Every week, I see a teen with depression and/or anxiety. Sometimes that teen is mine.
And while I can certainly opine over the lack of mental health resources for our children and teens — you have to be a certain age, you have to have certain insurances, if you’re uninsured or underinsured, you can see a community health professional but only for eight sessions — what I really get frustrated with is the fact that mental health is not seen as a health issue.
I know, you’ve read about this before. You’ve read about teens and kids struggling with distance learning and lack or dearth of social connections. (Though I’ve also seen many of my patients thriving too.) There is more awareness and, I’m happy to say we are talking about mental health more.
But it’s still not seen or accepted as a health issue. I’m not talking about the fact that it’s almost impossible to find a psychologist or marriage-family therapist or psychiatrist who takes your insurance. Or how many people just pay out of pocket, whether they can afford it or not.
I’m talking about the feeling of being alone. Not lonely but alone.
I have many friends and children of friends and patient families who hav a different medical diagnosis. There are meal trains and well wishes and people checking in on them. They can contact the school, and everyone is understanding about missed classes and missed or late assignments.
But when you have a child with depression or anxiety or ADHD or any other number of mental health issues, it’s harder to say, “My child didn’t do his/her homework because he/she couldn’t.” Or “My child didn’t make it to school today because we sat outside in the parking lot, and they couldn’t get out of the car because they were gripped with an anxiety attack.” She didn’t have the energy to get out of bed. He just couldn’t focus. The list goes on.
Those aren’t all my kid. But I know that if my child had type 1 diabetes or juvenile rheumatoid arthritis or nephrotic syndrome or any type of cancer, I could call their school, and everything would be understood.
Would they be as understanding when I say my child has depression? And that she goes to therapy, she is on medication, she (and her parents) is/are trying her/their very best? Maybe. Maybe not.
The first hurdle is for parents and guardians. Do we call? Do we reveal? Do we want to keep that information private? For my child’s privacy, I’m writing this anonymously. It’s not my decision to make to reveal her to the world.
But I have spoken with her school academic counselor, who was very understanding. Do I take the next step? Do I tell her teachers, especially the one who teaches the class she is getting a D in? (A class that is essentially a repeat as she aced it as an eighth-grader and is in high school now. In fact, she received an academic award in that subject the previous year.) Do they all need to know why she isn’t focused in class sometimes as she’s hit the pandemic fatigue wall? Do they all need medical notes from her physician so she can have accommodations for her late assignments?
When I’m struggling as a parent, I know that I can talk to my family and my spouse. But which friends can I talk to about this? I have a few who I am able to commiserate with, but there are so many parents who are feeling alone. Helpless in their struggle.
And there are some days when I do feel alone too. Not lonely, but alone.
This is where the health system has failed us. Because I know I am not alone. I know from my own experience as a pediatrician that I meet parents like me every day.
And, one day, our health system will hopefully not be governed by dollar signs and run by insurance executives who may or may not have a background in medicine.
Yesterday, I received a letter from an insurance company about antibiotic stewardship. I didn’t really need them to tell me when or when it isn’t appropriate to start my patients on antibiotics. I like that there is an awareness, but that awareness can be brought about by education, not a slap on the hand. I’m aware. Are you aware that I’m treating a whole person? Are you aware that if you made it easier for patients to get mental health care, then you’d likely be paying less for them to see GI specialists when their anxiety triggers abdominal pain? Or less so they won’t be hospitalized?
We are living through a global pandemic. But we have also been living through a hidden pandemic of depression and anxiety and a host of other mental health diseases and conditions. And the more we talk about it and discuss it, the better.
If you know someone who is struggling right now, or if you know a friend’s child is struggling, why not reach out to check in on them today?
The author is an anonymous physician.
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