Harmful Childhood Experiences and Mental Health Disorders in Adulthood are “very closely related” to each other, according to Dr. Frank Maffei, Chair of Pediatrics at Geisinger.
That’s why the rise in child abuse cases across the nation is so “worrying”. Adverse Childhood Experience (ACE) can lead to behavioral health problems in children and adolescents, which puts them at risk for suicide, Maffei said.
“If you have someone with a high ACE score, your risk of getting a mental illness is significantly higher,” Maffei said. “The CDC (Centers for Disease Control and Prevention) is examining harmful childhood experiences not only as a predictor of mental illness but also as a harbinger of physical illness. Our bodies respond emotionally and physically to these harmful childhood experiences. They have serious consequences.”
The ACE score is a tale of abuse, neglect, and other harmful childhood experiences. Higher scores indicate a higher risk of health problems later in life.
The State Department of Human Services reported in its latest Annual Report on Child Abuse that by 2020, 73 deaths and 115 deaths had been reported in Pennsylvania related to child abuse. Previous reports showed that there were 51 deaths and nearly 93 deaths in Pennsylvania. 2019. 1,840 children were killed nationwide for abuse or neglect in 2019, just over 1,780 in 2018. However, this is an increase of 10.8% compared to 1,660 in 2015.
The number of child abuse deaths has been much higher than the number of COVID-19 and influenza deaths. Cases have worsened, but it is common belief that cases of child abuse have also gone unreported, Maffei said.
“It’s not to the point where it’s really understood and appreciated, to the point where we need to address the child abuse epidemic in the same way that we dealt with COVID,” Maffei said. “It’s getting worse.”
Nearly all deaths are “horrific,” and often leave children with “devastating long-term consequences,” including brain damage, neurodevelopmental injury, and emotional disruption. Children who survive do not survive without harm, they survive with “severe disabilities that survive,” Maffei said.
Everything in childhood affects me mentally, emotionally and physically in adulthood, he said.
“We want to feed and keep our kids safe,” Maffei said. “Not only to enjoy childhood, but also to have a healthy and fruitful adulthood. You can’t be without each other. If you want to be a healthy adult, you need to start caring for your unborn baby, making sure your mother is well nourished. In childhood, you also have to take care of the children. ”
Northumberland County Child Mental Health Program Specialist William Brecker, the county’s Behavioral Health and Mental Disability Services, said he is seeing more services than ever before for mental health needs, but there are waiting lists for agencies that provide those services.
“They’re caring for the kids, we’re working with them every day, and the staff has been caring for the kids for three years in their case, and it won’t change if nothing changes in the child’s home,” Brecker said. We continue to treat these children (those with mental illness), but unfortunately these children are in the same environment as the trauma. It is difficult to improve one’s mental health when it does not address the factors that affect one’s mental health. ”
Symptoms are being treated, but no one is improving the cause of children’s mental health problems, Brecker said.
“They’re having problems because of their environment: abuse, neglect, lack of parents, trauma,” Brecker said. “They’re being cut, they might say they’re depressed or suicidal. We can deal with that, but until we are traumatized, we will continue to provide services. ”
Most teens won’t improve if they stay in the same home environment, he said.
“I don’t think there’s enough public light on issues of child abuse and neglect, and that children shouldn’t be in the home,” Brecker said. “I look at the heroin epidemic. That’s bad, don’t get me wrong, but I think we should pay as much attention as we do to child abuse and neglect and lack of parenting, because a lot of things will come to light. This is where it all begins. ”
These children who are being abused or being neglected are more likely to develop mental illness, commit crimes, or abuse drugs and substances when they are adults, he said.
“You have to stop the cycle somewhere. That’s where you should start, ”Brecker said. “I think it’s a big problem and it doesn’t get enough attention.”
For young people between the ages of 10 and 24, suicide is the second leading cause of death, and nearly 6,500 lives are lost each year, according to the Centers for Disease Control and Prevention. The CDC’s Adolescent Behavior and Experience Survey (ABES) shows that more than one in three high school students had poor mental health during the pandemic, and nearly half of the students felt constantly sad or hopeless.
