The number of children and adolescents diagnosed with mental health disorders is rising, but for many Georgia youth, mental health care is out of reach.
“You have to dig to find what you need,” said Jennifer Giegler, a Bibb County school teacher who lives in Macon with her husband and five adopted children, four of whom have a diagnosed mental health disorder.
She adopted three of her sons from foster custody. Each has his own history of mental illness. They suffer from a range of mental health conditions, including attention deficit hyperactivity disorder, post-traumatic stress disorder and reactive attachment disorder.
One in five 13- to 18-year-olds has a mental health condition, according to the National Alliance on Mental Health, also known as NAMI. And major depressive episodes in youth have jumped in the past four years, Mental Health America reported in 2018.
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Georgia faces a severe shortage of mental health care providers, with only eight youth and adolescent psychiatrists for every 100,000 residents, according to the American Academy of Child & Adolescent Psychiatry. Schools also face a shortage of counselors and psychologists across the state.
Voices for Georgia’s Children, a group focused on improving the lives of children, has called the shortage a crisis, reporting that about four in five children in need of behavioral health services don’t get them.
More parents across the state are searching for resources to help their kids. That help is hard to find, though, some parents like Giegler say.
Navigating a child’s mental illness is like walking along a slice of Swiss cheese, Giegler said. Some days you’re going along fine, she said, and then you find yourself in a big hole. It can be hard to find a way out.
“There’s not a lot of education for foster parents for children with mental illness,” she said. “There’s not a lot of education for parents, period.”
The search for support
Kim Jones suspected her son needed extra attention from a young age. In elementary school, he would refuse to get on the bus in the mornings. Some days, his meltdowns would last hours.
No one seemed to know what was wrong.
The Atlanta mother quit her job to stay home with her son, hoping to find answers. Two years later, doctors determined he had depressive disorder.
A diagnosis provided a path forward, but it didn’t solve all of Jones’ problems.
Jones couldn’t believe how difficult it was to find resources for her child. One obstacle after the next seemed to stand in her way.
When Jones turned to family and friends for help, they offered more judgment than support, she said.
A trained child care provider, Jones had worked with toddlers and infants for years. And yet, she found herself questioning her ability to care for her son. She took parenting classes, thinking they might help her remedy her son’s behavior.
Jones felt like her son’s mental illness was her fault.
“People were giving us bad advice, saying we just needed to be better parents instead of recognizing that maybe my child was dealing with something that was a medical issue versus a parenting issue,” she said.
After two-and-a-half months of phone calls, Jones found a psychiatrist with an open slot who accepted her son’s insurance. With prescriptions for an antidepressant and an antipsychotic, his condition began to improve.
Jones still wanted more information, though. She wished there were one place she could find all the resources she needed.
A health insurance representative directed Jones to NAMI, which provides support and education for those affected by mental illness. As Jones scrolled through the organization’s website, she began to cry.
“I realized I had been on the website before, but I wasn’t at that point willing to accept that my child actually had a mental health condition,” she said.
Jones couldn’t live in denial any longer. She enrolled in the six-week NAMI Basics class for parents and caregivers of children and teens diagnosed with mental illness.
There, Jones learned strategies to better understand her son’s condition and how to care for him. She also found a community of parents juggling the same challenges – friends she could call at 2 a.m. for help.
“That is so valuable to be able to just talk to somebody who is going through the same issue, because there’s such a stigma around mental health,” she said.
The friends Jones made in class and at her son’s health clinic became her strongest support system.
“When you have a child with a mental health condition, what ends up happening is your friends and family will kind of back off, because nobody – if your child has suicidal ideation or has outbursts or meltdowns, nobody wants to watch your child. Everybody’s a little scared or afraid, which makes a little sense,” she said. “But when you’re with other parents who have the same issue, there’s a sense of understanding.”
Giegler, the Macon mother, often feels misjudged by others.
“A lot of people that we know say, ‘Well, I wouldn’t let my child talk to me that way.’ But that falls back to the old adage, choose your battles,” she said. “And it’s really not any of their business, but you can’t sit down with everybody you know and say, ‘Let me tell you about their behavior plan. Let me explain to you how this child works.’ ”
Over the years, Giegler has found other parents with similar experiences that she can call when she feels like she’s hit her limit.
“You feel some bond, a sisterhood to those people, because they understand that you have a good heart, and you’re trying to do your best, but you’re human, too,” she said. “So, you know, ‘I hate you’ hurts every once in a while, or you’d just like to go one Saturday without going to four therapies.”
