Roger Marsh: Well, hello everyone. I'm Roger Marsh and you're listening to Family Talk, the broadcast division of the Dr. James Dobson Family Institute. As you may already know, Dr. Dobson is in California with his wife, Shirley. He's finishing a new book on the topic of marriage that's going to be called Forever My Love. He'll be back in the broadcast studio soon, but today you're going to hear the second half of a fascinating conversation between our own Dr. Tim Clinton and Dr. Matthew Stanford. They'll be discussing the very important topic of childhood and adolescent mental illness.
Dr. Matthew Stanford is CEO of the Hope and Healing Center and Institute in Houston, Texas, where he writes, conducts seminars, and serves individuals living with mental illness along with their families. Dr. Stanford earned his doctoral degree in behavioral neuroscience at Baylor University. He also completed a post-doctoral fellowship at the University of Texas Medical Branch at Galveston. Dr. Clinton and Dr. Stanford's conversation today centers around Dr. Stanford's most recent book entitled: Grace for the Children: Finding Hope in the Midst of Child and Adolescent Mental Illness. Let's join them right now.
Dr. Tim Clinton: Matt, so great to have you back. And one of my favorite subjects is mental health in the church today. It just goes up another level, mental health, our kids, and the church. Matt, as we get started, yesterday we referenced... And by the way, this is Mental Health Month. The month of May. Matt, we referenced that almost 50% of kids ages 13 through 18, according to NIMH, the National Institutes for Mental Health, will have a diagnosable mental disorder in their lifetime. That's stunning to me. Over 20% will actually have a severe mental disorder in their lifetime.
And Matt, we know this too, that earlier detection, recognition, leads to earlier treatment, which leads to better outcomes for our kids. The tragedy we have, most of these kids go undiagnosed, not treated, and even worse treated as if they're normal. And they try to fit them in sort of this cookie cutter of parenting that we think every child should go through. And it just blows up in our hands. It's like dealing with explosives, Matt. Give us your thoughts about, first of all, the status of where our kids are and what you're really seeing as a result of what we've been through over the last year.
Dr. Matthew Stanford: Well, I think our kids are unfortunately in a really bad spot. I think that. And I'm not a prophet of doom. Social media has come in and destroyed our children. Social media has just contributed to the problems that we already had. It has caused our children to not have as close of relationships and not have the ability to communicate as effectively as you have to when you do face to face. It's isolated our children. We are not teaching our children how to be resilient. And really the best model for resiliency for a child is their parents and how their parents deal with things. And so with the pandemic, for instance, while we're seeing all these problems with children, part of that we have to put at the feet of parents because parents didn't react to it very well and respond to it very well and our children see that. And then they have even fewer skills to be able to deal with something like that.
So, our children have extremely high levels of anxiety because of a culture that is just absolutely obsessed with performance and image. And they simply do not have the skills to deal with it. People really have to hear what we're saying here.
In the United States today, the second leading cause of death for children, 10 to 15 years old, the second leading cause of death is suicide. I mean, that is just an unbelievable statistic. Why we don't hear about that on the news every night, 10-year-old children don't commit suicide because everything's going great.
Dr. Tim Clinton: No.
Dr. Matthew Stanford: So, we have a serious, serious problem here. And as we've talked before, I really think the church has a tremendous role to play here. But I think unfortunately, we're behind the eight ball in some sense.
Dr. Tim Clinton: There's a lot happening as you grow up. Matt, you're changing physically, maybe wrestling with issues emotionally because there's so much stress and demand or things are happening in your world around you. Maybe you've experienced a lot of loss. There's just so many developmental milestones and journeys. And that's why I guess parenting is so important because the greatest gift we can give to our kids is that they're loved and that they learn how to love. Matt, let's jump in and let's talk about warning signs. I'm a parent, I'm looking at my son or daughter and I realized that where we're at, isn't kind of normal. Things are different. When I see that and the natural responses to deny it or pretend like it doesn't exist. You know that?
Dr. Matthew Stanford: Right.
Dr. Tim Clinton: It'll go away. Talk to us, Matt, about what I'm seeing and what I should be looking for and maybe how I can respond.
