Column: Hatem M. Elhagaly, Guest Column

Recently, there has been an increasing concern about mental illness in children.

This is not superfluous because according to a National Institute of Mental Health survey, about 20 percent of U.S. youth are affected by some type of impairing mental disorder. (Published in the November 2010 issue of the Journal of the American Academy of Child and Adolescent Psychiatry.)

This number is alarming, and many people may justifiably wonder about the cause of such an increase. Two factors may have contributed to this: a true increase in the prevalence of such disorders or simply increased awareness and recognition of them.

The short answer is, likely both.

Societal changes, such as increased school violence and augmented stresses affecting the old and young alike, may be responsible for the increased prevalence.

The increased recognition is a result of better awareness of the existence of mental disorders in children, which used to be given different labels in the past, mostly relating to bad behavior or mental retardation … etc. It is also a result of improved awareness of the impact of such disorders on the health and well-being of the children, as well as their development, academic accomplishment, social interactions and potential in adulthood.

The World Health Organization said that mental disorders are the No. 1 source of medical disability for people 15-44 years of age in the US.

The other dichotomy is whether these conditions are shaped by the genes or environment, particularly parental nurturing and methods of upbringing? Like the previous inquiry, the answer is also both.

The genes make some kids more prone to such illnesses than others. However, the environmental influences on the mind and psyche during this phase of brain development cannot be overlooked.

Of the more common mental disorders in childhood are:

• Anxiety

• Depression and mood disorders

• Behavior disorders

• Attention deficit hyperactivity disorder

• Eating and elimination disorders

• Autism

• Bipolarity and schizophrenia

The problem in making an early diagnosis in a child who developed a mental disorder comes from the fact that certain abnormal behaviors at one age could be normal at another, and to further complicate the matter, children considerably vary in their development.

Then how do we achieve early detection for early intervention, which was shown to be essential in altering the course of the disease? It seems that we need to be sensitive to the symptoms of mental disease, since they are more subtle than, let us say, fever or vomiting, for physical disorders.

Those symptoms of mental disorder include: changes in school performance, excessive anger, fear, sadness, anxiety, and sudden changes in behavior, appetite or previous routines.

There is also the more concerning signs of amplified aggression, destruction of things and mutilation of oneself or hurting others.

But when should a parent be concerned enough to bring the child to his or her primary provider? Two weeks is a reasonable waiting period for the mild to moderate presentation of the first group of symptoms. For the severe presentations and the second group of symptoms, a much earlier visit to the doctor may be warranted.

It must not be forgotten here that excessive complaints of physical ailments may be a sign of a mental ailment, and once a physical disorder is adequately ruled out, a mental disorder must be entertained.

To help prevent the development of mental illness, we may need to be more supportive as parents and ask the kids more frequently about their feelings and how their day went by at school. This is important to allow them to vent out their frustrations.

We must also take school violence and bullying seriously. For the separated parents, and particularly those in the process of separating, their No. 1 priority should be to afford the kids a transition that is least disrupting and disturbing.

It is important to allow the children to sleep enough and to use the bathroom as needed at school. It is also important to instill in them, along with respecting others, to respect themselves and accept who they are and how they look.

Some of the prevention is dependent on communal interventions, so we must collectively transform our concern about the children’s mental health into positive work to promote their mental health.

Hatem M. Elhagaly is a medical doctor specializing in pediatrics. He is more commonly called Dr. Aly.