NASW News’ “Social Work in the Public Eye”
The Herald-Sun, in Durham, N.C., recently published a guest column by NASW member Barbara Smith titled “Early intervention in youth mental health.”

Barbara Smith
“Much too frequently in America, we bear witness to horrific shootings,” Smith wrote, adding that while it’s important to have stricter gun laws, the country also needs “a humane and effective mental health system that gives priority to young persons with emerging severe mental illness.”
Smith, a clinical assistant professor at the School of Social Work and the Department of Psychiatry at the University of North Carolina at Chapel Hill, has spent the last 20 years of her career working with schizophrenic patients. She states in the article that people she sees with this issue are a part of the human dynamic as a whole.
She says those with an emerging mental health issue are in distress and open to receiving treatment in a humane way, and early intervention can create better outcomes where schizophrenia is concerned. However, in the U.S. it’s almost impossible for young people with emerging severe mental health issues to get the help they need, Smith says.
“Over the past 30 years, our mental health system has suffered from fragmentation and underfunding,” Smith writes. “The resources we do have are sometimes misdirected. We have over-relied on medications hoping for the quick and simple cure for disorders that are complex.”
Smith says that people with mental illness — particularly schizophrenia and other psychotic disorders — often are viewed as monsters by their fellow citizens. This public perception of mental illness can affect what happens privately, she says, such as denial when a young person develops psychosis.
“We ignore it or call it something else,” she writes, adding that being in denial can delay treatment.
Smith offers suggestions on how to improve the U.S. mental health system:
- Treat emerging psychosis like a true medical emergency
- Make youth mental health a public health priority
- Provide education to young people, their families, their teachers and their faith communities about early warning signs of mental illness and how to get help
- Create specialized early intervention teams that can respond rapidly and humanely to persons with emerging severe mental illness
- Strengthen the mental health workforce by developing training initiatives that focus on persons with severe mental illness
- Broaden the dominant medical model to include psychological treatment, social interventions, psychiatric rehabilitation and peer support.
- … Early intervention, easy access to care, the best treatment from a multidisciplinary team of professionals, shared decision-making and enough support to lead a meaningful life as a contributing member of the community. If we had those things in our mental health system, we would all be better off,” Smith says.
From the April 2013 NASW News.
I strongly agree with Smith’s suggestions to improve the mental health system and the need to focus on youth in particular. So often these kids slip through the cracks and help is not given. These children then grow up to be adults who do not know how to sufficiently deal with their mental illness. I also agree with Smith that while medications have been effective for many, oftentimes it is not treating underlying issues a person might have.
The National Institute on Mental Health (NAMI) estimate that four million children and adolescents in the U.S. suffer from a serious mental disorder that causes significant functional impairments, yet only 20% are identified and treated. These individuals often struggle in school and with peers, may end up getting in trouble with the law, or tragically end up committing suicide. It truly does take a village to raise a child, and it is up to communities to treat mental illness in youth as a priority in order to make the future better for these kids. Research has shown early treatment can reduce long term disabilities of mental disorders.