Juvenile Mood Disorders Bostic, Wilens, Spencer,

1
Cultivating Mental Health In Schools
Jeff Q. Bostic, M.D., Ed.D. Massachusetts
General Hospital Harvard Medical School
2

• Living in America (Now vs. Before)
• Life Expectancy 41 (1900) to 77 (2000)
• 23 households gt 75K equivalent now vs. lt1
  (1890)
• 70 own homes now v. 20 in 1900
• Violent crime down 70 large cities over past
  Decade
• Smog has declined 33 (while cars doubled)

3

• Living in America (Now vs. Before)
• Heart Disease Deaths decreased 60 past 50 yrs
• Stroke Deaths decreased 70 past 50 yrs
• Cancer decreasing 1 since 1993
• Infant mortality down 45 since 1980 (currently
  0.3 of births)
• Auto deaths decreased from 52,627 to 42,850 since
  1970

4

• Living in America (Now vs. Before)
• Yet
• 66 told pollsters 1997 that the lot of the
  average person is getting worse
• 54 think life worse now than parents generation
• Depression increased from 3-10 times over past 50
  years (while bipolar stable at 1)

5

• Factors Sustaining Stress/Unhappiness
• Expectations
• Perpetually Feel Good -- Pain can suggest need to
  do something different
• If Just Move to Right Spot, Pick Right Job or
  Spouse -- Myth of Unending Consumption
• Comparisons to Others
• Connections (Virtual vs. Real)

6
Three Generations

• Special Education
• Kids in 1980 So theyd put all the SPED kids
  together off in some separate place?
• Kids in 2000 So you used to put an autistic
  child in a regular classroom no matter what?
• Kids in 2020 So some parents would get the
  school to give their kids services, and other
  kids wouldnt get the same services even if it
  would have helped them, too?

7

• 1973 Rural Canada gets TV
• Social life reduced, most in older people
• Playing sports decreased
• Creative efforts decreased, in young as much as
  in old
• Aggression in New-TV towns caught up (2 yrs.) to
  Old-TV towns

8

• 1999 Bhutan gets TV
• American TV 46 channels, including Rupert
  Murdochs Star TV Network
• Usual mixture of football, violence, sexual
  betrayal, advertising, wrestling federations, etc.

9
Bhutan Television

• Increase in family breakups, crime, substance
  abuse
• 1/3 of parents reported prefer to watch TV over
  talking to children
• School Principal had to establish new staff
  meetings for violence at school

10
U.S. Media Effects

• Judge Selves By Others
• More TV watch, More Spend keeping up with
  Others
• Women viewing Female Models after viewing,
  womens mood fell
• Men viewing Female Models
• After viewing pictures of models, felt less good
  about own wives

11
U.S. Television

• TV now contains more violence and illicit sexual
  activities than earlier times, and than in real
  life
• More TV Watch, More crime and adultery believe
  occurs in real life
• More willing to think about doing things
  ordinarily taboo
• (R. Layard, Happiness, 2005, p. 88)

12
Adolescent Developmental Task

• Separate from Parents to Establish
  Identity
• Pick Fights to Separate
• Reject Anything Associated with Parent (Other
  Adults, Parents Agents)
• Leave Adult Tribe to Join Adolescent Tribe

13

• What Affects Happiness?
• Family Relationships
• Financial Situation
• Work
• Community and Friends
• Health
• Personal Freedom
• Personal Values
• (R. Layard, Happiness, p. 63, 2005)

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Separated lt Divorced lt Widowed lt Never lt Cohabit
Family Income Decreased by 1/3 (small effect)
Unemployed lt Job Insecure lt Unemployment Rate
People Cannot be Trusted
Feel Health Deteriorating or Worse than Others
Quality of Government Russia lt US lt Netherlands
God is Important in my Life
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• Diagnostic (for Happiness) Questions
• What are you enjoying? What were you enjoying
  before became so depressed/anxious?
• What are you grateful for?
• Who are you connecting with? Anybody youre
  working on forgiving?
• What are you involved with in your community?
• What are you shooting for these days (goals -
  help self vs. help others)?
• How are you doing with the Cosmos?

16

• From Whos Got the Problem to Wheres the
  Problem?
• The Relationship is the thing.
• Its not about which individual is right or
  wrong, but about enhancing the fit.

17

• CBT for Daily Brainbuilding

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• Mental Health Mantras
• 3 Generations What are we doing now out of
  habit/familiarity?
• Where is someone on the Spectrum? (Disorders are
  not all or nothing)
• Are we Preparing Beyond Protecting?
• Are we preparing young people for fear or
  happiness?
• Whats the Fit between child and us?
• What are we Mirroring to that child?