When Young People Suffer Social Anxiety Disorder: What Parents Can Do

Anne Marie Albano, Ph.D.
Associate Professor, Clinical Psychology in Psychiatry
Director, Columbia University Clinic for Anxiety and Related Disorders,
Columbia University Medical Center

Social anxiety disorder (SAD), or social phobia, can have a crippling effect on young people. Children who avoid raising their hand or speaking up in school can become tweens who withdraw from extracurricular activities, and then teens who experience isolation and depression. In fact, children with social anxiety disorder are more likely than their peers without SAD to develop depression by age 15 and substance abuse by age 16 or 17.

As they head toward adulthood, young people with social anxiety disorder tend to choose paths that require less involvement with other people, and so cut short a lot of opportunities. Bright, intelligent young people who have yearnings to be lawyers or doctors, but cannot interact with other people, may choose a profession or work that is very solitary; or they might not enter the work force at all.

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Understanding the Unique Barriers for People with Social Anxiety Disorder

Today we begin a series from the Anxiety and Depression Association of America, a national organization of researchers and clinicians focusing on science, treatment, prevention, and cure of these disorders. In the coming weeks we will share posts from members of this organization shedding light on the disorder, by creating awareness about symptoms, treatment and support.

Mark Pollack, M.D.
Grainger Professor and Chairman, Department of Psychiatry,Rush University Medical Center, and President, Anxiety and Depression Association of America

People with social anxiety disorder (SAD) face unique challenges when it comes to accessing mental health care, and many struggle for years before seeking any type of treatment. For family members supporting an individual with SAD, gaining a deeper understanding of the disorder can help you guide your loved one toward appropriate care and an improved quality of life.

About social anxiety disorder
Social anxiety disorder(SAD), also called social phobia, causes extreme self-consciousness in everyday social situations. (http://www.adaa.org/understanding-anxiety/social-anxiety-disorder) People with SAD have a strong fear of embarrassing themselves or being judged by others. It interferes with an individual’s ability to form relationships, succeed at school or work, and complete everyday tasks that involve interacting with others in person or even on the phone. SAD can have a significant impact on nearly every aspect of a person’s life.

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Fixing Mental Health Services without Coercion

Harvey Rosenthal
Executive DirectorNew York Association of Psychiatric Rehabilitation Services (NYAPRS)

In our final post on AOT Harvey Rosenthal explores the role of evidenced-based wraparound services in providing better mental health care outcomes.

Outpatient commitment typically involves mandating individuals to accept the same treatment approaches that have already failed or deterred them in the past. We know a lot more about how to help people in severe distress, but these methods are typically not offered or are not sufficiently available. These include a number of evidence based approaches like

  • Transitional Supports: using critical opportunities to engage people when leaving inpatient and detox facilities and prisons and jails
  • Individualized Care Management: organizing care across multiple behavioral and physical health and social systems that operates from shared information and offers real time response
  • Housing First and other harm- and homelessness-reduction models: offering individuals what they most need to be safe even if they’re not currently willing to take medications or stop using alcohol and drugs
  • Person-centered Planning Tools: utilizing Wellness Recovery Action Plans and Advance Directives
  • Criminal Justice Diversion and Re-entry Services: using court-based mental health workers, Crisis Intervention Teams, and better prison discharge plans and support services
  • Peer and Family Supports: incorporating peer crisis warm lines, respite houses, outreach, bridger and wellness coaching as well as family-to-family support
  • Employment and Education
  • Evidence-based Medicine: relying upon the latest research, providing more individualized care, and utilizing less drugs over a shorter period of time

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Reforming Mental Health Care Begins with Rethinking Provider Engagement

Harvey Rosenthal
Executive DirectorNew York Association of Psychiatric Rehabilitation Services (NYAPRS)

Last week, Harvey Rosenthal shared why he believes the answers to improving mental health care for individuals with more serious conditions lie in bringing state of the art engagement, services, and supports to scale, as opposed to expanding civil commitment programs. In this post, Mr. Rosenthal provides details about what these approaches and innovations should include.

Meeting individuals where they’re at
We need more accountable, aggressive action by providers. If a person does not fit into our current treatment paradigm—that is, if they don’t come into the office on time or take the medicine that is prescribed—they are typically considered noncompliant and often eligible for outpatient commitment.

