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Remarks by
A. Kathryn Power, M.Ed.
Director
Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services
National Summit of Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD)
Washington, D.C.
April 6, 2005
Attached is the text prepared for delivery; however, some material may have been added or omitted at the time of delivery.
Good morning. In a few minutes, Dr. Peter Jensen will be reviewing the goals for this conference, which is a “why we are here” overview. But let me give you one reason why I’m here. According to a recent study funded by the National Institute of Child Health and Development, children with developmental disorders may be almost four times as likely as typically developing children to have concurrent mental disorders. Four times as likely! These children need us! They, as well as other children at risk of social, emotional, and behavioral disorders, need developmental and mental health professionals to work together more closely on their behalf. They need us to share what we know, to identify what we still need to learn, and to build on effective tools already at our disposal. We already share a common goal: to help children grow into responsible and independent adults, capable of living, learning, and loving others to their fullest potential.
I am particularly gratified to share this welcome with Dr. José Cordero, from the Centers for Disease Control and Prevention (CDC). CDC is my agency’s highly valued partner in our efforts to transform mental health care in this country. This conference, which we are co-sponsoring, is one of our collaborative efforts to help Americans understand that mental health is essential to overall health. The corollary to that message is that mental health problems need to be addressed with the same urgency as physical health problems. As John F. Kennedy noted, “Actions deferred are all too often opportunities lost.” This sentiment certainly applies to preventing and ameliorating the consequences of childhood developmental disorders.
As adults, as parents, and as professionals, our job is to make certain that all children grow to be healthy adults. By healthy, I mean that we achieve the best possible outcome for the physical, mental, and social functioning and well-being of each individual. A child’s mental health is the foundation of a healthy outcome.
Childhood mental health significantly affects a child’s capacity for social and emotional learning. This learning, in turn, affects all other aspects of a child’s maturation. As defined by the work of Dr. Roger Weissberg and his colleague Dr. Mark Greenberg, social and emotional learning is a process through which a child acquires “the skills to recognize and manage emotions, develop caring and concern for others, make responsible decisions, establish positive relationships, and handle challenging situations effectively.” These are the very skills that ensure a child’s successful passage into adulthood and to the fullest possible life in his or her community.
Children with social, emotional, and behavioral issues, as well as those with developmental delays, need additional support in moving through this process. Their families need additional support. These children present parenting challenges that include behavior management issues and higher levels of stress. And yet, parents often are their child’s greatest advocate. They seek out information that will help them build on the special strengths they can see within their own child.
The key question confronting us today is this: how can we best support children and their families by identifying and intervening early with children who have mental and developmental challenges? The answer we have proposed—that one that you will be exploring during the various breakout sessions—is better integration of primary, developmental, and mental health in community-based care for children.
Behavioral health care and primary health care are artificially compartmentalized. This false division creates an environment in which mental health is not viewed as essential to overall health. It reinforces the stigma associated with mental disorders. It presents tremendous barriers to the effective treatment of related physical, developmental, and mental health challenges.
And, while integration is a critical step in creating better systems of care for children in general, it is even more important for serving minority children. Within the next half century, more than half of our population will be people of color. A significant percentage will be children of color. Even now, children of color are disproportionately diagnosed as having developmental disorders.
The U.S. Department of Education, for example, indicates that African-American children are twice as likely as white children to be labeled as emotionally disturbed. They are nearly twice as likely to be labeled as having a learning disability. Better integration of primary, developmental, and mental health care could contribute significantly to reducing mental health care disparities. It most certainly will lead to earlier and more accurate diagnoses and interventions for all children with developmental challenges.
Primary care can and should become a chief entry point into the behavioral health system. Parents and other caregivers regularly engage with the health care system for their child’s health maintenance, the diagnosis and treatment of minor illnesses, and the management of chronic illnesses. This frequent interaction opens wide the door to early identification of childhood developmental and mental disorders! Pediatricians, using standardized checklists as part of a routine physical exam, are in a frontline position to pick up early warning signs that warrant further assessment and care. In any health context, the sooner a disorder is diagnosed, the greater the likelihood that an intervention will be successful.
It is absolutely essential that we build on the established relationship between primary care providers and families to improve mental health care for children. We have an opportunity here to make their mental health care more family-centered and more intertwined with their overall development.
As you proceed with your agenda, I urge you to engage fully in identifying practical steps for transforming developmental health care for children. Help to shape a process through which any door becomes the right door for prevention, early identification, and amelioration of childhood mental and developmental disorders. To again quote President Kennedy, “Children are the world’s most valuable resource and our best hope for its future.” We cannot afford to squander this resource, or the contributions that each and every child can make to a bright, beautiful, and promising future for us all. I wish you a most successful conference. Thank you.
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