Focusing on children's mental health

Focusing on children's mental health
© Courtesy of Mental Health America

When Paul Gionfriddo was elected to the Connecticut House of Representatives more than four decades ago, he was assigned what was then an undesired area of focus: mental health policy.

“Nobody else wanted to do it,” the outgoing president and CEO of the national nonprofit Mental Health America (MHA) told The Hill in a recent interview. “And I quickly realized that there was a tremendous amount of need in the area.”

The policy issue became more personal to Gionfriddo about 10 years later, in 1990, when his oldest adopted child, Tim, developed schizophrenia at age 5.

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Since then, Gionfriddo has used his own family’s story in his campaign to promote early detection of mental illness, especially among children, and to raise alarm about how differently mental and physical illnesses are treated.

“If you really want to focus on the mental health of the nation — and we really want to make a difference in the next 10 years, same kind of difference we’ve made in the last five or 10 years — we’ve got to focus on kids,” he said.

Gionfriddo, 68, plans to retire at the end of the month after serving for seven years as the head of MHA  during a time when the public’s awareness of mental health has evolved, particularly amid the coronavirus pandemic.

He says his proudest moment leading the organization was coining the phrase “before stage four.” The slogan, which goes by the hashtag #B4Stage4, aims to frame mental illness in a way similar to physical ones such as cancer and heart disease and draw attention to how in the U.S. a person with mental illness generally hasn’t been treated until their condition becomes severe.

Gionfriddo saw that happen firsthand with Tim, one of his five children, whose experience shaped his understanding of mental health and the need for better detection and treatment, particularly among the young.

Tim’s schizophrenia manifested as Gionfriddo served his one term as mayor of his hometown of Middletown, Conn., and as he finished his 11 years in the state legislature.

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But Gionfriddo says it “didn’t matter” having a former lawmaker and mayor attempting to advocate for Tim: “We couldn’t be heard” to get the necessary services to help him stay in school and, later in life, stay employed and in housing.

As time went on, Gionfriddo kept documentation of everything involving Tim before deciding he needed to write a book to understand what had happened “to make his life so hellish.”

“And then in writing it, I came to some understanding, I think, and some longitudinal understanding about how many things we had to do wrong and therefore how many possibilities there were to change trajectories of lives for other people,” he said.

He finished “Losing Tim: How Our Health and Education Systems Failed My Son with Schizophrenia” shortly before being selected to lead MHA in 2014.

Tim died in January at the age of 35.

“I admired him a lot,” Gionfriddo said. “Not only do I love him deeply, but he was really a hero to me. He overcame a lot of adversity.”

As he shared his son’s story, Gionfriddo said he often heard from people who wanted to help Tim, to which he responded, “The thing that you could do was not what you do from today — it’s what we all could have done for him 30 years ago.”

“The way this most shaped my thinking about policy was to regret that I didn’t know more at that time when Tim was 5 years old and or even before that, when I had political power to make a difference — that I was focused too much on services for adults,” he added.

There was less data on and understanding of mental illness in the 1980s, Gionfriddo said, highlighting that lawmakers did not know that half of all mental illnesses emerge by the age of 14 and instead focused on severe mental conditions among adults.

“You can excuse the legislators of my generation for not having invested more in kids and understood what we needed to do to invest in kids and how seriously their mental health is being impacted by the world they lived in,” he said. “There’s no excuse for not understanding that today.”

While he acknowledges improvements in how open people are about mental illness and how more money is designated for the issue, he said more action is needed, particularly increased attention to children’s mental health, a situation highlighted by the pandemic.

More than 30 percent of parents said in October their children’s mental and emotional health worsened amid last year’s closed schools and stay-at-home orders, according to the Kaiser Family Foundation.

A Centers for Disease Control and Prevention study released last week found the number of emergency department visits for suspected suicide attempts among adolescents surged by 39 percent early this year compared to 2019 levels, an increase mostly driven by girls.

Gionfriddo also called for the standardization of annual mental health screenings for all people over the age of 11, saying it’s covered by insurance and would help unearth potential mental illnesses before they become more serious.

Traditionally, he said, advocates have separated people with mental illness into two groups, one for those with serious conditions and another for milder ones.

“What I hope we’ve been able to do over the course of the last seven years, and what was done for me over the course of the last 30 years, was to draw a line between those two and say ... the only difference between those two groups of people is that what are you dealing with 10 years sooner or 10 years later,” he said.

MHA announced earlier this month that Schroeder Stribling will replace Gionfriddo as president and CEO.

“I see MHA as poised to lead the nation in understanding that individual mental health and well-being are fundamental to all the crucial social and public health issues of our day,” Stribling said during remarks at the MHA Conference on Friday.

Gionfriddo says his retirement plans revolve around taking care of himself so he can “live a long time to help take care of others.” He intends to pursue his hobbies of running, playing accordion and gardening for relaxation.

But he’s not counting out more advocacy work, saying he’ll consider any opportunities that arise which “can be in fourth place in my life instead of first place.”