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Fixing Not Forcing Services

harvey2Harvey Rosenthal
Executive Director, New York Association of Psychiatric Rehabilitation Services (NYAPRS)

In the wake of several recent mass shootings, many are calling for an overhaul of the nation’s systems of mental health care. A national debate has been renewed over whether legislation is needed to force local officials and mental health providers to be more responsive to those with more profound mental health needs, and whether those groups should, in turn, force such individuals to accept some form of treatment. In this post, Harvey Rosenthal argues we should reframe the debate and focus on reforms that significantly increase the range and raise the bar for community outreach and supportive services.

Fixing Not Forcing Services

Over the past year, we’ve seen an intensified focus on our nation’s and state mental health systems that has drawn a broad array of advocacy groups to weigh in on the merits of two legislative proposals put forward by House members Rep. Tim Murphy (R-Pennsylvania) and Ron Barber (D-Arizona).

Central to Congressman Murphy’s bill is a provision that would require states to adopt or expand court-mandated outpatient commitment programs like New York’s Kendra’s Law in order to access federal block grant dollars. These and several other provisions have generated much controversy. While it now appears that contentious provisions like these will not be moved by the House GOP leadership this year, it is imperative that we address a number of challenges that the bills present.

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Now that the Fireworks are Over, Let’s Really Celebrate the 4th of July Holiday

What’s more American than hot dogs, and fireworks on the 4th July? How about celebrating that we live in a country that allows us to have a voice in public policy and encourages us to exercise our freedom to stand up and be heard? Where should you begin? Who needs to hear your voice? Consider lending your support to fund the BRAIN.

Now that the Fireworks are Over, Let’s Really Celebrate the 4th of July Holiday
The National Institute of Health (NIH) is seeking $4.5 billion to implement the “Brain Research through Advancing Innovative Neurotechnologies” (BRAIN) initiative. That makes this one of the more aggressive initiatives since the space race.

During a White House briefing in April 2013, President Obama stated the goal of the project is to “accelerate the development and application of new technologies that will enable researchers to produce dynamic pictures of the brain that show how individual brain cells and complex neural circuits interact at the speed of thought.”

While the executive branch has committed $1 million to jump-start the project, Congress needs to appropriate the majority of the funding. And we’re all going to need to do our part to educate them that funding the BRAIN is the right thing to do.

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Readers Reveal Thoughts about HIPAA Reform in Online Survey

During the month of June, Care For Your Mind explored with our readers the nuances of HIPAA regulations. Each weekly post included a short poll to assist in better understanding the views of the CFYM readership around this topic. The polls asked questions about individual privacy protection, as well as a family member’s right to be involved in a loved one’s mental health care.

Readers Reveal Thoughts about HIPAA Reform in Online Survey

CFYM readership while not self-disclosing, is positioned towards individuals living with a mood disorder, their families, and policy makers. It would be reasonable to believe that readers responding to the polls fall into one of those three categories. However, because respondents are not asked to self-disclose, one cannot not make any calculations about trends within those categories.

What can be determined from the poll results, is that further dialogue about individual privacy protection and the rights of family members to be included when a loved one’s mental health is at stake needs to continue.

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Coordinating Patient Care in the HIPAA Era

Leslie Secrest, MD
Chairman of the Department of Psychiatry at Texas Health Presbyterian Hospital Dallas

In our final post discussing the effect HIPAA policy and regulations have on both individuals living with a mood disorder and their families, we look at the implications of sharing elements of mental health treatment as part of the electronic health record (EHR).

Coordinating Patient Care in the HIPAA Era

Protecting patient privacy has long been a vital, but complicated priority for mental health care providers. In guarding our patients’ privacy, we aim to defend against prejudicial or discriminatory care. We balance those concerns with the realization that a patient’s health could be jeopardized if other providers do not have access to the full health picture. Sharing elements of a mental health record is, at times, in a patient’s best interest.

With the advent of electronic health records (EHR), it has become easier to control who has access to a person’s mental health information, and who does not. For instance, the EHR system that my hospital uses allows me to restrict mental health information to only the providers that I name. Certain keywords in the notes also trigger automatic privacy settings.

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