Access Institute | Early Intervention: Key to a Rejuvenated Mental Health Care System
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29 Mar Early Intervention: Key to a Rejuvenated Mental Health Care System

Early Intervention: Key to a Rejuvenated Mental Health Care System

Bart Magee, Ph.D.

Derek, a third grade boy, leaves his class suddenly during the morning meditation exercise. The school social worker finds him outside, alone on the playground bouncing a basketball against the wall. He tells her he can’t meditate because of his “bad thoughts.” He needs to get away from them. His newly quieted mind had opened the door to frightening images. A killer was chasing him and he was flooded with other gruesome scenes where death was imminent. It won’t surprise you to know this boy has great difficulty focusing in class, learning, and getting along with other children. Derek, at 8, has witnessed more violence than most of us can imagine, and needs more help than the caring staff at his school can realistically provide. When you add all the regular challenges of growing up, it is understandable that Derek is up against serious obstacles, ones that could soon become insurmountable. Some of the more tragic outcomes could include failure in school, gang involvement, substance abuse,or juvenile hall.

At Access Institute, we take the actions, words, behaviors, and lives of children like Derek seriously. We hear their pleas for early intervention by addressing psychological and emotional problems as soon as they arise. This means responding immediately when early warning signs are seen and working attentively to make a difference before problems get worse.

According to the National Institute of Mental Health, half of all cases of serious mental illnesses emerge by age 14 and three quarters by the age of 24. In spite of the fact that there are effective treatments available, most people don’t receive treatment, or get various kinds of half-measures or wait for long periods, sometimes even decades, before receiving care. In the U.S., the median delay before treatment is 10 years and only 17% of people with a mental disorder report receiving treatment in the last 12 months. The good news is that the percentage has crept upward from 13% a decade ago, but we clearly have a long way to go.

Psychological problems that begin in childhood (like Derek’s) and are not addressed in childhood have some of the poorest outcomes. These problems get worse over time and cause great personal suffering and are associated with higher levels of school dropout, unstable employment, relationship problems, disability, homelessness, and more.

What is Access Institute doing to address the need for early intervention? First, our In-School Mental Health Program works at the elementary school level, with very young, often traumatized children, who are showing early indicators of serious emotional and behavioral difficulties. We work closely with these children, letting them know they are not alone and helping them to address their inner struggles rather than fall victim to them. We also work at the greater school level, supporting teachers and other important team members closest to these kids and helping the educators figure out how to harness all the resources they can to support their students. Finally, we are patient, consistent and never give up because we know real change takes time. Even when problems start to improve, we keep up with treatment until we are confident that the child’s internal resources have been developed sufficiently to ensure continued growth and change.

As hard as we are working at Access Institute, we are far from reaching all children in need and ensuring them immediate access to appropriate care. Because of that we have to recognize the needs of adults, many of whom the need for treatment was not addressed in childhood and was delayed in adulthood. At our outpatient clinic we offer treatments that provide flexible and responsive care that recognizes the complex interplay of trauma and attachment. We compassionately attend to the ways people have learned to cope, even as those protective measures have failed or caused other harms. As with children, we know that mental health treatment with adults takes time.

The facts that change takes time and that developmental progress is incremental, needs a lot more edification and support, particularly in our impatient society. People want immediate solutions for their suffering and our consumer culture reinforces the notion of the quick fix in endless ways. Whether it’s an ad for a medication to adjust “chemical imbalances” or a self-help guru advertising the latest and greatest remedy, we are steeped messages that promote fast and easy results.

Most people have scarce working knowledge of psychology in general and the signs of mental difficulties in particular. Studies have shown that only a quarter to a half of the general public can correctly identify common mental problems like depression and psychosis. That’s why in all of our public programs and outreach efforts, we at Access Institute seek to educate and engage the public about the diverse mental health needs in our community. We all need to do more. Education and consciousness raising are powerful antidotes to stigma and denial and will help narrow that time gap between the moment that a need for help is expressed and the moment when real treatment begins.

In the end, when we advocate for early intervention we are actually promoting a profoundly revitalized model of mental health care, one that has the power to truly transform our society. It’s a model in which we raise awareness everywhere and always, provide ready access to high-quality care, start treatment as soon as possible and remember that slow and steady really does win the race. If we all get behind this approach, I guarantee we will see real change.

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