Scientists at the U.S. Centers for Disease Control and Prevention found that 13% to 20% of American children age 3 to 17 experience mental disorders each year, and that rates have been increasing.
A ‘hodgepodge’ of counting methods
The study also showed there are no standard ways of counting afflictions, but a hodgepodge including parental reports or reports directly from children. Some disorders, such as bipolar disease and anxiety disorders, weren’t included in the overall rates for lack of data. The disorders that were included span a wide range, including hyperactivity and severe autism.
Statistical experts are skeptical of the reported numbers. Data collection is inconsistent, with random phone surveys of parents yielding higher results than other methods. Families with health insurance report higher rates, and regional differences raise suspicion about different approaches in diagnosis. Double counting children with multiple disorders leads to inflated rates.
In the United States, at least 9% of school-aged children have been diagnosed with ADHD, and are taking pharmaceutical medications. In France, the percentage of kids diagnosed and medicated for ADHD is less than .5%. How come the epidemic of ADHD—which has become firmly established in the United States—has almost completely passed over children in France?
Different approaches to diagnosis and treatment
In the United States, child psychiatrists consider ADHD to be a biological disorder with biological causes. The preferred treatment is also biological–psycho stimulant medications such as Ritalin and Adderall….
French child psychiatrists, on the other hand, view ADHD as a medical condition that has psycho-social and situational causes. Instead of treating children’s focusing and behavioral problems withdrugs, French doctors prefer . . . to treat the underlying social context problem with psychotherapy or family counseling…
Different parenting styles
And then, of course, there are the vastly different philosophies of child-rearing in the United States and France. These divergent philosophies could account for why French children are generally better-behaved than their American counterparts….
From the time their children are born, French parents provide them with a firm cadre—the word means “frame” or “structure.” Children are not allowed, for example, to snack whenever they want. …
… French parents have a different philosophy of discipline. Consistently enforced limits, in the French view, make children feel safe and secure. Clear limits, they believe, actually make a child feel happier and safer … French parents believe that hearing the word “no” rescues children from the “tyranny of their own desires.” And spanking, when used judiciously, is not considered child abuse in France.
In an interview with The Atlantic, Gary Greenberg, a practicing psychotherapist and author of The Book of Woe: The Making of the DSM-5 and the Unmaking of Psychiatry, says no one can define “mental illness”.
What is the difference between a disorder and distress that is a normal occurrence in our lives?
That distinction is made by a clinician, whether it’s a family doctor or a psychiatrist or whoever. But nobody knows exactly how to make that determination. There are no established thresholds. Even if you could imagine how that would work, it would have to be a subjective analysis of the extent to which the person’s functioning is impaired. How are you going to measure that? Doctors are supposed to measure “clinical significance.” What’s that? For many people, the fact that someone shows up in their office is clinical significance. I’m not going to say that’s wrong, but it’s not scientific. And there’s a conflict of interest — if I don’t determine clinical significance, I don’t get paid.
Is a child autistic or just awkward? Special education services and insurance coverage are controlled by committee decisions on what is to be included in the DSM.
… You can’t just ask for special services for a student who is awkward. You have to get special services for a student with autism. In court, mental illnesses come from the DSM. If you want insurance to pay for your therapy, you have to be diagnosed with a mental illness….
Homosexuality was declassified as a DSM disorder in 1973. And I’m sure I’m not the only one who has considered that Oppositional Defiant Disorder (ODD), characterized by “negativistic, defiant, disobedient, and hostile behavior toward authority figures that persist for at least six months“, is a particularly arbitrary disorder.