The Truth about Mental Health in the United States

The Truth about Mental Health in the United States

Many of us assume that living in the United States provides us access to the best physical and mental health care in the world. Unfortunately, this is not true. One example of this fact comes from the ABC News Show 20/20 which aired on 9/11/15. An Olympic Athlete had been living with Bipolar Disorder for over 20 years even though her brother committed suicide due to being Bipolar. The family never discussed it due to shame associated with suicide and mental illness. The Athlete and her husband asked for help for 10 years and despite the fact she had all the symptoms and a family history of Bipolar, no one diagnosed her. She lives in the United States, her brother committed suicide because he was Bipolar and it still took 10 years for her to be diagnosed with Bipolar Disorder and not dismissed by psychiatrist as someone who was over reacting. Now that she is diagnosed she is dealing with the shame of being Bipolar.

We often hear parents complain that their teenager is driving them crazy or a teenager complaining how unfair their parents are to live with on a daily basis. However, there are another set of complaints that get ignored on a routine basis. The complaints that get ignored are parents begging for mental health care for their teen or a teen crying out for help by cutting themselves or running away on a regular basis. Many of us assume that if a parent wants mental health care help for their teen or if a teen needs help, all either one of them has to do is ask for help. Unfortunately, this is not how our world works. I have been working as a psychotherapist who treats teenagers for over 20 years. There have been many times I could not have a suicidal teenager hospitalized because the hospital had no beds for a suicidal teenager or the insurance refused to authorize the admission to the hospital.

It is very common for parents to ask everyone they can think of for help for their teenager and the only answer they get is, “I am sorry we cannot help you or your child.”

It is also not uncommon for teens to ask for help by admitting to someone that they are feeling suicidal and the teen is told stop being so dramatic or “sorry there is nothing we can do for you, but try calling this number.”

Some of you may assume that I must be exaggerating, but I am not. I have had many parents beg me to see their child because no one has any appointments or they don’t deal with their teen’s issues. When I interview the parents, they have been every where asking for help, but no one has offered any help or referred them to someone else because they don’t deal with their child’s issues.

For example, one Thanksgiving I had a mother have my answering service page me and she was begging me for help because her teen was suicidal. I referred her to the County hospital because based on what she said the teen needed to be hospitalized. She told me the County hospital gave her my telephone number because they had no more beds for anyone who was suicidal. The parents tell me they feel like no one cares.

Again, some people might believe this is an isolated case. Sadly this is not an isolated case. I specialize in treating suicidal and bipolar teens. There have been a number of times I have sent a suicidal teen by ambulance from my office to the County hospital only to have the teen released in less than an hour because the hospital had no beds. I had one person on the Psychiatric Crises Unit tell me on the telephone unless the person had a shotgun in their mouth not to send them to the Hospital because they had no beds for suicidal teens.

Now, some of you may assume the situation would be different if the teen had private insurance because I have been referring to the County Hospital. If you are thinking having private insurance would make a difference, you are wrong. I have had many private insurance companies deny my request to authorize additional therapy sessions for a suicidal teenager. When I remind the insurance that the teen is suicidal and needs therapy to prevent them from acting on their feeling, they often say to refer them to a community counseling center. When I remind them that most non-profit counseling centers have closed due to the economy they simply say sorry they have exhausted their benefits and they will no longer cover their treatment.

This puts the therapist in a difficult position. Do you just discharge the teen or do you continue to treat the teen for a low fee or for free? When 1 out of 5 teens have a psychological condition that needs treatment, what do you do when treatment is denied or there are no treatment options? Besides 1 out of 5 teens needing mental health care, the CDC has recently moved suicide from the third leading cause of death to the second leading cause of death for children 10 to 18 years old. Therefore, there are many teens who desperately need mental health care and can die without it. Also, when you examine the results further you find that teens who need therapy but fail to receive it are more likely to get involved with drugs, crime, are more likely to drop out of school, more likely to get pregnant or father a child and that child is more likely to become a foster child. These teens are also more likely to end up on probation, homeless and on welfare.

As a society we do not place much emphasis on mental health care. Mental health care programs are always some of the first programs cut when the budget is cutback. In fact if you look at the recent cut backs due to the Congress not balancing the budget, mental health programs were some of the first programs to be cut.

I find it very interesting that Contra Costa County had enough money to build a new Juvenile Hall, which is three times the size of the old Juvenile Hall, but there was not enough money to fund a large number of mental health services which had to be cut.

We often look at teens who are acting out and blame their parents. We ask why don’t they get their child the help they need? What stops them from helping their teenager? Why is the teen always getting involved with drugs or not going to school? The answer could be because the teen needs mental health care and the parents have been and continue to try to get their teen help but their is no help. The teen may be acting out because they are tired of asking for help and being in pain so they start looking for the easiest way out of pain.

