Today is April 19th, or Patriots’ Day, here in Massachusetts. It is a holiday unique to our state and Maine, which was once part of Massachusetts. The Boston Marathon is run, the Red Sox play a day game at Fenway and the battles of Lexington and Concord are re-enacted. (Much as it sounds like it, it is not a celebration of our New England football team.)
The events we celebrate took place in 1775. Even though that’s 235 years ago, there are still lessons we can learn from those events. Lessons that are still relevant as we all work to improve the mental health system for children and their families.
All of us are familiar with Paul Revere’s ride. But did you know that Paul Revere was able to be successful in rousing the countryside because he had played a part in the Tea Party (the first one) and had strong connections to other local leaders? He spread the word of the British advance by stopping at the houses of key people in each town along his ride. In other words, he was part of a network of leaders who were able to push forward change.
Most of the citizen soldiers who came forward that day, the Lexington and Concord minutemen, were untried and untested. Like many of us, they were scared but followed through anyway. They believed in and fought for rights and freedoms they just didn’t have under British rule. Because of them, many Americans of that time began to believe that it might be a worthy idea to fight against a system that wasn’t working for them and fight for one that represented their values.
This was an era when most European countries — and the colonies that would later become countries — were ruled by kings or queens. The British were considered the greatest military power of their time. Yet, the men who came out to fight that day believed that certain powers and rights rested with the individual and could only be given freely to form a union. Their power sprang from the individual taking action, not conferred by a monarch.
So those of us who advocate for a better world for children with mental health needs and their families can learn three key lessons from the events that we celebrate each Patriots’ Day:
First, be a networker like Paul Revere. Find other leaders and strengthen the network that can create change by being part of it.
Second, be ready to fight in small and large ways for the ideas and principles you value. Only by insisting that they are important can we alter the mental health system for children and families a little at a time.
Third, remember that the power to change things lies with the individual. It’s easy to focus only on our daily challenges but we are all able to move things in the right direction, even if it’s just a little at a time.
Have a happy Patriots’ Day!
There is a lot of buzz these days about evidence based treatment or evidence based practice. Mental health treatments are being studied, compared and evaluated in the same way that medical treatments have been: for effectiveness, for cost, for patient satisfaction and for long term results. Until recently, parents had to either be content with what was available, popular (anyone remember scream therapy?) or adapted from treatments for adults.
That’s why research is important to families. Most families who are right in the midst of trying to just access treatment, let alone effective treatment, probably wouldn’t say that. But it is. We are not so far away from the days when children were almost always given diagnoses that described their negative behavior (such as Oppositional Defiant) or by terms such as minimal brain dysfunction (now ADHD). Research has created a better understanding that first, children and teens actually do experience mental health episodes and second, that their psychiatric illness often looks quite different that it does in adults. It has helped shift society away from thinking that if a child has mental health needs, then the parent must have created the problem, though there is still too much of that thinking out there.
So with a salute to David Letterman’s Top Ten lists, I’ve put together a list of five reasons why research is important to families. This list is called Top 5 Ways Research Lets Families Just Say No.
Number 5. Research lets families say no to ineffective treatment – even if it’s the kind of treatment insurance companies will pay for. Research can give parents the information to hone in on those treatments that will be effective for their children, themselves and their family. It helps families know what kinds of treatments work for children with a specific diagnosis, such as eating disorder or trauma.
Number 4. Research lets families say no to treatments that waste their time and money. Research that proves the effectiveness of interventions can give families faith that the time, effort and money that goes into those treatment is worth it. As one mother put it: “I want to see the data to help me and give me strength when it is time to disrupt dinner and force my child to get in the car to see the therapist. Give me data so I have the strength to argue for this, because I am so tired.”
Number 3. Research lets families say no to policies that don’t work. Research results can be used by families and family organizations like PAL to advocate for changes in practice and policy that benefit them.
Number 2. Research lets families say no to treatments that are not culturally appropriate. Good data helps families understand whether a specific treatment works for children and families from their culture and if their experience is shared by others who share their ethnicity or speak their language.
And here’s the number 1 way research helps families say no: Research lets families say “no way” when the system doesn’t hold itself accountable. Data is a way to compare a system to itself over time or to evaluate multiple interventions to understand what is truly effective. If it doesn’t really work, why are we still doing it? Families want accountability. We pay high insurance premiums to ensure we receive effective treatment and we all pay taxes, which in turn can pay for services. Data can help us all determine ways to improve the services and treatments we offer our children and families.
So thanks to all the researchers for helping our families say “no.” Without you, we would be nowhere!