Dennis Embry on the Children's Mental Health Network
On the future of mental health
Posted Mar 26, 2016
The following interview is part of a “future of mental health” interview series that will be running for 100+ days. This series presents different points of view about what helps a person in distress. I’ve aimed to be ecumenical and included many points of view different from my own. I hope you enjoy it. As with every service and resource in the mental health field, please do your due diligence. If you’d like to learn more about these philosophies, services, and organizations mentioned, follow the links provided.
Interview with Dennis Embry
EM: You work as a “prevention scientist.” Can you tell us a little bit about what that means and what you do?
DE: When I tell people I am a prevention scientist, they almost immediate say, “Never heard of that.” To answer, I have an elevator speech.
“Think of the people you care about—at home, in your family, friends, co-workers, etc. Make a short list of all the good things you want to happen for them, and think of all the bad things you don’t want to happen to them. Wearing my clinical hat, I could help you, but that is not what I do. As a prevention scientist, I help whole communities, states, provinces, and even nations design, implement, and measure successful strategies to avert, reduce or stop multiple mental, emotional, behavioral and related physical disorders. We have projects in 28 states of the US, two provinces of Canada, and several countries in the European Union. I’ve designed scientifically tested public health strategies to prevent accidents to young children, violence, suicide, drug addictions, serious mental illness, child maltreatment, and more."
EM: You take a special interest in the mental health issues of children and are on the Children’s Mental Health Network Advisory Council. Can you tell us a little bit about your particular concerns with respect to children’s mental health?
DE: Children’s mental illnesses are epidemic in North America presently, dwarfing the polio epidemic of my generation. The Wall Street Journal commissioned an extraordinary study published on December 28, 2010, that showed 40.4 million out of 75 million kids in America had had at least one script for psychotropic medication in 2009, nearly 25 million for ADHD alone. Suicide is six times the rate of deaths from polio. One-out-of-two children in America will have had a mental illness by age 18, and mental disorders are the largest single expense for Medicaid in America and growing $1 billion per year.
We have better science to prevent mental illnesses today than we did at the time of the discovery of the Salk vaccine in 1954 to avert polio. My concern is that we are not using the science.
EM: You have worked in government. What changes or improvements would you like to see in how government thinks about mental health issues and/or deals with mental health issues?
DE: Public policy frames mental illness as some sort of persona of family or spiritual defect, as opposed to a largely scientifically preventable disorder. Further, governments cannot screen, refer and treat our way out of the problem. The current mental illness “epidemic” exceeds the polio epidemic by a factor of six—just counting suicidality, let alone any other mental, emotional or behavioral disorder. My Congressional briefing makes this pretty clear.
EM: What are your thoughts on the current, dominant paradigm of diagnosing and treating mental disorders and the use of so-called psychiatric medication to treat mental disorders in children, teens and adults?
DE: This is a road to national folly. It is like pursuing more and more iron lungs to treat polio, and vigorously ignoring the Salk/Sabine vaccines as well as the rigorous science to support them. Yes, we need these resources, but not at the level they are being used.
EM: If you had a loved one in emotional or mental distress, what would you suggest that he or she do or try?
DE: First, one needs to do the preventive/protective strategies with gold-standard levels of research that are clearly associated with reduced incidence and severity of mental, emotional, and behavioral disorders. These strategies fit neatly into our highly cited paper in the American Psychology, “the critical role of nurturing environments in human development.” The four principles (in Biglan et al. 2012) include:
a. Increase psychological flexibility. Fundamental to mental illnesses are psychological inflexibility.
b. Reduce toxic influences
c. Reduce problematic behaviors
d. Increase reinforcement of prosocial behaviors
These principles then turn into very practical steps for schools, families and communities that themselves have good quality research. The key issue to recall is that one cannot have a genetic “defect” disorder that is affecting half of the kids in America, if you believe the TV ads.
So here are practical examples in context:
a. Increase psychological flexibility. Example: a simple evidence-based kernel (e.g., breathing in from the nose, exhale from mouth using a metaphor such as smell the flower, blow out the candle) reduces anxiety problems in children. This technique is a language-mediated intervention that then reduces the underlying biology of anxiety symptoms.
b) Reduce toxic influences. Have early “bedtime” for electronic media (games, TV, video, internet, cell phones) and keeping OUT of the kids rooms reduces many forms of mental health symptoms AND prevents marijuana initiation in many kids that can worsen the risk for early psychosis.
c) Reduce problematic behaviors. There was an 80% plus reduction in problematic behaviors in the classroom in a few months in first grade using the PAX Good Behavior Game from our studies at Johns Hopkins; and this can reduce lifetime mental illnesses.
d) Increase reinforcement for prosocial behavior. Teaching kids to write positive notes complimenting prosocial behaviors in each other at school has significant impact on reducing antisocial behavior at school.
Dennis D. Embry, Ph.D. is a prevention scientist, a child and developmental psychologist by training, an entrepreneur, and the president of PAXIS Institute in Tucson, Arizona. PAXIS has prevention projects all over the US, Canada, Ireland and recently in Europe to better the lives of hundreds of thousands of children, adolescents, families and communities. Personally and professionally, Dr. Embry and his colleagues aim to put practical, proven simple tools in the hands of everyone to make their lives healthier, happier, more productive, and peaceful.
Eric Maisel, Ph.D., is the author of 40+ books, among them The Future of Mental Health, Rethinking Depression, Mastering Creative Anxiety, Life Purpose Boot Camp and The Van Gogh Blues. Write Dr. Maisel at firstname.lastname@example.org, visit him at http://www.ericmaisel.com, and learn more about the future of mental health movement at http://www.thefutureofmentalhealth.com
To learn more about and/or to purchase The Future of Mental Health visit here
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