If we want our teenagers to grow up to become productive members of society then we need to provide them with the mental health care they need. If we want parents to be responsible parents, then we need to provide parents options for how to get their teens help when they ask for it.

With the number of mass shootings, the significant increase in the number of children with anxiety disorders and the epidemic of teenagers cutting and teenage suicide, I am surprised we have not made it easier and more affordable for teenagers to get adequate mental health care. The President states we need to address mental health care, but I have seen very few changes in mental health care.

I have been treating teens for over 20 years and it is still a problem to get a teenager residential care if they need it. Also it is still difficult to get teens medication at an affordable price. I had a teen the other day who needs medication but they had no medical coverage to see a psychiatrist. The parent made an appointment but the fee for the visit was $450 and they would not reduce the fee. So what do they do?

We can write our Congressmen and Senators and demand that they fund community mental health centers. We can also demand that private insurance companies be required to offer teenagers and their families adequate mental health benefits based on what professional therapists are recommending. The professional treating the child knows what the child needs not some clerical worker with a Bachelors degree who is answering phone calls at the insurance company.

In short, if we want our teenagers to survive their teen years we all need to act together and demand that our children receive the treatment they need and deserve. Mental health care is not a dirty word. There is no difference between mental health and physical health. Therefore, they needed to be treated the same and we need to eliminate the stigma associated with mental health issues.

Finally, private insurance companies make huge profits and drive the cost of health care up based on how they do business. If we don’t start to speak up for our kids, they will never receive the care they need. Look at your next pay stub and look at how much you pay for health insurance and compare that to the benefits you receive. When you take your teenager to a psychotherapist most insurance companies only pay the therapist $75. Your copay is part of the payment. Your premiums are high, but they do not pay it out to providers they keep it.

Dr Michael Rubino has over 20 years experience working with teenagers and their parents as long as Bipolar patients. To find out more about Dr Michael Rubino and his private practice visit his website at http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3.

Facts about Teenage Boys Using Guns Across the United States

Facts about Teenage Boys Using Guns Across the United States

With the significant increase in mass shootings and the recent shootings in Gilroy, Texas and Ohio, I hear many children and teens talking about their safety at school and around town while they are playing or hanging out. Many teenagers seem to believe if they have a gun that will keep them safe. While researching this issue I read an article by Cody Fenwick regarding children and gun violence. His article was very alarming. September is dedicated to suicide prevention and October is dedicated to the issue of bullying so this month and next month are dedicated to safety issues involving teenagers and children. Therefore, it seems appropriate to address the issue of guns because they are a popular method of suicide and they can be used to bully kids too. In addition teenagers who cannot tolerate the bullying they have to endure every day often use a gun as their method of suicide. Some may use a gun to act out their frustrations too.

Many of us feel because we live in Pleasant Hill, Walnut Creek, Lafayette or Orinda that our children and teenagers do not have to worry about gangs or gun violence. Unfortunately, this is not the truth. According to a new research study in the Journal of Pediatrics, guns continue to be the third-leading cause of death for Americans younger than 18 years old, killing around 1,300 children and teenagers a year in the United States. In addition, almost 6,000 children and teenagers are injured per year. Many teenagers are permanently disabled from these injuries. For teenagers who commit suicide, guns are the second-leading cause of death. The CDC has recently moved suicide as the third-leading cause of death for teenagers to the second-leading cause of death. This is a scary fact that the rate of teenage suicides are increasing not decreasing.

The study examined data from the Centers for Disease Control and Prevention and the Consumer Product Safety Commission between 2002 and 2014. The study found that boys, especially older boys such as teenagers and minorities, were much more likely to be the victims of gun violence. The study did not say anything about where the boys lived. The facts are children who are male and teenagers, are at a higher risk for becoming a victim of gun violence regardless of where they live. Therefore, teenagers in our area are at risk of becoming a victim of gun violence.

The study does indicate there has been a decrease in accidental deaths such as boys cleaning a gun. However, the rate as a method for suicide has increased. I have mentioned before that suicide is no longer the third leading cause of death for 10 year old boys. It is now the second leading cause of death for boys 10 to 18 years old. This study confirms that statistic and indicates the preferred method of suicide for boys and teenagers are guns. According to Katherine Fowler, one of the lead researchers at the CDC, “Firearm injuries are an important public health problem, contributing substantially to premature death and disability of children.” Understanding their nature [guns] and impact is a first step toward prevention.”

