The New Year's holiday, for most of us, means a fork in the road: it's the time of year when we reflect upon the past and consider how the choices we make will shape our future. These moments of reflection and hope never escape me--and this, in particular, I owe to my young patients, who prove to me year after year that the barriers to fulfilling one's life potential can be removed. For the millions of children with psychiatric disorders, just as for everyone else, it simply matters what choices we make.
Today, as 2009 comes to a close, I'm thinking about a patient of mine, Sam, who has just been accepted for early admission to Duke University. Sam's accomplishment is extraordinary when you consider what his prospects seemed to be ten years ago. In 2000, when Sam was eight years old, his parents brought him to my office because he'd been expelled from his third grade class for behavioral problems. At this very young age, Sam had reached a fork in the road: his teachers were fed up, his classmates disliked him, his parents were desperate, and Sam, suffering from an undiagnosed psychiatric disorder, felt confused, rejected, and helpless.
Of course, there were people who blamed Sam's parents for his troubles. His mother and father were divorced and they both held high-powered full-time jobs. But the reality is that Sam, like some 15 million other children in this country, had a psychiatric illness for which there was no quick fix or magic bullet. Making the correct diagnosis took time and finding the right combination of therapy, medication, and a better educational setting was a process that took years. His treatment required patience as well as a network of caring, devoted experts and parents who saw Sam's potential and would stop at nothing to help him manage his condition.
Few people may realize it, but diagnosable mental health disorders affect 20 percent of children and adolescents at any given time, and an estimated 10 percent of young people are affected by serious emotional disturbances. As I think about Sam's admission to Duke, I can't help but wonder what direction his life may have taken had he not received the professional treatment, support, and time he needed to thrive. Sam could have easily been among the more than 50 percent of children with a psychiatric disorder who never get any treatment at all. He could have easily followed a path from academic failure to school drop-out to substance abuse to an early admission to jail.
There is no guarantee that we can save every child--how could there be? But an America that seriously believes in change and hope for the sake of a better future for our children needs to embrace child mental healthcare as a right not a privilege. This will require dollars and resources but it comes with an excellent return on investment. Just think of how much more Sam can give our country in taxes, productivity, and creativity after four years at Duke than after four years in jail.
We can take significant strides toward improving mental health care for all of America's children. As we make our resolutions for 2010, please bear in mind that the cause of child mental health needs our support now more than ever.
Harold S. Koplewicz, M.D. is president of The Child Study Center Foundation and Director of the Nathan S. Kline Institute for Psychiatric Research