Wednesday, November 27, 2013

Teens' Mental Disorders Often Untreated in U.S., Study Finds

Posted on 2013-11-22 02:00:28 UTC
-- Robert Preidt
Shortage of child psychiatrists partly to blame
THURSDAY, Nov. 21, 2013 (HealthDay News) -- Less than half of American teens with mental health disorders receive treatment, and those who do get help rarely see a mental health specialist, a new study indicates.
The findings underscore the need for better mental health services for teens, said study author E. Jane Costello, associate director of the Duke Center for Child and Family Policy in Durham, N.C.
"It's still the case in this country that people don't take psychiatric conditions as seriously as they should," Costello said in a Duke news release. This remains so, despite a wave of mass shootings in which mental illness may have played a role, she and her colleagues noted.
The analysis of data from more than 10,000 teens aged 13 to 17 across the United States also showed that treatment rates varied greatly for different types of mental health problems.
For example, teens with attention-deficit/hyperactivity disorder, conduct disorder or oppositional defiant disorder received mental health care more than 70 percent of the time, while those with phobias or anxiety disorders were least likely to be treated.
The researchers also found that blacks were much less likely than whites to be treated for mental disorders, according to the study, published online Nov. 15 in the journal Psychiatric Services.
In many cases, teens received treatment from pediatricians, school counselors or probation officers, rather than mental health specialists. This is because there are not enough qualified child mental health professionals to handle the demand, said Costello, who is also a professor of psychology and epidemiology at Duke University.
"We need to train more child psychiatrists in this country," Costello said in a university news release. "And those individuals need to be used strategically, as consultants to the school counselors and others who do the lion's share of the work."
As many as one in five children living in the United States experiences a mental health disorder in any one year, according to a U.S. Centers for Disease Control and Prevention report.
More information
The American Psychiatric Association has more about teen mental health.
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Saturday, November 23, 2013


              

Eddy - The Mayor of Montauk Manor

By Beverly Maher

I had just closed my chicken and rib restaurant. I am not a person who enjoys sitting idly. I found an ad in the paper to be your own boss and sell a product that was advertised to be the best product for your skin. The company was Newskin. I liked the idea that I may be able to work from home. I contacted the promoter, he invited my partner Bob, and I to come to his home, meet his wife, and see what the company could offer me to promote the product. They were in West Babylon, not far from my own family. When we pulled up to the house, there was a farm stand just to the left of the house. It was dark, so we were not able to see much. They were a nice couple. Joe was younger than Joanne was. He was promoting Newskin she was supporting his venture. In our conversation, Bob and I learned the farm stand was a mutual venture. We were also informed; Joanne owned and operated five adult homes on Long Island as well. Ambitious and interesting people. I liked the product. I told them I would try it and signed up. I had been doing it for a few weeks when I mentioned I was looking for part time work to supplement my income between sales. Joe mentioned his wife was looking for an administrator for one her homes in Lindenhurst. I called Joanne and she told me to come down the next day to find out the details. We walked around the huge house and she told me what she expected of an administrator. I met the residents they seemed gentle enough. They greeted me with smiles. The cloud of smoke that greeted me was surprising. The main door, which was actually the back door, enters into the smoking room. They had coffee cups and there was not much conversation going on. Most of them looked disheveled, whiskers on their chins. Some could use a shower. Joanne explained how the state regulated the home and everything had to be to the state's standards. The state regularly visited the home to ensure the safety of the residents. The house had a capacity for 29 beds, meaning 29 residents could occupy the home at one time. Joanne had 24 filled and it was very important to fill the rest. That would be the administrator's responsibility. I met the cook, who doubled as the aide, and I met the housekeeper. It was a good feel. I wanted to take on the challenge and asked Joanne when I could start. I had not mentioned to Jim or Joanne that I was leaving Bob. I was considering living in Suffolk County to be near my family already. I was waiting for the School year to be finished for Lauren, my special needs daughter. I started the next Monday. The last state visit was posted on the wall and I took it to my desk. There were 80 violations on it. I knew that would be my priority, both to learn the violations and to fix the violations. I left the door open to be able to listen to goings on outside my door. The smoking room was right outside the door. While I was reading, I heard a faint knock at my door. A man's head peaked in and asked if I had a minute. Sure, come on in. "I'm Eddy." He stated. "I'm Beverly, come in and have a seat, I replied." Eddy went on to tell me how he became a resident of Montauk Manor. His substantive demeanor was impressive. I certainly was curious as to why he was here. He was a man of about 60. Too young to be one of the elderly residents. Montauk Manor was diversely mixed with elderly residents, some Vets that were elderly, but most of the residents were mentally ill. Eddy told his story.

"I was married for 25 years. I got depressed a lot. I kept losing jobs. One day I broke down and did not want to do anything. They put me in a hospital and put me on Lithium. It started to get better, but my wife did not want me back. We had a daughter. She is such a good daughter! She lives in the neighborhood!" His voice had a pitch, one you would hear if someone was from the city. "I go to her house and I get to see my grandkids, we have dinner together, it's great!" "That is nice Eddy." He was clean, he was shaved, his matching outfit seemed out of place at Montauk Manor. I found out the residents called him the mayor. I could understand why.