When we look at these numbers, can anyone argue against taking steps to protect our children? Can you imagine a 10 year old boy using a gun to kill himself? Can you imagine a 10 year old boy feeling that his life is so bad at the age of ten that death seems like a better option than living? At the age of 10, he has given up hope for a decent life. This is a sad fact.

The study also indicates that in recent years guns were responsible for a large number of adolescent, males who were murdered. The study documented that deaths in the category of murder for boys under the age of 18 years old decreased to 53 percent. This is a decrease yet the rate is still 53%. The other causes of gun-related deaths include:

• 38 percent — suicides

• 6 percent — unintentional deaths

• 3 percent — law enforcement/undetermined cause

The study found 82% of deaths by guns were boys. This means 82% of gun deaths were boys who were children or teenagers. Putting it another way, this means these boys were not even 18 years old yet at the time of their deaths. The study also found that white and American Indian children have the highest rate of suicide using a gun.

We also like to think that the United States in one of the most advanced nations in the world. However, the statistics show that the United States has the highest rate in the world for children under 14 years old committing suicide. Again, the United States has the highest rate of children under 14 years old using a gun to commit suicide. That number scares me and is appalling to me. However, as an adolescent and child psychotherapist, I do not doubt it. I have heard 6 year old boys seriously discussing suicide.

Furthermore, I hear teenagers routinely talking about needing to carry a knife or gun with them for protection. They tell me you never know when you will be jumped or there will be a mass shooting and you need to be able to protect yourself. In fact, a few years ago a teenager was shot on his front door step in Danville over a marijuana deal which went bad. When I mention to teens the risks they are taking, they tell me there is no guarantee they will live until 30 years old. They would rather die protecting themselves than doing nothing.

As a society, we need to look at these numbers and ask ourselves some questions. What are we going to do in order to improve gun safety? How are adolescent boys getting access to guns? Most importantly, why are children as young as 6 years old thinking about suicide? Also what are we going to do so that children who are suicidal have access to mental health care? This is our problem because it does happen in Pleasant Hill, Walnut Creek, Lafayette, Orinda and Danville.

Dr. Rubino has 20 years experience as a psychotherapist working with children and teenagers. For more information about his work or private practice visit his website at http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3.

Allowing Teenagers to Learn from their Mistakes

Allowing Teenagers to Learn from their Mistakes

Working with teenagers, I hear very often from parents that they feel their teenager is not responsible and they have concerns about trusting their teenagers. I also hear from teenagers how they are upset with their parents for not trusting them and not allowing them to make decisions. I understand the parents’ concerns, but at times they are being unfair and unrealistic about their ability to control their teenagers’ decisions.

We routinely tell teenagers that they need to be responsible for their choices and actions. However, we seldom allow teenagers the ability to make their own decisions. It is not uncommon that parents have set rules and curfews for their teenagers. Also with the advancement in technology many parents have software installed on their teenagers’ cellphones so they can read their teenagers’ emails or texts. Also they have GPS programs so they can determine where there teenager is and try to figure out what they are doing.

Teenagers are aware that their parents have software programs on their cellphones so they can read their emails or texts or use a GPS program to determine where they are and what they are doing. This usually makes teenagers upset that their parents do not trust them. Teenagers’ tell me if they want me to be responsible how can I be responsible if they do not give me a chance? Also most teenagers have found ways to bypass these programs or they have developed a Texting code so parents will not know what they are texting about to their friends.

Teens there are some facts you need to be realistic about too. You cannot demand that your parents treat you like adults, but if you get into trouble, you want mom and dad to fix it. If you want people to respect your choices and opinions, then you must be prepared to accept the consequences and reactions from other people regarding your choices and opinions. You cannot have it both ways.

The other fact that parents need to accept is you cannot control everything your teenager is doing. You can monitor your teen all you want, but if a teenager wants to do something they will figure out away to do it. Also if you want your teen to be responsible you have to learn to accept their decisions and the consequences that may result from their choices. Additionally, your teenager needs to learn their decisions have consequences and teenagers need to learn to accept the consequences for their actions.

What parents need to do is have a calm conversation with their teenager. During this conversation you discuss issues that your teenager will be facing such as alcohol, drugs, sex and their futures. Explain what you expect and what you are willing to do or not to do. Therefore, they may begin to understand what consequences they will face depending on the decisions they make. They also may start to understand that you will not always be able to solve their problems. If they want to be treated as adults, they need to be able to deal with the consequences of their actions.

This is an important lesson for teenagers to learn. They need to understand that their actions have consequences and they are responsible for dealing with these consequences. One consequence may be that as parents you may be upset with their decision. This is a consequence that they need to be able to accept. Not everyone is going to always accept or approve of your choices. Teenagers need to learn this fact. It is important that they understand that their choices have consequences and they are responsible for their choices.

