The Demons of Childhood
Young brains break. Then comes the broken care system
When Alex McAbee turned 7, many of the happy accomplishments of childhood were missing from his short, tortured life. Indeed, he had not even learned to read, nor had he doffed a corny cap and gown to graduate from kindergarten. Instead, his milestones included several expulsions from day care, one after he had given a child a concussion. Then there was that dreadful day he poked out the eye of his grandmother's puppy, and the day he chased his younger brother, Hudson, around the house with a butcher knife. Drinking gasoline, rubbing his feces on the walls--the list goes on.
Then there were the routine travails, more than the family cares to count, when he would shriek and hurl his dinner against the wall simply because his hamburger was located in the wrong position on the plate. Or when he would just sit and scratch his face and gnaw on his own arm. His mother, Kelly Troyer, recognized that Alex desperately needed help, but she discovered that finding psychiatric care for children in Greenville, S.C., was not so easy. "I was at my wits' end," she recalls. "I went through hell trying to get him treatment."
That road through hell is a familiar one for parents of children with emotional disorders. It begins at home and runs through the schools and into the offices of pediatricians, psychiatrists, psychologists, cardiologists, child neurologists, behavioral pediatricians, and social workers. All of these specialists could tell that there was something seriously wrong with Alex, but the problem was figuring out exactly what. Now 9, Alex has been diagnosed at various times as having autism, attention deficit disorder, bipolar disorder, and oppositional defiant disorder. Each diagnosis, of course, required different medicines. Many failed, and some actually exacerbated the problem.
It is impossible to say just how often this kind of story is repeated in homes across the country. But with an estimated 20 percent of all U.S. children and adolescents having a diagnosable psychiatric disorder, and 13 percent of all adolescents experiencing "serious emotional disturbance," one can imagine that it is repeated in most communities every day. Indeed, the surgeon general's National Action Agenda in 2000 detailed a "public crisis in children's mental healthcare." Compounding the problem is the fact that today's children "are sicker, younger," says Richard Sarles, professor of child psychiatry at the University of Maryland and the president-elect of the American Academy of Child and Adolescent Psychiatry. Why? No one knows for certain.
Certainly, budget cuts haven't helped. Hospital beds for children in psychiatric crisis are decreasing, and in most communities, long-term care is virtually nonexistent. Richard Harding, former president of the American Psychiatric Association and a child psychiatrist in Columbia, S.C., calls the national problem a "perfect storm, where budgets are cut, and inpatient facilities are closing, and more children than ever need help."
But Kelly Troyer and her family were unaware of this in 1993 when Alex was born. All she knew after several months was that her sleepless, agitated second son wasn't acting right. And what she knows several years later is that the system that should have been there to help wasn't acting right either.