Dr. Matthew Stanford: Well, first, I have to say to parents let yourself off the hook. If you think there's a problem, then you should go get some help. I mean, we'll talk a little bit about how you might get the help. But the way you might kind of break that down is look at their mood. Do they have heightened states of euphoria or anxiety? Do they have low depressed mood? I mean, what is their mood like? And is their mood or their behaviors that you're seeing, are they consistent with a child of that age and gender? An average child of that age and gender? I don't mean how you would hope that your child would be. I mean how an average child actually acts. I mean, your five-year-old should not be able to sit through the opera and be happy. I mean, that's just not normal.
Normal for children is a very big tent. And so if you're not sure what that looks like, ask other parents, "Well, how is your son on this?" Or ask the teacher, talk to the other teacher. And then you want to look at different environments for their behavior and their moods and their emotions. How is it affecting their relationships? How is it affecting their school performance? How is it affecting their performance or their ability to be involved in activities outside the home or outside of school? Things you might watch for, for instance, heightened levels of anxiety or fear, unrealistic fears.
Dr. Tim Clinton: Sure.
Dr. Matthew Stanford: Again, children are afraid of the dark. That's normal. But if your child is 15 years old and they can't have the light out, well, that's not a normal level of fear for a 15-year-old. Your child is so down that they never want to do anything that's enjoyable that they used to enjoy. Okay, well, that's not a good sign. Children will tend to show a lot of physical symptoms as adolescents, a lot of physical symptoms, stomach aches, headaches, things like that, that you take them to the doctor and they really just can't find anything wrong. A lot of times that's a manifestation of anxiety. And adolescents will have a lot of a tendency to act out. They'll act out angry, have temper tantrums, maybe even aggressive. And it's not that they're bad kids that are just aggressive, it's that they're acting out their frustrations that they're having as a result of this.
So, when normal relationships are hindered or damaged, when normal academic progress is hindered or damaged, when you're caused to not be able to engage in extracurricular activities or things outside the home because of this other thing, well, then it's dysfunctional and that's when you need to begin to act.
Dr. Tim Clinton: Matt, there's that line in that old song, "I'm dying inside and nobody knows it, but me." We believe that, but it's not true. Everybody in the world around us, how about even in our families, Matt? They don't know how to function or get help. So you've got children that are in trouble, families that are in trouble, they're exhausted. And more, everybody needs help. Speak to that, Matt.
Dr. Matthew Stanford: Well, first I'd say for the child... I mean, one of the things that we do is we treat children often like they're just little adults and that's just so not true. As you said before, children are going through this dramatic changes of neurodevelopment and learning how to express emotions and learning verbal skills. And children are not going to come to you and say, "Hey, you know what? I'm struggling with my moods." Or, "I am really having some odd thoughts and I think I really need to talk to you about that." So parents, you have to be involved in your children's daily life. And I mean very involved.
My 15-year-old son knows that when I see him in the afternoon, the very first question I'm going to ask him is, "How was school today?" And he's going grunt at me and kind of growl and try to get out of the room, but I'm not going to let him go. I want to know, "How was school academically? Did you have a test? What did you do today? How was school socially?" We go through that. "Who did you eat lunch with? How was football practice?" I mean, I'm going to go through a whole litany of things and I'm going to find out what went on today, because if there's a problem, that's how I'm going to figure out that there was a problem. I'm going to have those interactions.
I mean, I know it's old and almost cliche at this point, but have dinner together, engage in conversation, have an hour where everybody puts their phones away and talks to one another. That will make all the difference in the world on catching something early for children, because it will give children an opportunity to discuss their issues and learn how to discuss their issues and vent.
For parents who have a child who's struggling, there is no reason that you have to do this on your own. Find a support group for families with a child that have that illness. I mean, there's any number of... If you don't know where to go, go to the mentalhealthgateway.org. Mentalhealthgateway.org is a website that we have. It'll help you find support groups around the country as well. Go to AACC's website, American Association of Christian Counselors. They will help you find support groups through there. Find a support group, find a pastor, find a set of friends that have children that struggle with the same thing. And don't do this on your own. Learn what's worked for them, learn what didn't work for them, share what's on your heart. And that will make all the difference. If you fall apart, who will care for your children?
