Juarez City.- Most of them referred by the State System for the Comprehensive Development of the Family, the Child Psychiatry area of the Hospital Civil Libertad on this border currently houses eleven girls, boys and adolescents (NNA) who suffer from mental illnesses, some derived from the consumption of substances such as marijuana or crystal.
“There are many factors, from the family environment, the social environment, the environment in which substance use takes place, and if we add these factors together, in psychiatry we call them adverse events in childhood,” explained José Guillermo Patiño Trejo, director of the Hospital Civil Libertad.
And the more adverse childhood events a person experiences, such as violence, aggression, abuse, substance abuse, social isolation and other factors, the more likely they are to develop symptoms or mental illness, she added.
This is the only psychiatric hospital unit for children and adolescents in Chihuahua and began operations in November 2022 with three patients. In just two years, there are already 11 children and adolescents hospitalized and receiving electroconvulsive therapy.
“What was previously known as electroshocks, which were carried out in a manner that was perhaps not so controlled, is now a procedure with all the necessary care, under anesthesia, doctors, etc.,” the psychiatrist added.
This unit has 20 spaces for the care of patients from six to 18 years old; upon reaching the age of majority, the adolescent is referred to the adult area if required; the adult area has 36 spaces.
It has two dormitories, each with capacity for 10 people, one for women and the other for men. It also has a dining room and a multipurpose room, where psychology and psychiatry specialists work.
The patients
The child psychiatry area is designed in a child-friendly manner; patients come from all health institutions with serious diagnoses, where outpatient treatment cannot be maintained in an adequate manner, explained Patiño Trejo.
“Many of them are referred, for example, from the DIF, although they are in shelters, they have a situation that requires some type of treatment and outside it is not possible to achieve control, so here we stabilize them and then they continue with their follow-up there in the DIF (shelter),” he said.
There are also patients referred from different subsidies and the ailments they suffer are very similar to those of adults, that is, suicidal ideation, severe depressive symptoms, psychotic disorders, including drug use and severe behavioral disorders, which would be the difference in adults, that care at home gets out of control and the life of the person and others is put at risk, he said.
“How do the symptoms manifest in them?” the specialist was asked.
From anxiety symptoms to a particular situation, it begins to be constant and disproportionate and begins to limit your quality of life, then that is when we consider it a symptom.
In general, all psychiatric symptoms can be anxiety symptoms, depressive symptoms, there may be symptoms where the person is out of touch with reality or behavioral issues that are already risk issues, which put themselves or others at risk and the conditions may not be there out there, so then hospitalization is sought, he mentioned.
In support of the people who treat these patients at home, this hospital offers them training in order to improve the quality of life of those involved.
“Here, together with the DIF, we offer workshops for caregivers, whether they are parents, guardians or caregivers of the care homes where the children and adolescents are, to reinforce a little bit that they can or that it is easier for them to manage the symptoms or help them manage the symptoms in people,” she said.
–Are they aggressive children and adolescents?
“Not all of them, there are some who may have aggressive behavior, others who have suicidal thoughts, there are some who have psychotic symptoms where they are detached from reality, many of them linked to substance use.
–When we talk about substance use, is there any one in particular?
“Those that have the most relationship in terms of the presence of psychotic symptoms and the (drugs) that are most consumed here in the area are marijuana and crystal meth, they are the two main ones and well, that also coincides with the fact that they are the ones that cause the most psychiatric symptoms and we see that in minors and in adults.
The director of the Hospital Civil Libertad mentioned that the effects of crystal on children are very harmful.
“The brain is not even formed yet at that age, so all the growth and maturation that the brain has from then on is altered and if the damage, the deterioration, in adults is significant, in children we could say that it even increases.
–And how did you get into the drugs of those children?
Many times it is because of their environment, many times because of acquaintances who offer it to them, they almost always start that way and then they skip it, most start with alcohol, tobacco, marijuana and then they experiment with other substances until they get to a more addictive one like crystal meth, it definitely grabs them and that is when it starts to get complicated.
–And these children do get cured?
“When symptoms are determined by the presence of a substance and there is no other condition, the symptoms are well controlled, the important thing is that they do not return to consumption. Many of them return to consumption, the symptoms reappear and there comes a point where the brain is so damaged that it is very difficult to treat them,” he explained.
He said that many of these people need to be taking the medication on a permanent basis, so the important thing is to prevent it.
–And can parents realize this?
I think the most important thing is communication within the family with the children, because that will allow us to see changes, perhaps subtle changes, but we can identify them if we have that closeness. Maybe changes in the sleeping schedule, changes in the person’s energy, if it was a person with whom we sat down to eat as a family and had a chat and suddenly they start to isolate themselves, well that is already a red flag that we have to take into account, she said.
“If they had certain grades at school and were doing relatively well, and suddenly their performance drops and there is nothing else going on in the family environment because many situations can be seen, then we would have to talk, I insist, approach them and talk about the consequences and assess whether it is possible that there is some consumption,” said the psychiatrist.
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