Supporting Your Child's Mental Health

Published in KIDS Newsletter for Foster Parents, a bi-monthly collaboration between CSU-Fresno and San Francisco County’s Family and Children Services

When they first met their new son Jamal, foster parents Janey and Steve didn’t realize how much he was suffering with anxiety. “He seemed okay at first,” said Janey, “but over time we realized that he was always anxious and afraid. He was constantly on the lookout for threats to his safety and would jump at noises. It was hard for him to sleep or do his homework or even
have fun.”

Janey and Steve took their concerns to Jamal’s pediatrician, and eventually a psychological evaluation showed he was suffering from post-traumatic stress disorder (PTSD). “I never thought about a child having PTSD,” said Steve, “but he’d already been through a lot by age 11.” With therapy, Jamal’s anxiety decreased, and Steve describes him as “a whole new person” without the constant burden of his fears.

How Common Are Mental Health Issues?

Mental health issues are very common both in the United States and in other countries. The National Institute of Mental Health (NIMH) estimates that about one in four American adults have a diagnosable mental disorder in any given year, although only about 6% have serious mental illness. But studies have shown that children and teens who are in the child welfare system have higher rates of mental illness than those of the general population. A study by NIMH found that nearly half of youth in foster care have significant emotional or behavioral problems. Researchers at the Casey Family Programs estimate that between one-half and three-fourths of children entering foster care need mental health services, and that 25% of emancipating foster youth are diagnosed with PTSD, which is about twice the rate of U.S. combat veterans.

When You Have Concerns about Your Child’s Mental Health

According to Dr. George Fouras, a psychiatrist who works at Foster Care Mental Health, Janey and Steve did the right thing by bringing their concerns to Jamal’s pediatrician rather than ignoring his anxiety or trying to diagnose it themselves. “Parents should start with their pediatrician,” he said, “or bring their concerns to their child welfare worker or the child’s therapist.” Those professionals can start the process of evaluation for your child.

Every parent knows that even in the best of times, children and teenagers naturally can be moody or difficult. How do you know when your child’s behavior warrants a call to the pediatrician? There is no single set of symptoms that define mental health problems, but NIMH says that parents can look for:

  • problems in all areas of life—not just at home, but also at school, with friendships, etc.;
  • changes in appetite or sleep;
  • withdrawing socially;
  • being fearful, especially of things your child usually doesn’t fear;
  • regressive behaviors such as bed-wetting that last for a long time;
  • seeming upset;
  • an increase in risk-taking behaviors;
  • self-destructive behavior such as head-banging, or a tendency to get hurt often; and
  • repeated thoughts of death

What if you’re worried about a child who is new to your home? How will you know if certain behaviors are “normal” for him or her? Dr. Fouras encourages foster parents to learn more about their child’s behavior and personality by asking social workers, teachers, previous foster parents or the child’s biological family. The better you know your child, the better you’ll be able to support him or her.

How Is Mental Illness Diagnosed and Treated?

Diagnosing mental illness can be a complicated process involving a medical examination, a psychological evaluation, or even a psychiatric evaluation. Once a child is diagnosed, there are two main treatments for mental illness: therapy and medication (see box at right for more information about medication).

Therapy means having sessions with a trained therapist. There are different types of therapists—licensed clinical social workers, marriage and family therapists, psychologists and psychiatrists. And there are many types of therapies and approaches. For example, a child with anxiety might benefit from cognitive behavioral therapy, in which the therapist helps the child recognize the events that trigger anxious thoughts and practice calming techniques. One of the most important things about therapy is a good fit between child and therapist, and it’s okay to ask for a different therapist if you think there isn’t a good fit.

The Role of Foster Parents

Dr. Fouras says that foster parents are an important part of the child’s treatment team and encourages them to work directly with their child’s therapist and doctor. “Just as they would accompany their child to a medical appointment about a sore throat, they need to check in with their children’s mental health professional if we’re going to effectively treat their children,” he said. “We need foster parents to be involved in their children’s mental health treatment and working with us as a team.”

Copyright © E.G. Communications, Inc. 2014