For the next couple of months I was very busy. I found a book for case management and found out that I would have to write about all the residents and keep up to date any and all issues corresponding to them. I would take some time out of my day to leave the office and talk to the residents. I informed Joe and Joanne that I lost interest in selling Newskin. I was excited about the new venture. Rob was 25 years old. A handsome young man. He was clean and never had to be reminded to take a shower. He wore very nice clothes. As I would learn he would receive a package from Florida, where his parents lived. His mother made sure he had everything he needed to keep up with his appearance. Rob was one of the few residents who did not need to borrow money for cigarettes and coffee right after they received their allowance. That was a common theme. I would see this throughout my adult home experiences with the exception of Merryville. Merryville was an adult home that specialized in Alzheimer's and Parkinson victims. Rob paced; he walked with a tempo. He did not speak. He knew how, he just chose not to. He would answer if spoken to, but only single syllable answers. He would awaken at around 8am, have breakfast and start pacing. He would go to his room walk to the end, turn around and walk to the living room. He would get to the end, turn around, and walk to the smoking room. He would have a cigarette standing and start pacing again. He did this all day long only stopping to eat and nap. His mother would occasionally call to speak to him. He simply answered in one syllable, yes, no. I spoke to his mother on a few occasions before I handed him the phone. She told me the medication he was on now was a miracle med. He used to be uncontrollable, at least now he was calm.

Josephine was a gas. She would walk all over town. All she wanted to do was work and earn money so she could buy coffee and cigarettes. She worked for Joanne. Joanne had a flower stand right next to Montauk Manor. When she needed Josephine at the farm stand next to the house, Josephine would walk the distance and work for the day. She was very small and frail looking. Her work ethics were extraordinary. She had the ability to work long hours even on hot days. Josephine was outgoing, very friendly. My sister came by once with a couple of her daughters and they loved Josephine's banter. She told them how beautiful they were. She shared a few funny stories with everyone. We all chuckled. Josephine was on medication for depression and anxiety. At that time, she was compliant with her medication and she was able to function in her day-to-day life. In private, she would tell me stories of her many mood swings and why her family was not anxious for her to live with them.

We had a few vets in the house. They were sweet, soft spoken and polite. They smoked and drank coffee throughout the day. The aide had to guide them to take showers and change their clothes. She would also shave them when she was not cooking. The housekeeper was good. Montauk Manor was a mansion and she was expected to keep up with all the residents' rooms. I discovered through the violation sheet how important it was to make sure the residents were not doing anything like using extension cords irresponsibly. The cook and I would help Helena, the housekeeper in the afternoons, after lunch. Helena would assist with the lunch. After we changed all the curtains in the living room and had it painted we started tackling the bedrooms. If they needed painting, we had Joanne set up the painter. We would do curtains and drapes, depending on the need. Before we knew it, Montauk Manor was looking like a real home.

That summer I decided to create a garden and grow the vegetables for the residents. Joe came over and roto tilled the grass covered area that would be our garden. I chose the area in the back, outside the smoking room window. I wanted the residents who did not go out to watch the progress of the garden. I worked hard to clean out the grass and get the soil ready. Eddy would be smoking his cigarette and watching me. The vets would be outside watching, smoking, drinking from their dirty Styrofoam cups. Eventually the garden was ready for planting. I planted tomatoes, peppers, eggplant, string beans. I planted anything we could use in the day to day cooking. The garden started to look like a vegetable garden. The plants were growing and we were all able to see nature grow. Eddy was watching me pick the weeds one afternoon and he announced, "We have a real victory garden!" His daughter was picking him up that day and while he was waiting, he said, "I am going to buy you a new pair of sneakers. Those sneakers you are wearing are all worn." I smiled at his thoughtfulness. I always wore white keds in those days. 

A couple of weeks later Helena ran into my office. She told me that Eddy looked sick and to come immediately to his room. After seeing Eddy, I called 911. They rushed him to the hospital. His daughter called and kept us abreast of his progress. He was having thyroid problems because of taking Lithium and would no longer be able to take it. When he returned to Montauk Manor all were very happy to see the mayor home again.
The state came in and inspected our home. I received a few violations and I had fixed all the old violations. One of the violations was that I was not a licensed administrator. I applied for my administrative license. I had all the qualifications except one. I did not have the experience in adult homes. This was my first and only experience. I would need five years to fulfill that goal. I was at Montauk Manor for one and one half years. I counted this towards my license. I had a long way to go.

I worked in a number of adult homes after that. Some hired me to assist with bookkeeping or general assistant to the administrator for helping with correcting violations. One hired me as a coordinator because they would not replace the incompetent administrator they had. Sometimes I worked as an aide, just to get the time in.

Two years after my time at Montauk Manor I was visiting my own daughter in Brunswick Psychiatric Hospital. Lauren had started exhibiting signs of schizophrenia while I was at Montauk Manor. It was difficult to find the right medication to keep her from experiencing the strange world of mental illness. As I walked to the back where the entrance was, I saw a man sitting on the stone bench with the sun beating down on him. He was squinting and I kept staring to see why he looked familiar. As I got closer, a smile started forming on my mouth. He was covering his eyes with his hand to block the sun, but it was unmistakable. As I got closer, I noticed he had at least a week of growth on his face, his clothes were dirty and he looked disheveled. He was wearing a pair of sneakers. They had no shoelaces; they were well worn and dirty. He noticed me. We smiled together, when our eyes met. "Hello Eddy." "Well hello there!" he said with that pitch in his voice. I did not ask why he was here. "Nice sneakers Eddy!" I said. He looked down at the white keds and said, "They're yours, I bought them for you that day I went with my daughter shopping. Do you want them?" "No thank you Eddy, you keep them for me.""Ok" he replied "Take care Eddy." I answered. I walked into the hospital to visit my daughter, my eyes starting to well up. He was gone when I came out. It is a sad world for the mentally ill.