Ask the Expert: Children’s Mental Health

Date: June 2, 2014

Vanessa Howells, M.D., child psychiatrist

Nearly five million children in the U.S. have some type of mental illness—one that significantly interferes with daily life. It’s important to recognize mental illness in children early on, when it is easier to treat. Vanessa Howells, M.D., a psychiatrist in the Community Psychiatry Program, specializes in the diagnosis and treatment of children with mental illness. Below, she answers questions about the symptoms of mental health disorders and when it’s important to seek medical attention.

Why are mental health disorders hard to identify in children?
Young children, particularly between the ages of 0 and 5, can’t tell you how they’re feeling. In addition, many behavior problems associated with mental health disorders can be seen in all children to some degree. These include aggression, hyperactivity and intense moods. Identifying the problem depends on the severity of symptoms and the cause, which could be a mental health disorder, developmental delay, home environment or a combination of factors.

At what age are most children diagnosed with mental health disorders?
Most parents seek treatment once their child starts school or preschool. Behavior problems become more obvious in the classroom setting.

What are the most common childhood mental health disorders?  How are they treated?
Attention deficit hyperactivity disorder (ADHD), anxiety disorders and mood disorders are the most common diagnoses. Many children also have developmental issues, such as speech and language disorders. Treatment options include therapy and medication, if needed.

What signs and symptoms should I look for?
Signs and symptoms can vary depending on the age and diagnosis of the child. Typically, the symptoms are chronic and cause significant impairment in functioning both at school and at home. A child with ADHD may be so hyperactive and impulsive that he or she has trouble learning and socializing normally. And, a child with severe separation anxiety might go to great lengths to avoid school altogether.

When should I seek medical attention?
Parents should seek medical attention when behavior problems are severe and persistent, especially if they pose a safety risk for the child. Parents should discuss their concerns with a pediatrician or mental health provider. Infant, toddler and child find programs, often available through your community’s public school system, also are a good resource for families if a child has developmental delays.

To schedule an appointment with a Johns Hopkins child psychiatrist, call 410-550-0104. Read more about how the Preschool Therapeutic Learning Center helped a Baltimore family get back on track.