Adolescent Mental Health, featuring Peter S. Jensen, MD | EDB 264
The REACH Institute founder Dr. Peter Jensen discusses the importance of mental health care for kids.
(VIDEO – 13 mins) Peter S. Jensen, MD is the Board Chair and Founder of The REACH Institute. The Institute is a 501(c)3 nonprofit dedicated to ensuring that the most effective, scientifically proven mental health care reaches all children and families. They train primary care providers, therapists, and other professionals to diagnose and treat mental health issues.
While serving as the Associate Director of Child and Adolescent Research at the National Institute of Mental Health (NIMH), Dr. Jensen saw a widening gap between scientific knowledge about mental health and the application of that knowledge to help children and teens. Science has made remarkable advances in understanding mental health problems and how to treat them. But healthcare professionals were not consistently or effectively using this knowledge to diagnose and treat common disorders. After leaving NIMH, Dr. Jensen went to Columbia University to serve as the founding director of the Center for the Advancement of Children’s Mental Health. While there, he developed the core methods REACH uses today. The goal was to close the gap between science and practice. The central strategy was to bring together leading scientists, mental health experts and agencies, primary care providers, parents, and schools to identify the best scientific findings available to help children. Then Dr. Jensen led REACH to implement, disseminate, and evaluate these methods. He describes the process as “putting science to work.”
For more about REACH: https://thereachinstitute.org/
AUDIO PODCAST VERSION:
Or look for us on your favorite podcast provider:
iTunes | Stitcher | SoundCloud
FULL TRANSCRIPTION
DR HACKIE REITMAN (HR):
Hi, I’m Dr. Hackie Reitman, and welcome to another episode of Exploring Different Brains. And today we have returning to us from the REACH Institute, Dr. Peter Jensen, who’s taking mental health to the youngsters who needed so much. Peter, welcome back.
DR PETER JENSEN (PJ):
Thank you. Thank you Hackie, it’s a pleasure to be here.
HR:
We have a parent who knows his kid is different and needs help. What do I do? I’m that parent, what do I do? Because my doctor says, “Oh, don’t worry about oh, grow out of it”. Because the doctor is, you know, doesn’t — isn’t trained, not his fault, by the way, but he’s had zero training.
PJ:
That’s true. And the parents don’t know that. They think the doctors got and he says, Don’t worry about it. That’s what I should do. So now, I that’s why I think organizations like yours are so critical. We have to reach out and educate. And sometimes parents have to learn, educate them beyond what their doctors know. They have to go now. It’s it’s a, it’s not an easy task…
HR:
Let me rudely interrupt to say this, what you just said, has gotten so much easier when I do it. Through the advent of Google, you have Google Now, when I went to med school used to have to go to the library and take out books, you can know as much as your doctor now about your kid’s XYZ.
PJ:
So true. But the challenge I think with Google, you can go and type in a word like autism or ADHD or Alzheimer’s, and you’re going to get 250,000 hits. And your so 250,000 links you could go to. And some of those are snake oil. How would you discriminate between? And I think in many cases, the snake oil might be more common than the solid science.
HR:
Well, when you use the Dr. Peter Janssen strategy, you go with the known organization.
PJ:
Yes, you go with organizations like yours, that have solid scientific information, many have scientific advisory boards. I wrote a big book a number of years ago called making the system work for your child with ADHD. And it was a whole chapter. How do you use Google smartly? So you don’t go down rabbit holes. How do you evaluate the quality of information? What does it mean to find one person who says this? What does that mean with no other scientific backing, or major organization behind it? And so that’s a skill.
HR:
And what my daughter would my daughter taught me she was going for her Master’s before her PhD was “Dad, you never heard of Google Scholar?” Which I had never heard of. That’s not very different. Google. And I was shocked when I went on there. I was stuck. You can’t, you can’t do what I do with regular Google, which is, I jump around to a bunch of different websites. And, you know, my ADHD kicks in. And I get a little bit of this and a little bit of that, but some scholarly articles in there any way, which is a little bit of a plus.
PJ:
No, it’s, it’s a great advantage. So Google Scholar is a great place to begin educating yourself. And it’s important for us always remember scientists fight things out for years, it’s this way, no, it’s this way. Until finally, after maybe 10 years of fighting, some definitive study comes out that says, No, actually, here’s the whole story. And actually, that’s what I did at NIH, we wanted to always have definitive studies that would guide the behavior of a primary care provider, and a parent or an adult, what’s the best treatment, this therapy, this medicine or maybe the combination? And so when you get, you know, 400 people involved in a study like that, with many scientists, then all of a sudden you have a chance for definitive finding that at the end of the day, everybody has to agree with even though there’s always a few fruitcakes out there who won’t agree with anything.
HR:
Let me change topics now to something like all mental health issues has gone through the roof during these COVID times, especially in female teens, and especially in teens in general, which is suicide.
