' actions. "Soon after, we realized, probably after two years of having them in our homes, even being untrained, these were not normal kid issues," recalled Jim. "But we had already brought them in our homes, and we made a promise to them that as long as they wanted to be here, they would always be a part of our family. And I've tried to always honor that promise to those children."</p><p>Christian had manic rages and was diagnosed with bipolar disorder at the age of nine. Medications helped stabilize him.</p><p>But Dan was getting worse. Around the time he reached the fifth grade, he exploded.</p><p>"There were times where I would pick him up from school, he would wait to get in the car where he thought no one could see him, and he would basically attack me, where he knew he could get away with stuff," Jim remembers. "He'd throw stuff at the drivers, he'd grab the steering wheel and direct us into oncoming traffic, and he thought it was funny."</p><p>Dan was diagnosed with post traumatic stress disorder. The Hoys tried all sorts of therapies to treat Dan's condition, including psychiatry and medications. But, according to Toni, "none of that worked either."</p><p>The Hoys tried between 20 and 30 different medications, but Dan's behavior became more unstable. His therapist recommended he be placed in a residential treatment center--a home with intensive therapy and specialized care.</p><p>But residential treatment is expensive. Despite looking everywhere, they were denied the family funding.</p><p>Treatment would cost over $10,000 a month. Their insurance wouldn't cover it, and neither would the Medicaid Dan received as part of his adoption package.</p><p>The Hoys scrambled to buy time while they looked for funding. But it all came to a head when Dan was 14.</p><p><span style="font-size:14px;"><span style="font-family:georgia,serif;"><strong>Violent behavior takes hold</strong></span></span></p><p>Jim described the situation in detail. "By that time, we had to have Danny residentially placed because he was trying to hurt the other kids--threatened to stab them, tried to push one of his siblings down the stairs."</p><p>They brought Dan to a nearby hospital for one of what would become countless psychiatric evaluations. By this time, hospital visits were becoming more frequent.</p><p>According to Toni, the situation was dire. "He was in the hospital, the hospital was wanting to discharge him. We were trying to stall, and we were asking if they'd hold him for just a couple of days. And they refused and told us that if we didn't pick him up they were going to call the [Department of Children and Family Services] child abuse hotline and report us for child abandonment, and yet DCFS told us if we brought him home they were going to try us for child endangerment for failing to protect the other children."</p><p>It was a lose-lose situation. "I thought at that time we were at our worst point, and it kept getting worse and worse and worse," recalls Jim.</p><div class="inset"><div class="insetContent"><p><a href="http://www.wbez.org/series/out-shadows" target="_blank"><img alt="" src="http://www.wbez.org/sites/default/files/story/insert-image/2011-October/2011-10-12/OutOfShadows-promo.jpg" style="width: 280px; height: 63px;" title=""></a></p><p><span style="font-size: 11px;">Out of the Shadows will explore the fractures in mental health care for children in Illinois and illuminate how it affects our youth.</span></p></div></div><p>The problems encountered by the Hoys are not typical. According to a report from DCFS, 95% of adoptions remain stable after five years. DCFS also offers a variety of post-adoption support services for families in need, but that offered little comfort to Toni.</p><p>"Ultimately, you know, it really came down to safety. When you really think about a vision of one of your children holding a knife to the other one's throat knowing that he's going to kill him, you know, can we go on living like that?"</p><p><span style="font-size:14px;"><span style="font-family:georgia,serif;"><strong>Neglect charges and state red tape</strong></span></span></p><p>Taking the advice of a therapist, the Hoys decided to leave Dan at the hospital.<br> <br> "I went there and told Danny that I wasn't going to pick him up. I mean it was the hardest thing I ever had to do in my life," Jim remembers through tears. "For the first time since I had made that promise to Danny and to Christian that we would always be there, I wasn't sure I was going to be able to fulfill it. It's very, very tough."</p><p>Toni and Jim relinquished custody of Dan and were charged with neglect. They later had the finding amended to no-fault dependency, which meant while legally they were still Dan's parents, the state of Illinois had guardianship rights over him. As such, he was able to access residential treatment at the expense of DCFS.