As a parent, you never want to see your child suffer or in pain, and when these challenges are related to mental health, the roadmap to healing can become more complex. In an interview with James Roberson, LMSW, Vice President of Programs and Innovation for KVC Hospitals, we discussed how adverse childhood events impact brain development and why it’s important for a child to understand how their own brain works to better manage their own emotions.
James also talked with us about psychiatric crisis and what’s happening to someone while they experience a crisis. He shared helpful information on how to know if your child or teen is experiencing a psychiatric crisis and what you can do to help them.
Q: How do you describe a psychiatric crisis to communities and families and even the children you work with?
James: In general, I describe a psychiatric crisis as a shift in your emotions, thoughts or behaviors to an extent that can lead to you hurting yourself or others, and/or put you at risk of being unable to care for yourself or function in the community in a healthy manner. For example, if something is impacting a child’s ability to go to school, get along with friends, or relate with parents, then that child is in a crisis.
One way I describe this to young patients is I tell them that they should spend a good amount of their life feeling OK and comfortable. If someone is going multiple days or weeks in a row feeling uncomfortable with him or herself and it’s impacting their confidence and ability to engage in the world, then that’s a crisis. Children’s brains develop every second of every day. If the brain is developing under high levels of stress, we need to respond immediately.
Q: What type of treatment does someone in crisis need? When should someone in crisis seek treatment?
James: For a long time, people have struggled to talk about what mental health treatment should look like because it’s dynamic and different for every person. When someone is having a psychiatric crisis, society’s response tends to be, “go to therapy,” or “go to a hospital,” with very little discussion about how important it is for someone to go to the right kind of therapist or hospital that can treat their specific needs.
Professionals will help someone experiencing a psychiatric crisis engage in specific actions to address the underlying reasons for the crisis. This may include medication interventions, learning new behaviors, and/or changing habits such as diet and exercise. A psychiatric crisis is an extremely impactful moment in a person’s life, so it’s important that they get back to baseline quickly or the consequences can be dire and have a big impact on their mental health.
When experiencing a crisis, a good place to start is to speak with your primary care physician or a community mental health center to explain your symptoms and issues and receive a referral to a mental health specialist. If you already have a psychiatrist that you meet with, let them know what you’re experiencing, and they’ll understand the importance of seeing you quickly to map out a treatment plan. You can also visit your local hospital or ER and ask for a consultation. Never be afraid to call 911 for help if you or someone else is in danger.
Q: How does KVC treat a child or teen experiencing a psychiatric crisis?
James: Within the first 24 hours, once a patient in crisis enters one of our Hospitals, they will see four to five different medical professionals and receive full-scale assessments so we can understand how they’re doing physically, socially, psychologically and educationally. The assessments help us understand how the crisis started and guides an effective treatment plan. Our goal isn’t simply to provide a diagnosis. We want to know what has happened in their life and what is happing now.
Most youth that experience crisis have experienced one or more adverse events, such as major life disruptions, abuse, bullying, witnessing violence, or other stressors. We believe these types of events lead to extreme levels of stress. In childhood, we even call this toxic stress, because it negatively impacts the brain and other systems in the body. While medication can be helpful in treating symptoms such as depression and anxiety, it’s often the whole child and their entire life situation that requires intervention and treatment.
Q: Are certain children or environments more prone than others to experience childhood adversity?
James: We have a good idea of the types of circumstances that place youth at risk of exposure to adversity. For example, factors such as family unemployment, lack of housing and transportation, and barriers to accessing education and healthcare all increase the likelihood of exposure to adversity. However, we also know that childhood adversity occurs in every socioeconomic environment and looks different for every person.
We call it adversity when someone experiences stress that they can’t manage or don’t have people in their life to help them manage it. In any situation, when a child doesn’t have adults to help them overcome stressors or when adults contribute to the stress, the youth will most likely be negatively impacted. With positive interactions and support from adults, we often see higher levels of resilience or the capacity to overcome adversity.
Q: What can we do as a society to reduce crises in children and teens?
James: To have a prosperous community, we must improve all children’s mental health. Physical health, education, economy, community safety, and every other measure we use to evaluate our communities is dependent on how our children experience the world. Healthy children grow up to be highly contributing adults.
We all have the capacity and knowledge to adjust how our communities support and protect children and adolescents to reduce the likelihood a crisis will happen. With small adjustments and purposeful community action, we can have a huge impact on children’s mental health. It only takes one caring adult to make the difference for a child. One safe and loving relationship with an adult can help a child learn to trust and build the skills needed to thrive.