PJ:
So it’s a huge issue. It’s actually it’s one we didn’t see coming in. So just to acquaint your listeners with kind of what you’re referring to, we know that teenage females risk for suicide attempts coming to ers is more than doubled. Okay, across the country, for boys, it’s increased but not quite doubled. We are seeing 2030 40% increases in child mental health problems and where people are looking at it. And I have to tell you, I, I was there at 911 That was in the city. And for 911, it was a single one time event. And except for the kids who lost their parents, or had actually seen, you know, there at the site and saw something, the effects were real across kids in general. But it was like this kind of an effect. It was somewhat more anxiety, some more depression, somewhat more behavior problems. But it was a one time event. Now for the kids who actually experienced loss of a dad, it was like this, so a loss of a parent. And so we didn’t see how this huge district I didn’t see personally, I actually I was asked about this early on, I thought, well, let’s wait and see. And I told them that our New York experience, but this is very different. This has changed their lives dramatically. Their schooling, their peer context, isolation at home, totally different. And so we are seeing, and now as kids are trying to go back to school, some kids are having anxiety who never had anxiety before, or increased behavior problems, or depression. And so this is a whole new kettle of fish for all of us. And so what I can best say, we are working our way through and do we know exactly how to respond to this? Well, the kid comes in with anxiety now we would probably turn to our normal ways of addressing anxiety would reassure the parents, educate the parent, educate the kid, try a few things, maybe some brief therapy, maybe if we had to try a medicine. But those are things we learned for all of the other garden variety things, will this be different? Or the same methods be be helpful? We don’t know at this point.
HR:
How aware is the school system when it comes to mental health?
PJ:
The problem is: you seen one school system, you’ve seen one school system. And there’s such variability across the country. And it’s dictated partly by the school board’s policies, and then the local superintendent, and then principals have their own pensions. But even the principal can’t necessarily always see what’s going on in the classroom. So all of the same problems, and the general public stigma exists in the school system. Now, sometimes a school teacher after 2030 years, or even three or four years may learn a lot about neurodiverse brains, why this kid can do this. And this could even do that. But think about how that is taken up. One school teacher said not my job three R’s. You know, I’ve just have to do this curriculum. And no, I’m not adapting for anyone. Another teacher might say, I just love these little ones, I’m getting inside this little guy’s heart. And that gives me such pleasure, as I know how to reach them, even though they didn’t reach him in the previous grades. And so even this, so think of neurodiversity also in teachers brands, unfortunately. Now, do they get good training, I’ve always thought if we could train every school teacher in optimal classroom management, like how not to be a yeller, how to use positive consequences for reinforcement. How to capture the heart of each kid, how to rein in the kid who’s a little kind of out there disrupting her curriculum. That is a huge skill. It’s teachable. Most teacher education programs spend, give a lecture on it, and that’s about it. And they’re not coached on it because their teachers don’t have those skills. And so this is a huge problem if we had incredibly, if we could maximize the talent in our schools. I think half of kids behavior problems would drop 50% but drop away. Right 50% Because the stress of school, the stress of failure, the stress of being bullied, all those things contribute enormously to mental health, anxiety, depression, disruptive problems, etc. Even the simple ADHD, you could take an ADHD kid. And if you are the master of your curriculum, you could take that ADHD kid and bring him up front, intrigue, his interest, his humor, treat him special, desperately needs to be treated special, you know, touch him on the shoulder, and become his favorite teacher, to kids. And that kid will work for that teacher, not for the one who’s always about the three R’s and scolds him. So these are skills. They’re not taught. And but you see variations from top flight performance, to bottom to bottom. And you know, when we were doing one of the big studies, I went around, and I sat in classrooms, just monitoring the teaching, not in my own pocket for kids who are in the study. And I was so sad, because I realized, even the standard teachers hitting a curriculum that gets the middle third, loses the and bores, the ones that the top and I just realized. And then I saw teachers who were yellers. And I see the teachers on support. They’re not given this training. You know, it’s not like they were never trained. And so schools are a huge problem. And I just will say we haven’t. Now I will recommend someone you might get on on your interview program is PAX is in association. And the leader of packs is very skilled at doing this. He’s also very good speaker. The problem is, alright, maybe the PAXIS Institute… Yeah, PAXIS. And so they’re doing a really good work on the Good Behavior Game trying to get into multiple places across the country. And so that’s a very innovative program that needs to be in every school.
HR:
What is the one thing you wish everyone knew about mental health in adolescence?
PJ:
Parents need to educate themselves. These problems are common, they can derail any team from their optimal performance. But if you educate yourself here on this site, and other places, you can make all the difference in their lives.
HR:
Well, Dr. Peter Jensen of REACH, thank you for your patience and for spending the time and keep up your great work. What you’re doing is terrific.
PJ:
Thank you so much.