It is important that parents learn to accept the fact that they cannot control their teenager’s choices. Allowing them to learn from their choices is the best way for them to learn responsibility. It is also away for parents to learn to allow their teenagers to grow up and be responsible adults. Yes at times this may be difficult, but parents need to be realistic that they cannot control their teenager. Also it is better if they make mistakes before they are 18 years old. Typically these mistakes can be resolved easier if they are under 18 years old. When they are over 18 years old, they face the same consequences as a grown adult. Parents it is important to remember that part of your teenager becoming an adult is allowing them to make choices and to learn from those choices. Also the time to start educating them about choices and right and wrong is when your child is in elementary school. If you wait until they are teenagers, they think they know more than they do and they are less likely to listen to you.

Dr. Michael Rubino has over 20 years experience working with teenagers and their families. He is considered an expert working with teenagers. For more information regarding Dr. Rubino’s work and private practice visit his website at http://www.RubinoCounseling.com or his Facebook page at http://www.Facebook.com/drubino3.

Why Some Teenagers Act Out

Why Some Teenagers Act Out

It seems that many adults do not really understand what children want from adults. It also seems from what I have seen and heard that many adults do not understand that children are not bad. Children are not born bad, we make them bad by how we treat them. Yes you do have children with loving parents and families who make very poor choices in their lives. As a result, they end up in jail or hurting people. However, these are the rare cases.
The most important relationships in a child’s life is his/her relationship with his/her parents. A child wants love and to feel wanted by their parents. Parents are a child’s safety net. As long as Mom and Dad are okay then they are okay. If their parents are not okay, then a child’s safety and life is in danger. Children cannot tolerate this fear. Therefore, if their parents have a problem instead of seeing their parents with problems a child changes the situation so their parents are great and the child is bad.

I have seen this many times with foster children. Their parents are usually great people and Social Services are being mean to their parents. They can be living is the best foster home in the world and if you ask them if they want to return to their natural parents, they say yes. They are desperate for that validation from their parents.

The problem is many parents do not know how to express love to their children because they never experienced it themselves as children. Therefore, they do the best they can do and feel they are good parents because they are better than their parents. However, when they hear their children asking for more they get mad at their children. They want their children to validate them for being good parents. They do not understand that a child doesn’t have the cognitive abilities to do so.

Therefore, a child tends to feel unloved, unwanted and form a belief they are useless. They tend to hang around people who reinforce this belief. They are afraid of people who might love them. They are afraid these people will discover the truth about them and leave them. They feel safer with the people who tell them they are worthless.

Walking around with this feeling can hurt a great deal. As a result, kids start to do drugs, alcohol and hang out with gangs. The drugs and alcohol help to numb out the pain of feeling worthless while at the same time it reinforces the belief that they are worthless.

Most often these kids act out at school and tend to get arrested for stealing or drugs. Some people try to help but the child pushes people away. It is better to leave someone than to be left. Most people get tired and say there is nothing else they can go and give up. Once again, reinforcing the child’s belief.

These are the children and teenagers who really need our help. The harder they push us away, the harder we have to say we won’t go. There have been many times that I have hint to Juvenile Hall to do sessions. The teen is shocked! I tell them that I told them they can push as hard as they want, but I won’t believe they are bad or walk out. At times this is difficult because they often test me over and over to see if I am for real. If they see I am for real, I am only one person they need other people to stay.

What I have seen in working with teens who act out for over 19 years, is they are looking for someone to say I care and you are important. They prefer that it comes from their biological parents, but once they accept their biological parents cannot provide this, they look to other adults.

Those of us who work with acting out teenagers as therapists, teachers or foster parents need to understand how severely these children have been hurt by their biological parents and the hard work it takes helping them over come that wound.

Extended family such as aunts and uncles, you too need to understand how deep the wound is for these kids. If you are not dealing with your own wounds, they need you to be in it for the long run.

This may seem like I am asking for a great deal, but look at how many teens are dying from suicide, drug overdose, shootings etc. When you see the number of young lives being lost you can see that it is worth the effort.

Yes it takes a great deal of effort but when you communicate to a teen that yes you are worth something, you are love able and I care about you. Watch how they go out into the world and help others and share love with others. So the price is worth seeing a teen full of life and going out and sharing it with the world. Watch some of Challenge Day’s videos on YouTube to see the love teens can spread if we give them love.

Dr. Michael Rubino has over 19 years experience working with high risk teenagers & foster children and is an expert in this area. For more information on Dr Rubino visit his website at http://www.rcs-ca.com or follow him on Twitter @RubinoTherapy.