The Case for Universal Childhood Therapy
(This is an edit of an older piece, which has been sitting in my queue for quite some time. The writing quality is not as good as I wish it had been at the time, but I suppose we all get wiser as we age.)
The Case for Universal Childhood Therapy
Crazy About Mental Health!
Whenever a mass shooting dominates American headlines, a portion of the media assigns blame to America’s subpar levels of mental health care and awareness. These tragic moments are some of the few times when mental health comes into the national discussion, which is really too bad. It is estimated that some 30,000 Americans die from gun violence every year, not all of which could possibly be related to mental illnesses, while 40,000 die from suicide– a cause of death much more directly related to mental illness. Other, less fatal statistics abound- 6.7% of Americans are estimated to suffer from clinical depression at some point in their lives, while 18% will deal with General Anxiety Disorder. Obsessive Compulsive Disorder afflicts 2.3%, while some 2.7% suffer from various forms of manias and panic disorders. 6.8% are bipolar or schizophrenic. These are only some of the most common mental ailments afflicting Americans- dozens of other, less well-known illnesses plague countless more. And given that data collection on these statistics tends to focus on cases where the patients come seeking help, we have no way of knowing the real statistics of mental illness sufferers who do not seek treatment. The numbers could well be far higher.
Now, most of these disorders- OCD, anxiety, depression, and the rest- are relatively manageable if properly treated early on, and modern psychiatry has advanced to the point where practitioners have both a neurological and psychological understanding of most ailments. And most health insurance plans by major providers in this country offer coverage for therapy and psychiatric drug treatment, so access to mental healthcare for the majority of Americans is not a major problem. The uninsured don’t have this coverage, which is a pressing problem that must be fixed, but for the most part Americans have access to quality care.
Yet millions still suffer. The problem is not that the care isn’t there; the problem is that, while available, it isn’t widely used or emphasized to the same extent that, say, dietary or sanitary health is emphasized. The notion that there is a “stigma” against the mentally ill is overblown, but their problems are certainly not given as much attention as other more purely physiological health issues.
It’s common practice for doctors to pay attention to children’s physical health- from the counting of toes and fingers at birth to the constant checkups and physicals administered throughout childhood- but there is no equivalent emphasis placed on mental health. This is unfortunate, because most neurological disorders can be detected by early to mid-childhood. It would make sense for health policy officials to insist that, alongside the standard physicals and checkups, children undergo a few therapy sessions at an early age.
The idea is simple. To the existing battery of physical examinations, vaccinations, and other physical health checkups would be added a couple of rounds of psychotherapy. This could be as simple as a series of questions administered to the patient on their personal history and emotional cycles, and if the therapists detected any potential disorders or problems, additional sessions of psychotherapy using various techniques would be recommended. Three introductory sessions per child sounds about right, placed strategically at important points in early childhood, adolescence, and just before adulthood. Kids would go to a therapy session before starting elementary school, before starting middle school, and midway through high school. This way the patient’s formative experiences can be monitored and, in the event that any traumatic experiences in that time threaten the patient’s mental wellbeing, the resulting disorders can be dealt with at an early age rather than festering and deepening over the years.
What about the majority of Americans and American children who don’t suffer from mental illnesses and wouldn’t need the therapy?
In short, there’s no real downside to therapy. If anything, it helps individuals have a better, more well-rounded view of their emotional state, something many Americans pursue through other practices like yoga anyways. And three sessions separated by a few years each is a relatively small commitment. There’s certainly a stigma associated with therapy at the moment, but it’s a stigma not particularly founded in reality- an estimated 27% of American adults report having gone to therapy at some point in their lives, no trivial portion of the population.
There are some- most likely far-left outfits like the “Mad Pride” movement and far-right anti-government paranoiacs- who would shriek bloody murder at such an extension of a government mandate into people’s personal lives. Who is the state to judge what is “normal?” and what is “deviant?” the lefties might ask. Why does the government want the people conforming to a certain mental state? the rightists might wonder. And there is indeed something almost Orwellian about a state insistence on mental wellbeing. But like most Orwellian-seeming plots, this one is not actually totalitarian. Patients would not be coerced into doing anything against their wishes, and therapists would make only recommendations- not commands. The purpose of this addition to healthcare policy would be to help people who otherwise wouldn’t find help, before they need that help.
Meanwhile, the potential benefits of early childhood therapy and mental illness detection are innumerable. Hundreds of thousands, perhaps millions of lives could be made happier or even saved. There would be lower rates of suicide and homicide. Throngs of Americans could be made more productive and innovative in their newfound ability to manage their disorders. Decreased costs in emergency mental healthcare could save countless public dollars, as preventative mental healthcare will have nipped those cases in the bud. More people could be free from the demons that otherwise would haunt them.
It would be expensive, of course, and before this could be feasible the government would need to find some way to pay for it. But once that means is found, the benefits would be well worth the costs.
American policymakers should act to make early childhood therapy and mental illness detection standard parts of every American child’s health program, to complement the current focus on physical health. At a certain level, we have to realize- mental health is health. Just as it’s important that we identify individuals with pancreatic cancer and strive to help them with the best care possible, so must we search out those suffering from depression and anxiety and work to help them as best we can. There’s a difference in the kinds of health, but they carry equal moral weight.
And as someone who’s been in and out of mental hospitals over the course of my adult life, this issue hits home to me. I wish I had been forced to talk to a therapist back when I was 8 years old, so that the patterns that would eventually culminate in terrible mental illnesses could have been discerned and dealt with by professionals. I always knew I was different, but I never knew it was treatable until I sat down with a pshrink in college. But by that time OCD, anxiety, and depression had already done their dirty work on me.
We should make a point of it, as a society, to make sure our kids don’t have to go through what we’ve gone through. We should devise and implement a system whereby we treat the issues of the brain as proactively as we treat the issues of the body. I’m no health professional or healthcare policy wonk, so I’m in no place to give specifics. But if we can tilt the conversation towards some form of universal childhood therapy, and start having vicious arguments about how to provide it, the world will be much better for our kids.