<![CDATA[Michael J. Lustick, M.D. - Children & Community]]>Thu, 20 Jun 2024 07:46:04 -0700Weebly<![CDATA[Improving Mental Health Care in Our Communities]]>Tue, 03 Feb 2015 19:41:33 GMThttp://mlustickmd.com/children--community/improving-mental-health-care-in-our-communitiesWorking Beliefs and Assumptions

1.  The vast majority of behavioral / emotional problems that people suffer from are the equivalent of emotional asthma where the expression of the problem is a result of constitutional vulnerability and psychosocial environmental irritants.  Mental Health problems are becoming increasingly common in children, adolescents and adults because the protective structures in families, schools, communities and jobs continue to erode.

2,  Mental health care is primarily geared toward tertiary prevention where the acute symptoms ( i.e. emotional wheezing) determines whether treatment is available.  As a result there is monetary incentive to emphasize serious biological disorders while under appreciating the influence of psychosocial factors.  

3.  The relative lack of sports and arts programs in schools and communities for children and adolescents who are not particularly talented reinforces the over use of electronic entertainment as a substitute for natural world exploration and person to person engagement.  Disadvantaged communities in particular have been stripped of basic, available age appropriate activities for children and adolescents.  

4.  The lack of Community connections and structured involvement for adults and parents creates an experience of isolation and frustration that contributes to alienation and fosters despair in families and children.

5.  Parents with seriously emotionally disturbed children are confronted by the demands of work and economics and the demands of their disturbed child’s daily care and treatment.  For single parents the stress can be overwhelming.  The siblings in families where there is a seriously disturbed child carry an enormous burden that is difficult to address.

6.  The lack of community resources and the limitations of the health care “system” have created an enormous stress on schools.  Many parents have come to believe that Special Education Services can get their child the resources that otherwise are unavailable.

7.  Families that are economically compromised find it very difficult to proactively structure family life because they are just trying to get by each day.

8.  Conglomerate health care organizations have created partnerships with government and insurance companies that channel health care dollars into programs that are “paper perfect”, but do not necessarily connect to the authentic lives of the people in the communities served.  

9.  The erosion of respect for authority and institutions that represent authority has created a paradigm of cynical angry rebelliousness in children and adolescents that many parents and adults agree with and foster.   Every institution in our country is under assault and children grow up with that as their belief system about the adult world.

10.  There is an exaggerated belief that psychiatric medications will be the real solution to any significant psychiatric problem.
​Paradigm considerations for Mental Health Care Reform

1.  A coherent Mental Health Care Plan must be based on diagnostic formulation that addresses the the etiologic factors that are causing the enormous increase in need.

2.  Unless the MHCP addresses primary prevention and secondary prevention as part of its strategic plan there will never be sufficient care for tertiary prevention.

3.  The MHCP can be most effective if it strategically targets secondary prevention.  By doing so the underlying primary prevention issues will be better understood and addressed, while the number of people needing tertiary referral will be minimized.

4.  Treatment focus needs to strategically address the minimization of psychiatric symptoms and the augmentation of age appropriate, adaptive capacities.  Each developmental stage should have established skills and capacities that should be targeted for practice during the treatment process.

5.  The strategic promotion of healthy community initiatives can create the psychosocial holding environment that will decrease stress on all families and individuals by fostering increased community connectedness.

6.  Although Community Health will require the collaborative efforts of a number of stakeholders, it will be important to have a specific person who is highly visible and is directly responsible for the success of the initiatives and who has a well developed strategy with administrative support.

7.  Two major cohorts that need to be actively engaged in the process of  Community Health  promotion are High School Students and the over 55 population.

8.  Children under the age of 5 must be a priority for supportive services so that each is “school ready” by Kindergarten.

9.  The transition ages from 17 until 22 must be carefully and comprehensively addressed so that youth expect to get the support needed to launch them into successful young adulthood.
]]><![CDATA[The "Cute" Sexualization of Young Children ]]>Sat, 20 Dec 2014 19:54:05 GMThttp://mlustickmd.com/children--community/the-cute-sexualization-of-young-childrenThe almost daily reports of sexual misconduct in our society demands that we carefully examine the overt and covert messages we communicate.  The full page ad titled HSQ Kids on page 5 of Sunday's NY Times front page section (11-2-14) depicting an 8 or 9 year old boy and girl dressed for what could easily be seen as a night out holding hands is a case in point.  The apparent cute, attractive couple is an example of the over sexualization of prepubertal children that reinforces destructive attitudes toward children in general and little girls in particular.  As a child psychiatrist for 35 years, I continue to be appalled by the exploitation of children in ways that package them in costumes of sexuality that adults have been conditioned to view as cute.  Until we can all begin to see such packaging as exploitation, we we will continue to cultivate public health attitudes about sexuality in children that easily lead to future molestation and premature sexualized activity. The increasing awareness of just how pervasive sexual misconduct has become should give us all pause to examine our attitudes and behaviors.

]]><![CDATA[Children, Family, & Society]]>Sat, 29 Nov 2014 16:36:06 GMThttp://mlustickmd.com/children--community/children-family-societyChildren need parents to survive.  Parents need children to help them cope with the ephemeral nature of existence.  Families exist in order to facilitate the growth and development of all family members so that societal values are propagated from generation to generation.  There are direct connections between the needs of the child, the parent(s) and society.  Children are fortunate when they are brought into the world by parents who are predisposed to love them.  That love connection is evolution’s answer to the extended duration of helplessness that human children experience.  The family’s purpose is not that experience of love; that love is the starting point for facilitating the emergence of an individual who is capable of working and participating in the community of our society and is capable of sharing with others in a way that is mutually meaningful.  As parents it is your job to facilitate the growth of your child so that he/she is capable of pursuing a life that has realistic options for love, friendship, and work.  As parents you have the right to continue to pursue those goals as well and it is part of the challenge of parenthood to achieve balance between the needs and desires of all its family members.  Families do not function well when either parents or children are over-valued at the expense of the other.  The most difficult and important challenge to manage with children is constructing a daily, weekly, monthly, and yearly rhythm that accounts for the normative developmental needs of each of its members.  That rhythm must be grounded in the realities of succeeding in contemporary society and in the core values of the family.
Contemporary society presents unique challenges to parents and families.  The essential dynamic that is under continual scrutiny is the legitimate use of authority.  As a society, we have witnessed a re-examination of foundational authority structures over the past fifty years.  The loss of innocence exposed in our Presidents, the Vietnam War, the Women’s Movement, the Corporate scandals, Church scandals, Sports scandals, the denigration of compromise by politicians and the Age of Terrorism have all contributed to a landscape of distrust, frustration, anger, hopelessness, selfishness, distraction, sensation-seeking and revenge.  As parents we are expected to navigate through this mindfully while fostering an authentic sense of hope and meaning about the future.  It is, indeed, a heroic undertaking to avoid a global cynicism that masks our own frustration and confusion and that can leave our children floundering for meaning and vulnerable to sensation-seeking consumerism that is the primary marinade of our children’s mass media, pop culture.
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