An Uncomfortable Topic Demands Attention

There’s a child of our acquaintance who has been friendless for as long as anyone can remember. Kids say she steals and talks nonsense and stares into space. There’s another who tamps down his rage by eating. He’s a teenager now, lonely and heartbreakingly obese.

There’s a runaway who used to be a classmate of one of our children. She started cutting classes in second grade because her big sister dared her to. There’s also a drug-addled child who used to come to our home for slumber parties. We caught her going through the liquor cabinet once, when she was in elementary school.

To hear the litany--and it could go on--you’d think the local kids had gone to hell in a handbasket. In fact, most parents will tell you, kids like these can be found in any town, anywhere. But kids like these are also an uncomfortable subject for many reasons, the main reason being that it’s hard to discuss them without using the words “mentally ill.”

Uncomfortable words, those. Even more uncomfortable applied to children. Have you noticed, for instance, how assiduously the debate in the Columbine High School shooting has skirted the obvious point that at least one of the shooters had been, at least at one time, under psychiatric care?

“There’s a sort of shamefulness about it,” a thoughtful child psychologist sighed to me this week, off the record. “People have difficulty recognizing mental illness in general, but especially in adolescents and children, because there are such moralizing attitudes toward mental problems. They don’t want to describe kids like the ones in Littleton as, say, paranoid or sadistic. They’re afraid even to use the terms.

“People want to instead say, ‘Well, those kids were victims and they fought back.’ But that’s only part of it. Kids tend to get picked on because they’re mean in the first place. And kids with more serious problems are easy targets because they’re already doing things that make other people dislike them.”

This, of course, is the side of a story like Littleton that tends to go unspoken, that is too uncomfortable to discuss out loud. Better to blame society or bad parents or the hot breath of “evil” than to acknowledge an enemy we’re too ashamed of to understand.

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Maybe it’s because of this attitude that a modest proposal on deck here in Los Angeles County comes as such encouraging news. The new head of the county Department of Mental Health, Marvin Southard, who is breathing new hope into the long-embattled system, has suggested that county clinics be expanded to provide mental health care for more kids in public schools. Care could include private off-campus therapy and classes taught by psychologists that focus on relationships.

Lest you be among those who thought that sort of work was already being done by guidance people and school psychologists: California ranks worst in the nation in the ratio of students to public school counselors. School psychologists in this state tend to have caseloads so massive that few can do more than administer tests to the most undeniably troubled kids.

And the troubles are epidemic. There is no more psychologically stressful time of life than adolescence. Whatever a child’s frailties--from nervousness to schizophrenia--adolescence will strip them bare. L.A. County has 81 school districts with more than 2.6 million students under the age of 18. By the county’s conservative estimates, some 312,000 at any one time suffer from some form of mental illness, and half of those are seriously disturbed.

Last year, according to Southard’s people, maybe one in five adolescents got the therapy they required. If you’re thinking, “Yeah, but they’re just teenagers,” imagine a college campus without mental health care services for the teenagers it serves. Or imagine yourself as one of those troubled kids we’ve put on hold for these many generations. So uncomfortable to acknowledge. So alone.

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Southard’s plan, to be paid for with existing state and federal money, is, as I said, modest. The expansions start in Los Angeles and the San Gabriel Valley, with more schools to come later. It’s a testament to the long absence of support for kids’ mental health needs that it has professionals here so thrilled.

Still, it’s a start--and perhaps a fresh chance to look at another unspoken side of the story: the fact that competent help remains so hard to find. The field is evolving, and finding good counselors is a crapshoot, even in big cities. Why? Just a thought, but maybe it’s because it’s hard to ask the questions you need to when a subject is as uncomfortable as this one, even now, after Columbine.

Shawn Hubler’s column runs Mondays and Thursdays. E-mail: shawn.hubler@latimes.com