‘As a parent, you feel guilty’
Four different therapy sessions is just a normal Saturday for Giegler and other parents she’s met whose children have been diagnosed with mental health disorders.
“You parent children differently with mental illnesses,” she said.
And it’s only gotten harder over the years.
“When they were small, it was easier to contain them,” Giegler said. “But as they got older and they went through puberty, and a lot of their hormones discounted anything that their medication would do, their mental illnesses started to show much more.”
Managing five children – some with mental illness and some without – comes with its own set of challenges. Giegler sometimes worries that the siblings will impede one another’s recovery or dominate their parents’ attention.
“You try to divide your time up equally, but if somebody is mentally disabled, you definitely spend a lot more time on them than the other children,” she said. “And as a parent, you feel guilty that they’re not getting the same amount of attention or their share of the funds and time.”
Parents play a central role in their children’s treatment, said Ashley Allen, director of Macon-Bibb and Monroe County services for River Edge Behavioral Health. They can serve as the conduit between the therapist and the child, she added, by implementing strategies learned in counseling at home and providing the therapist with updates on their child’s progress.
The hardest part is often getting parents in the door.
“I think there’s still some stigma around mental health that at times might slow down the process of getting help sooner rather than later,” said Jill Stapleton, vice president of clinical services at Lighthouse for Families, the community counseling branch of The Methodist Home.
By the time kids get help, their condition has often reached crisis levels, she said.
Not only do parents face a shortage of mental health care providers, Stapleton said, but they also face steep costs.
“It’s extremely expensive,” she said. “And so, then you have a parent who has identified a fabulous resource for their kid that they’re just not able to afford and insurance isn’t gonna cover, and you’re just in this conundrum of trying to figure out how to best meet the needs of your kids.”
The Mental Health Parity Act of 1996, which was expanded through the Affordable Care Act, requires health insurers to set the same dollar limits for mental health coverage as it does for medical and surgical benefits. But more than 20 years after the law’s passage, there still are gaps in mental health care coverage.
Community counseling centers like River Edge Behavioral Health and Lighthouse for Families seek to bridge the gap. They accept Medicaid as well as private insurance and sometimes offer a sliding fee scale for uninsured clients.
Counselors can also connect parents with family therapy or even a personal therapist.
“It’s helpful for some parents to have their own therapist, just so that they can be able to process their feelings about their child living with a mental health diagnosis or some additional coping skills that they can learn,” Stapleton said. “And part of that is modeling for their kid, as well.”
Giegler has suffered from anxiety as a result of her childrens’ post-traumatic stress disorder. The unpredictability of their triggers can be paralyzing.
Family therapy has helped, though. So has spending time with friends and her husband.
“It helps with you keeping yourself at your best so that you can be the best parent to your child,” Giegler said.
‘That’s still your child’
Jones hopes to educate others not directly affected by mental illness, so they might one day have more compassion for her son and the millions of other youth across the country with mental health conditions.
Also she wants parents with mentally ill children to know they’re not alone. Jones is now the executive director of NAMI Georgia, and she’s determined to bolster resources and support for parents like her.
It took time for Jones to come to grips with her son’s diagnosis, but with time, she’s learned to accept her new normal. She knows it’s a medical condition and one that can be treated.
“It’s so important for the parents to be able to hear, ‘That’s still your child,’” Stapleton said. “They’re not a depressed child. They’re a child with depression. They’re not their diagnosis.”
Some days, Giegler struggles to internalize that message.
One night, she came home from a 12-hour work day to find one of her sons, 17 at the time, hadn’t left the couch all day. He’d been struggling in school and picking fights at home for months.
An argument over dinner left Giegler in tears.
But the next morning, she found an apology note on her steering wheel.
“Have a good day, Mom,” it read. “I love you.”
In that moment, Giegler could finally see that her son’s behavior wasn’t rooted in a lack of love. It was rooted in mental illness.
“I knew that even though it was hard on me, it was harder on him, and that if we hadn’t taken him in, there’s no telling where he would be,” she said.
Parenting five adopted children is no easy feat, and mental illness has only made the journey more complex. But Giegler thinks the ups and downs have made her kids stronger.
“I think that our children are better suited for the world. They understand that everybody is different,” she said. “They definitely fight for the underdog.”
Samantha Max is a Report for America corps member and reports for The Telegraph with support from the News/CoLab at Arizona State University. Follow her on Facebook at https://www.facebook.com/smax1996 and on Twitter @samanthaellimax. You can also join her Facebook group. Learn more about Report for America at www.reportforamerica.org.