So, give your children an opportunity to discuss things long before they ever have problems. Be involved in their life, know their teachers. This will help you know if there's a problem and also help you if there is a problem. And then get the support that you need to care for your loved ones. I mean, emotional support, spiritual support. If you're in a church that you do not feel like you can share with the leadership of that church about what's going on with your child, you need to find another church. Absolutely. And there are churches out there where you can share that.
Dr. Tim Clinton: Matt, in your book, Grace for the Children: Finding Hope in the Midst of Child and Adolescent Mental Disorders, you address a number of issues. I want to talk just for a moment about depression. Depression on our kids. It's like those two words don't go together, but they do, Matt. We're seeing increasing numbers of depression among our children and adolescents. Talk about depression for a moment and what happens to a child's heart, their soul in that journey, and how often we push them to "just snap out of it". Explain it to us real quick.
Dr. Matthew Stanford: I mean, depression can happen at any age. I mean, you can have five, six-year-old child that has depression. One of the things that we tend to do as just people is think that your mood is heavily associated with your circumstances. So you look at a child that seems really down and you think, "Well, why would this child be down? Look at all they have around them. They have a wonderful life. They're a child." That is not everything to do with it. Your child can have a wonderful existence around them and they can be profoundly depressed. So you're looking for a low mood. You're looking for lack of interest in pleasurable activities that they used to enjoy. You're looking for high states of irritability, agitation. You're looking for isolation. The child wants to spend time by themselves all the time. You're looking also for changes in weight and eating. They don't want to eat with the family or they're overeating. You look for those types of things.
If it's depression, that's something that you're going to see both in the school setting and in the home setting. It's not something that's just going to happen in one environment or the other. And if you're seeing those things, you simply need to take your child to the mental health care provider have them assessed. That's not something that you, as a parent, can just talk your child out of. They need to have a professional intervention to help them move through. You're a part of that, but you shouldn't put the burden completely on your shoulders.
Dr. Tim Clinton: Matt, it's true that part of the depression could be biology. There's so much we've learned about clinical depression and how the brain works. And so making sure we understand what a child is going through. I think a lot of people initially would look at a child and say, "What's wrong with that child?" The new perspective is, "What's going on with that child?" Or, "What happened to that child?" Because it's not just normal to be going through a clinical depression like that.
Dr. Matthew Stanford: No, not at all. You're right, what's going on with the child. I think we also have to have a grace response, like we talked about yesterday. And that is how can I assist that child to bring them back to where they should be in relationship to other children their age? A lot of times we put the impetus of changing on the child or on the parent, and we wouldn't necessarily do that to a person that was an adult and struggling with a very similar type of thing.
So, just step back for a moment and think about a six-year-old child who has very little understanding of emotions and feelings, and certainly no thoughts of how their brain works and things like that. And now they have feelings of worthlessness and hopelessness and they don't have any positive feelings. It's all negative feelings because their brain is generating all of this. They have no idea what's going on. They don't know how to walk out of that. They don't know how to even ask for help. So that's a much more discouraging situation than even an adult that's struggling with that because at least an adult might have some awareness to say, "I'm depressed. I don't know how to not be depressed, but I'm depressed." The child doesn't even have that. They don't even have a word for it. So they're fully lost and it's only through assisting the parents that we'll be able to help them move forward.
Dr. Tim Clinton: Matt, I want to ask you also about disruptive disorders, maybe intermittent explosive disorder, things like that, that we've learned about. And there's a lot more information out there that we've become aware of on why kids behave the way they do.
Dr. Matthew Stanford: I mean, I think you really nailed it with that last statement and that is we have to stop looking at a child and just assuming that we know that's a bad kid and that's why he's acting like that. I'm going to tar and feather him and I'm going to get him going right. We have to ask ourselves, why is this child acting this way? And the answer is not always bad parenting. In fact, more often than not, the answer is not bad parenting. There is a reason that children act the way they do, good or bad. And so if a child is acting out, there's a variety of roots. That child may have been abused. That child may have a neurodevelopmental problem. I mean, who knows what could be going on with that child?
