Children: Are We Too Quick To Suspect Mental Illness?

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Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More

Children: Are We Too Quick To Suspect Mental Illness?

Several of my readers have protested about what they see as a tendency to label children as having mental disorders when these kids are merely being the individuals that they are. Now there is evidence that this may be true, as expressed by the British Psychological Society.


It’s been reported that children who seem shy in school, or quiet, or sad, or who talk back, are at risk of being diagnosed with depression, social anxiety disorder, oppositional defiant disorder, attention deficit disorder or any of a wide variety of mental health problems. What often follows these diagnoses are powerful prescription medications such as Ritalin, Prozac or others. These children can also be placed in special education programs.

The driving concern that fuels this trend is the broader definition of mental illness in the new DSM V (Diagnostic and Statistical Manual) that is not yet published. Given the new diagnostic criteria and additional behaviors listed as indicative of mental illness in the DSM V, there is the danger that too many children could be viewed as having mental disorders when it is not necessary.

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Experts report that what is of primary importantance for most children is that they be given support and help when they appear to be going through a difficult time. A child who looks sad is not necessarily depressed, but may be in need of someone to talk with.

Many parents contact me with questions about their children’s behavior. They worry about autism, learning disorders, dyslexia and hyperactivity. When a parent expresses worry that their two-year-old may be hyperactive, you know that something has gone wrong. I was recently approached by a grandmother who was concerned that her two and a half-year-old grandson’s nursery school teacher had referred him for evaluation because of aggressive behavior. She explained that the child was very bright and could already read on a first grade level. He was much taller than all the other children in his class, and was often mistaken for a five-year-old. His aggression took the form of pushing other children out of the seats he wanted to sit in. Does this strike a chord? No matter how large or how smart he was, the child was only two and a half-years-old! His behavior was typical of toddlers. The evaluation showed no signs of any mental disorder and in fact commented on his advanced intellectual development. This may simply have been a case of adults “forgetting” how young he really was.

Readers also complain that mental disorders and their diagnoses seem to be like fashion fads. Once, ADHD was a fad. Now, some have complained that Reactive Attachment Disorder is the new fad. Reactive Attachment Disorder (RAD) is a complex psychiatric illness that can affect young children. It is characterized by serious problems in emotional attachments to others.

While many of these complaints are valid, it would be a tragic mistake to overlook children who truly do fall under these diagnostic categories. For example, some well meaning people state that ADHD is over diagnosed and is not real. This type of attitude can result in failure to get the needed help for those children who do suffer from the disorder. ADHD is very real and unbelievably painful and challenging for parents, teachers and children. Some disorders may appear to be faddish, but are very real none the less. They are serious and are not to be trifled with. As the saying goes, “Don’t throw out the baby with the bath water.”

I want to strongly emphasize the fact that it is not my intention to criticize parents, teachers or mental health professionals. Everyone has the best interests of children in mind. Worried parents, teachers and other professionals may, at times, be overly zealous in looking at a child’s behavior. If this happens, it’s out of genuine concern for the child.

If you have any doubts about your child, consult your physician who can make the appropriate referral if it’s deemed necessary. If teachers are expressing concern, they should be taken seriously and not dismissed. Again, consult your physician and, if necessary, get a referral to a child psychiatrist or child psychologist.

Your comments and questions are welcome.

Allan N. Schwartz

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