In a blistering new report, the U.S. surgeon general on Wednesday said growing numbers of emotionally disturbed children and teenagers are "suffering needlessly" because mental health services are inadequate and many institutions designed to help them are ineffective.
 

 The first-of-its-kind study, the latest effort by the Clinton administration
 to reinvigorate public interest in mental health issues, highlights the extent of mental illness in the young as well as the extent of neglect.  One in every 10 children is impaired by emotional disturbances, the study said, but fewer than 20 percent of those who need help get it.
 

 As a result, millions of children experience problems in school, delays in development, or other setbacks that can affect their ability to grow into happy, productive adults, states the report.
 

 The timing of the study is notable: it comes as legislatures across the country reconvene to address budget and policy concerns, and during the waning days of a Clinton presidency that has sought to make childrens' health issues a priority.
 

 The surgeon general's report suggests actions that could become a blueprint for improving mental health care for kids: more training in recognizing early warning signs for doctors, teachers, and school
 counselors, better information on effective treatments, more emphasis on prevention, better coordination between programs, and, most important, a sustained public effort to dispel the stigma
 that prevents many families from reaching out for assistance.
 

 Tipper Gore, the vice president's wife, helped mobilize the Clinton administration around mental health issues, after admitting she suffered depression when her son was badly injured in a car accident about 10 years ago.
 

 Just this week the federal government, acting on an executive order from the president, offered employees improved mental health benefits.
 

 Surgeon General David Satcher noted that "children are suffering disproportionately far more that adults in terms of undiagnosed and untreated mental health problems."
 

 He added that "despite our efforts, we haven't made any real progress in 20 to 30 years  People still don't seek the help their kids need, and the social environment is still not conducive to getting that help."
 

 Satcher said the greatest personal surprise was the scope of the issue. Emotional and behavioral problems affect more children than any kind of health concern, according to research cited at a September conference convened by his office.
 

 While mental health practitioners have long sounded similar themes, the decision of the nation's public health chief to highlight the concerns is unprecedented as was Satcher's earlier focus on suicide and mental health for the overall population.
 

 The new report is a collaboration between three federal departments Education, Justice, and Health and Human Services underscoring how mental health problems tend to spill into many areas.
 

 Satcher's efforts on behalf of mentally ill children also resonate with efforts being undertaken by other federal agencies. The Food and Drug Administration recently required drug makers to test medications on children so side effects and long-term impacts can be better understood, and the National Institute of Mental Health has stepped up funding for research on treatments for children and adolescents.
 

 The attention to kids' emotional disturbances is long overdue, said Kimberly Hoagwood, associate director for child and adolescent research at NIMH. "Children's mental health care research has
 lagged badly: it's about 20 years behind what we know about adult mental health care," she said. "But at long last, we are coming into our own."
 

 In academic terms, that means an explosion of knowledge about how to diagnose and treat kids' mental health problems over the past decade.  Now, early symptoms of many mental illnesses in children and teens have been pinpointed, and effective treatments have been identified
 in many cases.
 

 In practice, though, much of this research hasn't made it out into the real world. Relatively few therapists treating teens have formal training in new therapies that have been shown to help depressed
 teens, part of a wide and persistent gap between research and practice, which the surgeon general's report says needs to be corrected.
 

 Still, many professionals and parents are concerned that some childhood conditions, such as attention deficit hyperactivity disorder, may be overdiagnosed and inappropriately treated with medication. Yet there is also concerns about underdiagnosis and the prevalence of treatments
 that haven't been proved effective.
 

 The new report offers many suggestions, including encouraging professional schools and organizations to teach doctors, nurses, teachers, social workers, day-care providers, and probation
 officers about new research findings in children's mental health, especially so they can pick up early warning signs of significant problems and make appropriate referrals.
 

 Better systems for identifying emerging emotional problems also need to be developed, the report suggests. "What we really need is to make this part of any regular evaluation whether medical or otherwise of how a kid is growing and developing," said Dr. Rex Cowdry, medical director of the National Alliance for the Mentally Ill.  The surgeon general's report suggests the need for a universal measurement system for child mental health that would identify kids with problems, track their progress during treatment, and document how patients fared after treatment ended.
 

 An alliance between schools and mental health agencies appears to be part of the solution. In Chicago, the public schools are implementing a curriculum in "social and emotional learning" to
 help teach kids coping skills that will prevent problems from escalating. And the children and adolescent services division of the Illinois Office of Mental Health has targeted collaboration with schools as its top priority, said clinical director Dr. Peter Nierman, a child psychiatrist.
 

 "The challenge of the future is to bring services whose effectiveness is grounded in strong scientific evidence into community settings, including schools, child care centers, recreation halls, and juvenile justice facilities. That's where the kids are, and where our greatest opportunities lie."
 
 
 

Return to the EBD Teacher Page