There is an adolescent mental health crisis in the U.S. and experts continue to weigh in on various ways to mitigate it. But one thing is sure: the Supreme Court decision to overturn Roe v. Wade will undoubtedly make things worse for youths across the country.
I looked through the window at my 11-year-old patient to make sure she was not harming herself. She was in the “quiet room,” our alternative to physical restraints in the child psychiatric hospital. Earlier in the day, she scratched herself so deeply that she drew blood while screaming that she wanted to die. Later, I asked her why she wanted to kill herself.
“Because my parents don’t want me. And now my foster mom doesn’t want me either.” She looked at me and her big brown eyes filled with tears. I squeezed her hand. But she needed so much more than hand-holding from her psychiatrist.
Proponents of abortion bans claim to be pro-birth — maybe even pro-baby. They want all babies to be born, no matter what. As a Child and Adolescent Psychiatrist, I am pro-child. I work with many of those babies, now children, who were born into traumatic situations with parents who were traumatized themselves. I work with those babies, now children, whose foster parents cannot handle them because they are in and out of the hospital after suicide attempts. I work with those babies, now children, who are facing an increased risk of substance use disorders because both parents struggle with them. I work with those babies, now children, who are hurting themselves because they can’t understand why their parents don’t want them. I work with babies who are now children, born into seemingly privileged circumstances, to a mother who was pressured into having a child she did not want, leading to splintered family dynamics that reverberate through the child’s life. I work with babies, now children, who are hoarding food in the hospital, under their beds, because they never have enough food at home.
Children and adolescents are at higher risk of dying by suicide if they are exposed to adverse childhood experiences (ACEs), such as abuse, racism, or poverty. With the overturning of Roe v. Wade, many women will be forced to have children they cannot support, and even before that, many women will not receive adequate prenatal care in these forced pregnancies.
The mental health of children is partially nature and partially nurture. Sometimes the traumatic environment a child is living in leads them to develop mental health issues, but sometimes the child was already born with multiple strikes against them. Like the child with fetal alcohol syndrome, a disorder caused by maternal alcohol use during pregnancy, who has been admitted to the hospital dozens of times because they are destroying property at home and at school. Like the child who was born prematurely, in part due to the mother not having access to prenatal care, who has developed severe developmental and behavioral problems. Like the child developing psychosis at an early age, whose parents both have severe psychotic disorders, and did not want to have a child in the first place.
Children who are born into a world that does not support them can face a lifetime of issues. Children exposed to lead at an early age, which is tied to living in poorer neighborhoods subjected to environmental racism, are at an increased risk of learning disabilities, decreased IQ, and problems with impulsive behaviors, at no fault of their own, which can put them at higher risk of committing crimes. And I’ve seen many children, mostly Black and Brown, who were traumatized at a younger age, neglected or abused by their parents, and shuttled into juvenile detention facilities because they’re in fight or flight mode — and they’ve chosen fight.
The emergency rooms and child psychiatric hospitals are overflowing. Pediatricians are being forced to handle severe psychiatric disorders because child psychiatrists are scarce. The reversal of Roe v. Wade scares me because I know the effects it will have on the pediatric mental health system, which is already overburdened and under resourced. But even more important: What will happen to the babies of mothers who were forced to give birth? What will happen to the babies who were forcibly born who must endure a lifetime of psychiatric issues with little support? What will happen if these children give up on themselves and are criminalized? I don’t have all the answers, but I know they will suffer. And I, as a Child Psychiatrist who deeply cares about children throughout their life span, will suffer, too.
We need the rights codified by Roe v. Wade back. But in the meantime, we need funding and support for traumatized children and adolescents who don’t have their basic needs met. We need programs to support foster parents who are overwhelmed because they are fostering a child who has a severe psychiatric disorder, leading them to become aggressive with others or themselves. We need funding pumped into programs to support women who are forced to give birth to children they have neither the resources nor bandwidth to care for. We need funding funneled into prenatal care outreach efforts, so that children are not being born with health conditions that might have been prevented. And the people who fought to overturn Roe v. Wade should be leading the charge.
Amanda J. Calhoun, MD, MPH, is an Adult/Child Psychiatry Resident at Yale Child Study Center/Yale School of Medicine. Calhoun is also a Public Voices Fellow of the OpEd Project at Yale University.
Source: MedicalNewsToday.com
