Tuesday, May 31, 2005

Child Psychiatry: raising some questions

I don't think this culture's problems can be more apparent than in the field of child and adolescent psychiatry and psychology. At every turn there is a contradiction and denial of the obvious. Here are some recent statistics (from a lecture I had) that are hard to digest:

Conduct disorders: 24.8% of boys (lifetime prevalence)
ADHD: 26.3% of boys (lifetime prev.)
Emotional disorders: 36.2% of girls (lifetime prev.)
Sexual abuse of kids: 1 in 4 girls, 1 in 8 boys
Self-abuse (cutting and burning): 20% of general kid population, 40% residential kids
Fetal alcohol syndrome: 3 per 1000 babies born

Not to mention drug abuse, drug induced psychosis, schizophrenia, eating disorders, suicides, etc...

If these numbers are true, and I suspect they are not far from the truth, what is wrong with us? Do more than half of North American children have a serious psychological disorder?

Perhaps a better way to explain these astounding statistics is this: we'll admit that they describe real behaviors (e.g. real depression and cutting and suicide attempts in 14 year olds who break up with first sexual partner, or real law-breaking behavior in adolescent boys). And that's pretty bad. Then we'll ask why they are now, apparently, so prevalent.

I would suggest it's because we would rather say that the problem is with the kids than with the parents, teachers, and society that raises them. For instance, it's much easier for the tired, overworked teacher to have her problem kids labeled "ADHD" so that the blame for their poor grades doesn't rest on her. And what can a teacher do anyway, if the parents don't back her up? So it's easier for the parents too to have this diagnosis. (This is not to say that real ADHD may exist, just much much rarer than it is diagnosed today).

Here's another example: the 14 year old girl who breaks up with first sexual partner is counseled in exactly this way "Don't worry, that relationship is just the first rung on a long ladder of life's relationships." Going by current numbers, this may be because the majority of counselors are on a long ladder of sexual relationships. But no wonder the girl is depressed! She has formed a deep (although apparently casual) psychological, emotional and physical bond with her partner, which can only properly exist in the context of a lifelong commitment. So of course the girl will may become suicidal or turn to self-injurious behavior to cope. She doesn't get the treatment she needs, and more importantly, no one was there to help her avoid the problem in the first place.

The list can go on and on. The point in common seems to be that adults are excusing their own actions and kids are being increasingly harmed by it...

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