So just assuming that you know what is wrong with that child, which, again, as you said, a lot of times in a church setting, we think about it as just a behavior problem and we're going to just discipline it out of him. Well, the reality is, let's imagine just for a moment that that child is being neglected at home emotionally-
Dr. Tim Clinton: And screamed at, yelled at, or watching violence all the time.
Dr. Matthew Stanford: Absolutely. And now they come to church. One of their parents brings them to church and they're acting out in class. And then what you're going to do is you're going to discipline that out of them. Well, all you're doing is you're just proven to them everybody in the world just abuses them. That's all. You don't even know what's wrong with them. You don't even ask. That's what we have to do. We have to stop judging. We have to step back and say, "I want to help this child. And the only way I can help this child is I'm going to have to gather some information. So let me talk to the parent, let me observe the child, let me see what's going on here to see how I can assist them." And that will make all the difference in the world.
Dr. Tim Clinton: Matt, with that, Dr. Dobson reminded us that when you look at childhood discipline, first of all, you want to look at the issue of willful defiance versus irresponsibility. Leaving a bike out in the yard, meaning just you forgot about it because you're a six-year-old kid, you forgot to put it back in the garage. It's different than being defiant. Those kinds of lenses are what we need to bring to the church. It's what we need to bring to those who are in caregiver roles. It's what we need to add to our understanding as we look at the world around us and try to minister to people.
Dr. Matthew Stanford: No, absolutely. I think what we want in the church, a lot of times, is a quick fix. And so we've got kind of our two or three responses to whatever it might be and we're not willing to even try to figure out what's going on before we just respond. Something we haven't even talked about that could be a whole other scenario is one 12-year-old child can be very immature, and another 12-year-old child can be tremendously mature. Like you said, the child who leaves the bike out in the yard, you have a 12-year-old child that has the maturity of a six-year-old. You have a 12-year-old child that has the maturity of a 20-year-old. They could be very different. So normality in children is a big, big tent. We've got to stop narrowing that down and we have to start working with children individually.
Let's say a child shows up and acts out in the Sunday school class. The first thing you should do is have a conversation with the parent. "Has your child ever acted like this at home? Have they ever acted like this at school? Let's find out why they acted like this." Because unless you find out why they're acting the way they are, it's going to be real tough to keep them from acting that way again, if indeed that's a problem behavior. You also have to ask yourself, "Have I set up a structure in which a normal behavior in a child is seen as a problem behavior because of the rigidity of the system that I've set up?" Five-year-old children do not enjoy the opera. I just say that all the time. I mean, I know people that think their kid ought to just be able to sit through the longest, most boring church service they've ever been to. And that's just not normal.
Dr. Tim Clinton: Matt, one other issue that comes up often is the issue of medication in our kids. I know we need a balanced perspective here because there is such a thing as over-medicating kids. There are also a lot of kids who are undermedicated, who are not getting what they want. Matt, we also know that, for example, in treating ADHD, you hit puberty, what may have worked prior to puberty and what is going to work after puberty could be very different. In other words, it may have a reverse effect. So management here, med management becomes really important, but can you address it? Because I think a lot of parents get worked up and a lot of people get confused when it comes to medication in kids.
Dr. Matthew Stanford: I mean kids again, they're not just little adults. And so they're going through significant neurodevelopmental changes. They're growing. So it's harder to treat them with medication than it is in adults because you don't have a stable base. Also, another problem is that most psychiatric medications have not been tested on children. So, my recommendation to parents is this. If you take your child to a mental health care provider and they say, "We have assessed the child. We want to have a child assessed. We want to do a psychological assessment to determine if a child meets criteria." That's the first thing you do. You do not put a child on medication unless that child has been assessed to determine that they truly meet the criteria for an illness. Which means you don't go to your pediatrician and say, "Well, the teacher said, she thinks he has ADHD. What do you think?" "Okay, well, here's some prescription." No, you don't do that. You get them assessed.
