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Dr. Harold Koplewicz

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How to Help Young Men? Start When They're Children

Posted: 10/11/11 01:09 PM ET

New York City Mayor Michael Bloomberg recently announced an ambitious project to help the more than a quarter million young black and Latino men in our city who seem to be slipping into a kind of dysfunctional parallel universe: failing in school, finding no jobs, and landing, in appalling numbers, in prison. Bloomberg and philanthropist George Soros each pledged $30 million personally, to cover about half of the project, dubbed the Young Men's Initiative.

This is a very interesting and well-meaning endeavor that has, not surprisingly, prompted plenty of criticism: that it's hopelessly paternalistic, that the target group, men from 16-24, excludes others that are just as bad off, that it won't work because these young men are beyond saving -- or don't deserve the special treatment.

We know the odds of successfully initiating social and economic change across a population that the Bloomberg administration estimates at 315,000 are daunting. That doesn't mean it's not worth doing, and Bloomberg and Soros are no strangers to spending money to experiment on social change. But we also know that whatever good this program will do for these young men, the best thing that could have been done for them was a concentrated effort, earlier in their lives, to get them the support they needed to flourish in school, and develop the interpersonal skills to be successful adults -- spouses and fathers as well as employees or entrepreneurs.

When we consider the dire problems of undereducated and unemployed young men in our city, we should think about the next generation as well, and how we can help them now, before they find themselves in this predicament.

Early education is the point at which we can most successfully intervene to help children who are not prepared for school or able to function effectively in a classroom. When kids get to preschool or kindergarten and are unable to behave, or participate in learning, they need immediate attention. Some of them need the kind of training and skill building that has been taught effectively in Head Start -- a program perennially targeted for budget cuts.

Some of them have psychiatric and learning disorders, which, undiagnosed and untreated, cause the frustration and misery that leads kids to drop out as soon as possible. Psychiatric and learning disorders can also be the cause of the widespread disruptive behavior that makes so many of our classrooms very poor learning environments for all the children, not just the ones who are acting out. Untreated disorders have also been clearly linked to drug abuse, teenage sex and pregnancy, and incarceration. It's fair to assume that a high percentage of the young men Bloomberg and Soros are targeting have been struggling with issues like ADHD and dyslexia all their lives without getting help.

Unfortunately, black and Latino children who do poorly in school are less likely to be recognized as having a disorder, to be properly diagnosed, or to receive treatment. We need to give our early-education teachers better training in the signs and symptoms of early-onset mental illness. We also need parents to have the resources -- in the form of parent education, information and mental health coverage -- to get kids treatment that will allow them to succeed in school, behave in school, and develop their potential.

For kids who have disruptive behavior, there are excellent tools for both parents (behavioral therapy called parent-child interaction therapy, or PCIT) and teachers (teacher-child interaction training, or TCIT) to more effectively rein in kids who are out of control at home and in school. In many cases, the techniques, using positive reinforcement for desired behaviors and consistent consequences for undesired behaviors, have a transformative effect on young children, who are able to control their own behavior for the first time.

The challenge of getting these kids help is compounded by communities that are sometimes wary of the health care system -- in many cases for historical or cultural reasons. African-Americans live under the specter of experimentation, from slavery to Tuskegee; Latinos often have to reconcile the need to treat these real and possibly debilitating disorders with their religious beliefs. That is why educating the whole community -- and the whole family -- about mental illness, treatable behavioral issues, and neurodevelopmental disorders like ADHD is paramount.

We have every reason to believe, however, that early intervention is the cheapest and the most effective way to ensure that black and Latino boys can take advantage of education opportunities and be prepared for the job market. So as we try to bring disadvantaged young men off of what can be a terrible dead-end track, let's also try to keep the youngest and most vulnerable members of our city and our society on a brighter path from the beginning.

Harold S. Koplewicz, M.D. is a leading child and adolescent psychiatrist and the president of the Child Mind Institute. For more about Dr. Koplewicz, go to childmind.org, which also offers a wealth of information on childhood psychiatric and learning disorders.

 
 
 

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