He is six years old. His mother begins the intake stating that he is "ADHD" and "Bipolar". She tells me his 3 year old little sister is also "Bipolar". I'm horrified. She's only 3 years old! The mother states this as if it were a fact. She continues...
The six year old was molested at a very young age by a male relative. The children were exposed to yet a second molester and domestic violence. The family has been homeless for the past year and were recently found living in their car. They are currently living in a homeless shelter. The mother has untreated mental illness which makes her highly emotional and volatile. The children have been removed from her care twice due to charges of neglect.
My question is this: How can you tell whether the children's behavior is actually them and not the chaotic, neglectul and abusive situations in which they are living? I strongly advocated with the mother to stop labeling her children as being mentally ill until an accurate assessment could be made. I suggested that we work to stabilize their environment, remove them from abuse and neglect and provide counseling for the experiences they have been through. Then, and only then, can we tell whether what's going on with the child is something within themselves or simply their reaction to the situations they've experienced.
I wish members of my profession would stop labeling children as "mentally ill" and administering medications as the first intervention. It should only be done with great reservations and as a last resort - when every other intervention fails.
I wish my profession would inform and encourage parents to think for themselves and participate in the treatment process. No one knows a parent's child like they do. Parents shouldn't merely accept a diagnosis of mental illness because someone with a degree and license on the wall says so. Clinicians are people too. We are not gods. We make mistakes. We can be misled. Parents have a right, and an obligation, to make a conscious choice about whether they accept our assessments or not.