• Stigma: A childhood legacy?

    Many argue that the developed world is too quick to diagnose children and adolescents with serious mental disorders - particularly since the brain is still developing right up to the early 20s.  It's a valid point.  How can we know whether a child has an illness of the brain if the brain is still forming?  Moreover, how fair is it to label a child with an illness that will go on their files and stick with them for life, like gum on a shoe?

    Yet, psychiatric units for children and adolescents exist and are usually operating at maximum capacity. Child and adolescent mental health specialists argue vigorously that mental illness young people is as prevalent as in adults. Having worked in such a unit from time to time, and knowing my own experience, it's clear that there are children who cannot and do not live well and productively without psychiatric intervention of some kind.  Having met many of these kids, they are from all walks of life, so the presumption cannot be made that they are simply damaged;  a product of poor parenting; the result of a chaotic home environment. This is far too neat and tidy an explanation.

    Sadly, children also suicide and posthumous investigations nearly always show that emotional or psychological issues had been emerging in the build up to their decision.  

    But why do mental health problems in children appear to be on the rise?  Are these incidents actually on the increase or is it just that families haven't spoken out about it until more recently?  Is it because we hold our children in higher esteem than we did only a century ago?  In 1913, children of five were still being sent up chimneys and down mines to work for a day's wage.  My own father was a strong advocate of children being seen and not heard and that was only 30 years ago.  Is it because of computer games and the slow death of face-to-face interaction?  Who knows.

    What is clear is that no parent of a child in distress really feels safe or comfortable talking about it.  Labels stick and the judgements follow isolating already isolated families trying to get to grips with a living nightmare.  

    I don't know what the right answer is, but I do know that we need to hold these young people's hands very gently through the process of diagnosis and treatment.  Before we label them with a mental disorder that will stigmatise and marginalise them, we must call in to question our decisions and our practice at every step.  Is a label absolutely necessary if treatment and intervention can still be applied without it?  These are little people, in most instances unable to effectively advocate for themselves.  They are guided by parents who rely so heavily on the professional opinion.  This, over all other things, is the reason why we have a huge moral and ethical responsibility to do the right thing by them.  


    This advertisement was developed by the Citizens Commission on Human Rights (CCHR).  The CCHR is a US non-profit, non-political, non-religious mental health watchdog. Its mission is to eradicate abuses committed under the guise of mental health and enact patient and consumer protections.



  • Comments on this post (1 comment)

    • Zoey McGill says…

      I totally agree. It seems to be very much believed by the medical profession that early diagnosis is best. I think diagnosis though can often exacerbate the symptoms/condition due to the nature of (these illnesses are about your brain & your thoughts & feelings) and personal perceptions about the illness/diagnosis – by the patient themselves their loved ones, social networks and the broader public.
      I know I judge myself more being diagnosed with bipolar than I do others with the diagnosis or would do if a friend was diagnosed. (The lack of support I was offered around my own diagnosis left me in a very dark place).
      This is one of the major reason I am a huge advocate of functional medicine. Modern psychiatry diagnoses people based purely on observation & judgement, their is no biopsy no blood test. While in extreme cases an early diagnosis and drug intervention may be life saving, a child could be diagnosed with childhood bipolar/ADHD or a miriad of other labels depending on the particular doctor they were seeings opinion and put on Ritalin or similar. When all that was biologically wrong was low zinc (pyrrole disorder) and adjusting to a new school. Topical Zinc cream, couple of sessions with a councillor and happy days!
      I know personally I’d be much more comfortable saying my child was low zinc, than potentially bipolar, even if there was no stigma… Because what is bipolar? What is schitzophrenia – they are so many different things to so many different people who have been labelled with them…
      It will be a big job changing public perception because I think even the people who have mental illness & who diagnose it have such varied perceptions of what it actual is. It’s not the same as having and accepting other illnesses because there is no biological test for it. Hopefully with the work of people like Dr William Walsh, the current medical profession will become more open minded and educated and this will change.
      Sorry rambled and got off track a bit here.

      on October 18, 2013

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