</p><p>But not everyone was pleased with the decision.</p><p>Kendall Marlowe is a spokesperson for DCFS. "Adopted children are not returnable, like an ill-fitting garment," Marlowe says. "There's a reason they call it permanency."</p><p>Marlowe says that families seeking treatment like the Hoys place an undue burden on a department that was never designed to handle such requests.</p><p>"There have been academic studies that show that a high percentage of children who enter child welfare systems throughout this country, are, at the root cause of it, entering those systems because of unmet mental health care needs. And that's just not the best way to get help to children and families," says Marlowe.</p><p>Marlowe thinks families should be more vigilant about getting early preventative treatment through health service systems. "Broadly speaking, we will be more effective at delivering mental health services when it comes from the health service system. And that is not something that state will be able to conquer on their own. It will need a federal role to truly be effective."</p><p>But it was too late for the Hoys to seek preventative treatment at the time of the relinquishment. Over the next two years, Dan would live in two different residential centers. Toni and Jim ultimately regained custody of Dan, but he's in juvenile detention after an incident at his last residential center.</p><p>His future remains uncertain as the Hoys work towards obtaining funding for his treatment.</p><p>"You know, hope is like the air we breathe. I mean, to me I will never be out of hope for Danny. But at the same time, we gotta be somewhat...have reality and focus too," Jim says. "Right now, if anything, Danny is worse than when he went into the residential system. That being said, my family was made complete when Danny and Christian came into our lives. Like we said, from day one when they came, if they wanted us to be mom and dad forever, we would be. And we're here."</p></p> Tue, 25 Oct 2011 15:35:00 -0500 http://www.wbez.org/content/adopting-fight-familys-effort-provide-their-mentally-ill-child-turns-custody-battle Out of the Shadows: Obsessive-Compulsive Disorder in Children http://www.wbez.org/blog/2011-10-25/out-shadows-obsessive-compulsive-disorder-children-93453 <img typeof="foaf:Image" src="http://llnw.wbez.org//blog/photo/2011-October/2011-10-25/by Matthew Purdy.jpg" alt="" /><p><p>Let’s face it: we’re all a little obsessive at times. There are some things we’ve done the same way since we were children. But what happens when a child is so adamant about certain actions that it becomes clinically diagnosable?</p><p>Childhood-onset Obsessive Compulsive Disorder, or OCD, is not uncommon. But it can be difficult to diagnose. What’s the difference between a clean kid and an obsessively hygienic kid? How can you tell a young child who likes to open and shut the door apart from a child who feels like they have to shut the door three times?</p><p>The answer is usually right in front of us. This is especially true when kids, unlike adults, are unable to distinguish “strange” behaviors from normal ones.</p><p>Externally, extreme cases of OCD affect a child’s sleep pattern and social interactions. Some children will instigate seemingly pointless fights with family members over things that seem mundane, such as the symmetry of objects on a dresser, or the way food is presented. Internally, severe OCD can result in depression, feelings of shame, and mania.</p><p>While the compulsive aspect of OCD can be easier to spot, there are times when OCD manifests in a way that we can’t see. A child may have intrusive thoughts, fears, or images which routinely afflict them. Anxiety, stress and trauma tend to worsen symptoms.</p><p>According to the NYU Child Study Center, OCD is thought to be neurological in origin. It’s also often hereditary. An estimated 20% of children who are afflicted with OCD have a family member with the disorder.</p><p>Kids with OCD are usually overwhelmingly preoccupied with things that usually seem irrational. They become ritualistic in bolstering their obsession. Common examples of obsessions in children are contamination—constant concern over germs, irrational fears, symmetry of objects, religiosity, hording, and numbers.</p><p>Compulsions usually result in actions, which are a proponent of the obsessions. They manifest in many ways, such as excessive handwashing, repeatedly making sure things are a certain way (IE making sure a door is locked), or counting. Children with OCD will often become upset when the result of one of their compulsions is changed or flawed.</p><p>On the up-side, OCD in children is not only highly treatable, in some cases it fades with age. Treatments available for children with OCD include an array of medications, or talk-therapy.&nbsp; Developing coping strategies and being able to recognize and understand the obsessions, sometimes has the ability to moderate symptoms.