Now they meet criteria for the illness, you know that they meet the diagnosis, and now you go to a child and adolescent psychiatrist and you discuss medication options with them. And when they tell you, "Well, I'd like to try on this medication." You say, "Okay." You become an informed consumer. You say, "Is that medication been tested on children his age for this illness?" And sometimes you're going to find that they're going to tell you, "Well, no, they haven't."
"Okay, well, I would like to start with a medication that's been shown to be safe and effective for children his age for this illness." And then, again, you're just becoming informed consumer. If a child needs medication, then medication is wonderful. If a child doesn't need medication, then no one should take medication that they don't need. And make sure that you're also getting some type of psychological talking type therapy in addition, so that a minimum of medication can be used.
Dr. Tim Clinton: I love the words of Jesus when he said, "Suffer the children, and don't forbid them to come to me: for of such is the kingdom of heaven." Matt, we opened up talking about an NIMH and some of the statistics that are out there that nearly 50% of our kids... And mom and dad, you need to hear this. If you think you're alone, you're not. Nearly 50% of our children will have a diagnosable mental disorder by the time they reach age 18. And Dr. Stanford, we agreed, and the research is there, that most of these kids go undiagnosed and certainly not treated.
Dr. Matthew Stanford: Absolutely.
Dr. Tim Clinton: I mean, they're like one of the most underserved populations in our country. And yet the majority of mental health disorders are recognized by what age, again?
Dr. Matthew Stanford: 50% by 14, and 75% by 24. We're only talking about the disorders of the young. And so it is not something that happens once you become an adult. In half of the cases, this is in place by the time they're 14 years old. It's like any other medical condition. The earlier you recognize this and the earlier you intervene, the easier it is to treat and the better outcomes you have.
Dr. Tim Clinton: And then churches developing mental health ministries. So significant. I know Matt we've teamed up on a new program called Mental Health Coach First Responder training. Nearly 5,000 churches now engaged in that process. And we're training Mental Health Coach First Responders out on the front lines in and through those local churches, because we believe the church is the place. Our friend Ed Stetzer said, "A church without the broken is a broken church."
Dr. Tim Clinton: Matt, let me give you the closing word and give a word of encouragement to parents and challenge to the church as we go.
Dr. Matthew Stanford: Well, I'd say to the parents, there is hope for a normal life, there is support for you. And above and beyond all that, God cares for you and your children. This isn't a surprise to him and he transcends these types of circumstances and is present and wants to empower and equip you to see them through. For the church I would say, I mean, we are the front line for the mental health issues that go on. People are more likely to go to a clergy before they go to a mental health care provider or a physician. So we have to be prepared. God is sending these people to us to care for them. And we have to develop programs and process that will draw them in, and that will comfort them and support them as they go through these very difficult things. We do that for people that have physical illnesses, and we certainly should do that for people who have mental illnesses.
Dr. Tim Clinton: Dr. Stanford, on behalf of Dr. Dobson and his wife, Shirley, their family, the entire team at Family Talk, we thank you for joining us. Thank you for addressing what is a pretty tough issue, but I think one of the most significant topics certainly in this year and that we're praying that God will do some great things. To all of our listeners out there, listen, if this has touched a nerve in your family, if it's really an issue or a challenge that you have, if you have some concerns or issues or maybe encouragement you'd like to offer up to the church and more, we'd love to hear from you. Jump up on our social media. Give us some of your thoughts. Call our toll-free number. And as always, thank you for listening.
Roger Marsh: Well, that was the conclusion of Dr. Tim Clinton's conversation with Dr. Matthew Stanford on the topic of mental illness in childhood and adolescence here on Family Talk. We hope that you've been encouraged by their wisdom and insights shared today. And like Dr. Clinton just said, if you'd like to add to the conversation, share your story or talk with like-minded believers, be sure to visit our Facebook page. Just go to Facebook.com and search for Dr. James Dobson's Family Talk. By the way, you can learn more about Dr. Matthew Stanford, his books, and his ministry by visiting our broadcast page at drjamesdobson.org. That's drjamesdobson.org/broadcast. Thanks so much for making us a part of your day. I'm Roger Marsh. Have a blessed day.
Announcer: This has been a presentation of the Dr. James Dobson Family Institute.