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2. National Research and Trends There are an estimated 4.5 to 6.3 million children and youth with mental health challenges in the United States. About two-thirds of these young people do not receive the mental health services they need. In many communities, services for youth with mental health challenges are unavailable, unaffordable, or may not be sufficient to address their needs, leaving these youth at risk for difficulties in school and/or the community. (http://store.samhsa.gov/shin/content//SMA08-4351/SMA08-4351.pdf) ADULT&child

3. Consequences of not addressing Mental Health Needs Increase risk for school failure Social isolation Violence Substance abuse Unsafe sexual behavior Incarceration Poor Health ADULT&child

4. Most Common Child and Adolescent Diagnosis Depression Anxiety ADHD/ ADD Trauma ADULT&child

5. Check yourself Remember we all have some symptoms of anxiety and depression. When assessing and diagnosing mental illness we look at duration, multiple symptomology, and impact on life functions. NO Medical Student Syndrome Today!! ADULT&child

6. Depression Younger youth 1 in 33 Older youth 1 in 8 Ages 10-19, an average of 430 youth a year were treated inpatient setting for an attempt for self- inflected injury between 2007-2011 in Indiana (Indiana State Department of Health, suicide in Indiana Report, 2013) Indiana ’s suicide rate has been slightly higher than the national average for nearly a decade. In recent years, suicide among Hoosiers ages 15- 19 has wavered between the 2nd and 3rd leading cause of death. ADULT&child

7. Depression Symptoms Frequent sadness, tearfulness, crying Increase in irritability and anger Decrease in activities Persistent boredom/ low energy Isolation Low self-esteem Extreme sensitivity to rejection/ failure Difficulty with relationships Frequent physically complaints Frequent absences' from school/ poor grades Poor concentration Major changes in eating and or sleeping Talk of running away ADULT&child

8. Most At Risk Youths (www.nimh.nih.gov, 2005; Reynolds, W.M., 1988)www.nimh.nih.gov Starting antidepressants After being released from a psychiatric inpatient hospital stay Real or perceived distress or “hassles” – Peers – Family – School Family history Friend committed suicide Diagnosis of depression/anxiety/ bipolar disorders Little Family/Social supports Few coping skills ADULT&child

9. Anxiety Restlessness Poor concentration Feels tense Reoccurring thoughts that interfere with activity Gets upset when separated from parent Nightmares Fears of being alone Stomach aches/ nausea Fatigued easily Excessive worry about: grades, family, relationships, performance with sports Tend to be harder on themselves and strive for perfection ADULT&child

10. Multiple Anxiety Disorders General Anxiety Disorder Panic Disorder OCD Separation Anxiety Social Anxiety Specific Phobias Selective Mutism PTSD ADULT&child

11. ADHD/ ADD An estimated 7% of U.S. children are diagnosed with ADD/ ADHD Any misbehaving child can be diagnosed with ADD/ADHD. 10 million child have been diagnosed with it, and ninety percent of Ritalin is sold in the U.S. Many believe that the real problem is cultural. Life has become so stressful that most adult feel overwhelmed by normal children. (Everything Parent’s Gide to Children with ADD/ ADHD, 2005) Rate of ADHD children in traumatized children is between 28- 30 % (Putnam 1998) ADULT&child

12. ADHD/ ADD Symptoms Inattention: ▫Difficulties listening, even when being directly addressed ▫Difficulties continuing to pay attention to activities involving either work or play ▫Difficulties paying attention to details and avoiding carless mistakes ▫Difficulties completing tasks, chores, and assignments ▫Difficulties organizing activities and task ▫Difficulties doing task that require sustained mental effort ▫Difficulties keeping track of possessions and materials Hyperactivity/ Impulsivity: ▫Squirming and fidgeting even when seated ▫Getting up when expected to remain seated ▫Running excessively and climbing in inappropriate situation ▫Difficulty playing quietly ▫Being always on the go ▫Talking excessively ▫Blurting out answers ▫Not waiting his or her turn ADULT&child

13. Trauma Trauma occurs when a child experiences an intense event that threatens or causes harm to his or her emotional and physical well-being. ▫Can be the result of exposure to a natural disaster  Tornado  Flood  Hurricane ▫Medical Trauma ▫Terrorism ▫Abuse  Sexual  Physical  Domestic Violence  Extreme Neglect ▫Other ADULT&child

14. Trauma and Triggers After Trauma ▫Youth is on Constant Alert ▫Youth may over interpret signs of danger ▫Youth overreacts to normal situations ADULT&child

15. Traumatized Youth’s Responses Fight/ Flight ▫Hyper vigilant ▫Easily Offended ▫Over reactive ▫Violent Freeze ▫Dissociation ▫Nonresponsive ▫Self-Mutilation ▫Self-Medication ADULT&child

16. How to Access Services You can call your local Community Mental Health Center or provide the number to the patient. To access who your local Community Mental Health Center is: ▫Access the Indiana Council of Community Mental Health Centers:  http//www.iccmhc.org  Or Call 317-684-3683 ADULT&child

17. Questions ?? Tara Elsner, LMHC Amanda Stropes, LCSW ADULT&child