</p><p>There are many resources for parents of children with OCD. More information on OCD and treatments for OCD can be found at <a href="http://kidshealth.org/parent/emotions/behavior/OCD.html" onclick="window.open(this.href, '', 'resizable=no,status=no,location=no,toolbar=no,menubar=no,fullscreen=no,scrollbars=no,dependent=no'); return false;">KidsHealth.org</a> and ocdchicago.org.<br> &nbsp;</p></p> Tue, 25 Oct 2011 15:12:00 -0500 http://www.wbez.org/blog/2011-10-25/out-shadows-obsessive-compulsive-disorder-children-93453 Out of the Shadows: Schizophrenia in Children http://www.wbez.org/blog/2011-10-25/out-shadows-schizophrenia-children-93452 <p><p>A schizophrenic child is unsettling for most people to think about, especially if all we know about the illness is what we see in Hollywood.</p><p>And while childhood-onset schizophrenia is rare, it exists. About one in 40,000 children is diagnosed with the illness. But before we can try to understand the illness in children, we need to begin to understand it in adults as well.</p><p>Like most things in Hollywood, the depiction of schizophrenia we see in movies and on television is very different from the reality of the illness.</p><p>Having multiple personalities—termed Dissociative Identity Disorder in the DSM—is not a by-product of schizophrenia. Schizophrenia is not synonymous with violence, either. And perhaps the one of the biggest misconceptions our society has about the illness is that it can’t get better; with treatment, it can usually be controlled.</p><p>About one percent of the population suffers from the illness. By itself, the illness can be very mild, but is easily exacerbated by trauma. It is not unusual for victims of physical or sexual abuse with a predisposition to the illness to begin displaying symptoms at some point in their lives.</p><p>But what are these symptoms? The biggest indicator of schizophrenia happens when a person begins to lose touch with reality. This can range from experiencing confusion and sometimes having trouble discerning dreams from reality, to the kind of extreme cases of schizophrenia often exploited in the entertainment industry.&nbsp;</p><p>These extreme cases, which have usually gone untreated for long periods of time, involve the total warping of one’s perception of reality. A person with schizophrenia might confuse television or movies with everyday life, believe they are in constant danger, or see and hear voices and sounds that aren’t there.</p><p>In children, these symptoms manifest somewhat differently. Childhood-onset schizophrenia may begin with symptoms like not wanting to bathe, withdrawing and becoming more isolated, or having difficulty connecting with others. More noticeable and indicative symptoms are changes in speech and behavior patterns, hallucinations, and severe anxiety or fear about things that may seem odd.</p><p>We must keep in mind that the illness can take on many forms, and symptoms listed here can overlap with those of other mental illnesses.</p><p>Unfortunately, it is believed that the earlier the onset of schizophrenia, the worse it is likely to get. As with many mental illnesses, the best treatment is the combination of therapy and medication, and a supportive family life. Specialized programs (with school or community projects) can help moderate symptoms as well.</p><p>While there are many treatments for schizophrenia, the illness is chronic. In order to control the condition, which is usually accompanied by depression, people who suffer from the illness will require life-long treatment and support.</p><p>But research and treatments for schizophrenia in children and adults have made much progress in the past few decades, and the ability for people who suffer from the illness to lead a normal life has largely increased.</p><p>There are support groups for children with schizophrenia as well as parents with children who suffer from schizophrenia. They can be found both online and at many community health centers. More resources about schizophrenia in children can be found on the American Association of Child Psychiatry’s <a href="http://www.aacap.org/cs/root/facts_for_families/schizophrenia_in_children" onclick="window.open(this.href, '', 'resizable=no,status=no,location=no,toolbar=no,menubar=no,fullscreen=no,scrollbars=no,dependent=no'); return false;">website</a>, as well as Mental Health America’s<a href="http://www.aacap.org/cs/root/facts_for_families/schizophrenia_in_children" onclick="window.open(this.href, '', 'resizable=no,status=no,location=no,toolbar=no,menubar=no,fullscreen=no,scrollbars=no,dependent=no'); return false;"> </a><a href="http://www.nmha.org/index.cfm?objectId=C7DF8F81-1372-4D20-C84C5539FAB14576">resource page</a>.</p></p> Tue, 25 Oct 2011 14:59:00 -0500 http://www.wbez.org/blog/2011-10-25/out-shadows-schizophrenia-children-93452