Monday, December 11, 2006

And the answers are--response to comments on Zero Tolerance post

Pepper: it sounds like you have been through the mill as a parent and I am glad things are better for you and your daughter. Your experiences with medication and (mis)diagnosis are reflective of the sad state of our knowledge base about psychiatric illness in children and about the lack of adequate care available. As we all know, taking care of the mentally ill is not a priority in this country (probably not anywhere). And there is a distinct national shortage of Child and Adolescent Psychiatrists. This will guarantee me a job forevermore but I could do with losing this particular popularity contest. What an amazing story.
Ren.kat--You do ask the tough questions. Child Psych journals and conferences do daily battles over what is Bipolar Disorder in Children. I am convinced it exists as are most Child Psychiatrists but it is also diagnosed in some kids (and adults) who do not really have it. One tactic scientists have used is to study the children of Bipolar parents. It is clear that some of the kids have classical bipolar symptoms but others do not. There are also kids who look a bit Bipolar but may not have the full illness. We do not know what they will grow up to have (if anything). In my profession, there is a split between the narrow definition of bipolarity in children (essentially same symptoms as in adults) and the broad (basically kids who are explosive and impulsive but do not have clear cut mania or mood cycles). One issue brought on by managed care is: no diagnosis, no treatment. So at times, people get labels because "I don't know what you have" won't get you health care.
I haven't heard anything to suggest that most of the kids who were involved in school shootings were or are Bipolar. Much was made in the press of the discovery that a few had received psychiatric treatment and/or medication. I wholeheartedly agree with the concern about stigma and do not want to add to any perception that the mentally ill are necessarily more violent than other people. But some Bipolar kids can be quite mouthy and I do have to defend their right to get back into school after they say something inflammatory.
Regarding racial issues, I was going to make the point that most of the shooters were white but deleted it after realizing that the one teen was American Indian, so as to not make broad racial comments myself. I'm not really all that knowledgeable about the details of violence within inner city schools. Of course, these spectacularly violent episodes in schools would never have happened if the kids were unable to readily get their hands on guns. But that is a topic for another post.
I did a (little) research on this theme before posting and discovered that they are having troubles with school shootings in Germany, as well. I guess the U.S.A. does not have the monopoly on this brand of human ugliness.
m.m.crow: I'll look for the book you mention. My motto in life is "so many books, so little time."
Thanks to you all for your interest and comments. This is what makes blogging fun.


Self Taught Artist said...

for some reason when I read 'taking care of the mentally ill is not a priority in this country (probably not anywhere) it just prompted me to remember something I saw on tv, there is some country...up near I think sweden, or norway?...they actually cater to and take care of all of the mentally ill. It was fascinating!

theres my 2 cents off the topic for the day

my personal thoughts are that violence in schools happen for so many reasons, cruelty amongst students not to mention all the dysfunctional families. Then you expect this child to perform and be normal under really constraining (yes, most schools are emotionally and physically so) situations. Keeping in mind that schools were first and foremost created to keep youth out of the workforce (that is a fact), I personally see nothing natural about the entire system.

At least the Greeks mentored their youth and looked for the natural inclinations and propensities in the child to find out who they were and what they might become.

ren.kat said...

Thanks for responding to my questions! I have a very close eye on my children- but all's swell :-) It is a complex issue, and a complex disorder. I had just never ever heard bipolar mentioned in conjunction with these school shootings.

I have a very different take on why this may happen- I seriously doubt is has anything to do with access to firearms. Here in Norway we have as many guns per capita as in the US. Yet shootings are unbelievably rare. (The murders we do have are usually stabbings). We've also got our share of dysfunctional families and domestic violence problems. We've also got our share of unbalanced individuals (heck, I taught in a performing arts school and the statistics were that 40% of our students were in psychiatric treatment). We've never had a mass shooting. . . knock wood and say every incantation you know!

I think it has to do with the desire for fame- the fascination with death that is in the "mass media" culture (I hesitate to say "American culture" because I know - as an American- that there is no such thing as one American culture). Kids want to be important and the way to do it is to be famous. The cheapest, fastest way to do it is to make national headlines. If you're depressed it could sound like a good deal.

But that's just my opinion :-)

Pepper said...

I took a different course than most parents. Simply because I know her, I knew what was going on, and the enormous amount of stress she was under. I was also confident that she could handle it. It turned out well. We can laugh at the past and we learned from the past. I can't believe I taught her how to drive. I enlisted other people to teach my other two children because I was deathly afraid. I should of been terrified with her but I wasn't. In fact I fell asleep. What a responsible parent I am.

ren.kat said...

I've been thinking- and not to go too far into details about your personal life, but you said that part of your job entails going into the schools and making a case for re-enrollment for kids who've acted out, one way or another- Did I get that right? I was curious if you get to speak on behalf of the kids who feel you can get behind, or are you like a defence lawyer who is obligated to work for on behalf of a client? Just thinking that each job poses it's own set of frustrations and challenges.