Suicide rates remained stable from 2000 to 2007, but rates began to rise from 2007 to 2018, the pre-pandemic. Dr. Angelica Kloos, interim director of pediatric psychiatry at Geisinger, said the trend in mental health and suicide risk has been on the rise over the past 20 years.
“That was when we got into the pandemic,” Kloos said. “In the wake of the pandemic, children and families were facing a lot of stress. When we stress the family system and the child, we anticipate that mental health risks increase.”
“Changing social dynamics”
The change in “adolescent social dynamics” may be partly to blame, Maffei said.
“The first thing that comes to the fore is whether the explosion of social media and electronic communications has somehow led to more isolation,” Maffei said. “I don’t think that’s the only reason, but certainly most experts have acknowledged that it’s part of that multidimensional reason for the rise in teenage suicide.”
While social isolation and self-doubt can cause feelings, Maffei said social media cannot be the only factor. Substance abuse has also increased, he said.
“The pandemic increased the importance of the social connections and dynamics that adolescents have,” Maffei said. “We have seen an increase in teen suicide attempts, especially among girls and young women. Emergency visits among young women increased by 50 percent due to suicide attempts in the nation. The increase in the number of boys was almost 5% ”.
The teenage brain is still developing. Part of the brain – the prefrontal cortex – did not fully develop until the mid-20s, Maffei said.
“It’s a very intricate brain force that really improves the ability to make decisions,” he said. “It simply came to our notice then. If this prefrontal cortex is not fully mature, you can make a decision based on feeling rather than logic or fact. That’s why we all took risks in adolescence, we were impulsive, sometimes prone to emotional change. Because we were developing that. ”
Also, Maffei said, teenagers are trying to look different. They are faced with a special set of situations. High school has bullying. Some groups are excluded, which leads to greater isolation, he said.
“They just went through a physical transformation called puberty,” he said. “Now they have to deal with a body that has undergone significant changes in adulthood. This leads to a lot of stress. They are working on a lot of issues. They are talking about sexual identity. They are finding their team. They’re trying to find where they fit. That can be very difficult. ”
Teenagers are “a very vulnerable population,” Kloos said.
“They are given this new and strong social environment,” he said. “Their environment was much bigger, and their interest in socializing in development is much stronger. These social interactions help to develop a sense of self. At the same time, these young teenagers in particular do not have the ability to regulate these emotions and understand some of these situations. They suffer a lot, but they may not have the skills and strategy to deal with them. ”
Kloos also noted that gun violence plays an important role in the mental health of adolescents and children.
“Every time there is a tragedy like the one in the news lately, it is disturbing for children and families as our sense of security and normalcy is disrupted,” Kloos said. “As parents, we can be sure to provide support and comfort to our children. In addition, we need to limit the exposure of our media and listen carefully to the questions or concerns that arise from them and provide them with appropriate developmental answers to help them feel safe. “
Young children will be more responsive to stressors in their homes and classrooms. Children and teens are more responsive to their social groups, he said.
“Older teens are trying to achieve autonomy,” Kloos said. “They’re learning less, they’re thinking about universities, having limitations later on. Navigating in these situations is often a good stressor, but it can also be a challenge for them. ”
Young children will often respond to behavioral problems when they are stressed. As they get older and reach adolescence and adulthood, they are more likely to show classic depression, Kloos said.
“If a young child is depressed, they may not see these classic signs of depression,” she said. “More anger may appear, anger, boredom.”
How much COVID has played is still up in the air. Children and teens have anxiety about going to school as well as a lack of ongoing structure when it comes to changing personal and distance learning, Kloos said.
“It was a real struggle for them to get back on track,” Kloos said. “The more stability and predictability we can give them, the more we will see improvements in these areas as the pandemic is overcome.”
The brain of a teenager needs to be nurtured and checked. Do mental health hygiene with children and teens: ask how they are, what’s going on at school, make sure they’re getting enough sleep, make sure you don’t rule out some suicides, Maffei said.