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Mental health professionals on children and mental illness

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Will he ever be able to enjoy life, or will the anxiety block him at every turn? Reassuring him and telling him not to worry is not working. Would you suggest further visits with a psychologist? A psychiatrist? Should we be considering antidepressant or anti-anxiety medication? How ill does he have to be before we should push for more treatment? I welcome any comments you may have. Thank you

Dr. Ian Manion and Dr. Michael Cheng: In response to your question, "Will he ever be able to enjoy life?" although we do not know enough about your son to comment, we can say that there are numerous examples of people coping with anxiety, OCD and Asperger's who manage to cope with their challenges and do well.

For example, there are many famous individuals with Asperger's who have written about their experiences such as:

Look me in the eye by James Robison

The Way I See It by Temple Grandin

Martian in a Playground by Clare Sainsbury

Should he consider medication? You mentioned that he has seen psychologists and psychiatrists in the past; these professionals would be in a good position to let you know whether or not medications might be helpful. We would recommend ensuring that there has been a good attempt to start with non-medication treatments, e.g. coping strategies for anxiety, addressing any sensory issues, using sleep strategies, etc. Should those difficulties persist despite non-medication strategies, then medications may be very helpful.

Although there is no medication for Asperger's per se, there are nonetheless medications that may be helpful for anxiety and obsessive compulsive symptoms, such as specific serotonin reuptake inhibitors (SSRIs).

How ill does he have to be before pushing for more treatment? Treatment doesn't only have to be limited to medications. And things don't have to get worse before different strategies are tried. Just like with physical medicine an ounce of prevention can be worth a pound of cure.

Various therapies can help with self esteem and help cope with stress. Depending on your area special resources may be available to children and adolescents on the autistic spectrum. Often a first step is a diagnosis from a health care provider. Even if your son does not qualify at this time for an official diagnosis of Asperger's many of the strategies can help. Social skills training can help your son feel more comfortable with peers; reading about other children with similar challenges who grew up to lead successful lives can also help your son's resiliency. Many of these people can also relate their own experiences with what has worked for them. Sometimes this does involve medications. More often however treatment or managing also involves non medication methods.

And last but not least, we recommend contacting Autism Canada, which provides information on their website and depending on where you live, may also provide more direct support.

Christine Diemert, globeandmail.com: Thanks Dr. Manion and Dr. Cheng for joining us today. We had a lot of questions I hope we were able to get to most of them. Before we close, I want to ask whether there is anything you'd like to add.

Dr. Ian Manion and Dr. Michael Cheng: The breadth of questions received today speaks to the complexity of the issues at hand and the need for ongoing dialogue. There are many efforts under way to ensure that child and youth mental health continues to be on the national radar. There are clear knowledge gaps as well as major challenges with respect to the co-ordination of care for children and youth across the country. But there is also hope. There is a growing band of champions from across the country who are committed to making things better.

The Globe and Mail should be commended for its efforts to bring awareness to the serious mental health issues faced by Canadian children and youth. While we might tend to focus on the most serious and dramatic situations impacting young people and their families, let us not forget those experiencing day-to-day symptoms that may be less obvious but also have serious impacts on the quality of a young person's life. In some respects, those young people may benefit most from our efforts at prevention and early intervention. It is also clear that many parents are struggling as they do their best to support their children and youth. A comprehensive system also needs to attend to the needs of parents and caregivers and recognize their critical role in such a system.

Mental health issues can affect each and every one of us, both directly and indirectly. The people who have spoken out today are contributing to a more open conversation that all Canadians need to participate in. Only through such dialogue will we be able to make a system that actually works for our children and youth.

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