Our expert answers 3 Questions
I am using the history of psychiatry as a tool to understand the complex issue of mood and behavior disorders in children and adolescents. With support from a Robert Wood Johnson Foundation Investigator Award, I am looking at transformations in the field of child psychiatry and the evolution of Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnoses for children. Although many scholars have looked at the social, economic, and professional forces that affected the construction of diagnoses for adults, there has been almost no literature on the origins and development of DSM diagnoses for children.
The national statistics about the prevalence of mental illness in children are mind-boggling. Some argue that as many as 80 percent of children will meet criteria for some kind of mental illness before they reach adulthood. While official psychiatry organizations take this kind of data at face value and argue for more services, critics of psychiatry point to this data as evidence for their claims that psychiatrists are engaging in social control (by defining what should be normal or abnormal thoughts and behavior). Meanwhile, on a clinical level I have seen many parents who want a diagnosis for their child because it gives them an explanation (and removes blame).
We need to know more about the need for mental health treatment for children and adolescents before we can problem solve around how to deliver it. Do we need more child psychiatrists and/or better training for pediatricians? Or do we need better parent education and work in the schools on coping strategies for children? And what needs to be done about the overwhelming influence of the pharmaceutical industry in the field of child and adolescent mental health? I am looking to outline possible research programs for the future to address these questions.