October 22, 2015

Mental health: The parental role

Parents have a major role in promoting their children’s mental health. That is what Dr. Hazen Gandy, head of the Division of Child and Adolescent Psychiatry at the Children's Hospital of Eastern Ontario (CHEO) recently told an audience in Ottawa.

Gandy put a diagram of the brain on the screen at the front of the hall.  He pointed to two parts, the limbic system and the frontal lobe.  The limbic system is more primitive and develops earlier.  It is the seat of emotions.  The frontal lobe is responsible for judgment.  Because, he explained, the limbic system is functioning before the frontal lobe is in full operation, the parents need to function as the child’s frontal lobe.

A young person needs at least one adult to whom he has a meaningful attachment. 

Gandy urged that parents work on making that attachment, through regular contact with the child or youth.  The parent needs to be there at times of distress.  This attachment is not just for infants and small children.  Rather, he urged, it is needed all the way up to adulthood.  This attachment helps the person to be alone as well as with others.  He can still feel loved.

The parent is a role model.  Children watch the parents and learn their way of responding to things and situations.  It is important to strive to provide a positive, constant, and reliable social and emotional environment. 

Parents need also to promote resilience.  They should engage children with empathy, communicate with respect, and listen.  They need to be flexible and should give their children the chance to contribute.  Stress the child’s strengths and let him come up with his own solutions. 

Gandy mentioned two areas of concern, sleep and social media and mobile technology. 

Sleep disorders, he said, can have a serious impact on mental health.  Many young people do not get enough sleep.  They may go to bed with a smart phone or down an energy drink late at night. 

As for social media and mobile technology, they are “the arch-enemy of attachment.”  They intrude on the most intimate attachments.  And yet, teens seem to love them. 

Gandy then turned to mental health issues and how to deal with them. 

His key message was to tackle the problems early, when it is least difficult to deal with them.  And if a child has a problem, become an expert in the condition.  (Gandy’s advice in this regard should apply to other illnesses or disabilities as well.)  And advocate for your child.  Ask questions of treatment providers and experts.  Collect and track information.  Make use of experts and supports such as advocacy groups.

Access to services is a big problem for many conditions.  Often there are waiting lists.  Be sure, he said, that your child is on the list.  Check periodically to see where he is on the list.  Check on resources that may be available to you while you wait on the list.

The parent, he cautioned, needs to recognize that treatment takes time, both with psychological therapy and with medication.  Do not expect a miraculous cure.  And there may be side-effects. 

If a child suffers side effects from medication, discuss these with the doctor, and if there are adverse reactions to medication or inadequate effects, discuss these with the doctor.  Medication is not simply a one size-fits-all proposition and needs to be tailored.

When serious problems arise, Gandy urges use of the emergency department of the hospital, generally known as the ER, when necessary.  In addition to helping with the emergency situation, the ER may be able to link you to services.  But again, it is no magic bullet.  Then there is the matter of hospitalization.

Hospitalization, he said, can reduce risks and promote stabilization, but long stays can lead to dependency and loss of independence.