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Raising a Child with Mental Health Problems

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From the U.S.: My wife and I are foster parents with the opportunity to adopt a child that has been in our care for a year. We have been asked to adopt her brother who suffered a traumatic brain injury at the age of 2 and was neglected much of his life. He is 7 years old now but has a history of aggression and has physically attacked both adults and children and there are incidents where he has shown cruelty towards animals.

His current foster mother describes some episodes of aggression that require he be physically restrained for several minutes at a time until he calms down and he does not seem to know what he is doing while in that state. He is currently taking Risperdal and trileptal to help curb his aggression. He has cognitive disabilities and scores on the lowest level in terms of his aptitude so behavioral therapy may not be an option. It looks like he is bipolar 1 with signs of dysphoria and psychosis. I am just looking for some guidelines on what to expect in terms of his care (social and financial) and what are the inherent risks associated with this type of behavior.

Raising a Child with Mental Health Problems

Answered by on -

A.

You are right to ask these questions. This child needs a home. You need to know what to expect. The medications he is taking indicate to me that he is a handful.

An important question to ask is how someone determined he is bipolar. What went into the analysis? Are the medications being used to treat a mental illness or to control his behavior? If he is truly bipolar, he may be on the correct medications. But antipsychotic medications are often used because they are effective in calming someone down when aggressive. The distinction is important because any medication used long term is going to have an impact on his developing brain. As far as I know, prescribing Risperdal to a kid is an off-label use. You will want to ask about potential long term side effects.

If the problem is primarily behavioral due to neglect, lack of socialization and lower than average intelligence, medication will calm him but won’t help him learn. Please, please don’t write off behavior therapy. It is often effective as a teaching tool with people who are as intellectually disabled as this little boy. He can learn. It will take time and patience but he can learn. I suggest you ask for a consultation with an ABA (Applied Behavior Analysis) certified specialist to talk this over.

A powerful intervention for someone like this child is love. He has every reason to not trust people and to be defensive and offensive in his behavior. It will take lots of time and attention to win his trust so he can look to you for protection and comfort.

In your state, the Department of Aging and Disability Services (DADS) oversees care of people like this boy. Before agreeing to adopt him, request a consultation with the mental health worker who is most familiar with his case. Make sure you are fully aware of services and financial support that are available.

This little boy will require a lifetime of care. It is an enormous commitment to take him into your family and into your heart. Such relationships can be very, very rewarding. But it is certainly important that you go into it with your eyes open. Including him in the family will effect every member. Do think carefully about whether you and your partner have the emotional energy, time and resources that will be necessary for many, many years ahead.

I wish you well.
Dr. Marie

Raising a Child with Mental Health Problems

Dr. Marie Hartwell-Walker

Dr. Marie is licensed as both a psychologist and marriage and family counselor. She specializes in couples and family therapy and parent education. Follow her on Facebook or Twitter.

APA Reference
Hartwell-Walker, D. (2018). Raising a Child with Mental Health Problems. Psych Central. Retrieved on January 19, 2019, from https://psychcentral.com/ask-the-therapist/2016/08/12/raising-a-child-with-mental-health-problems/
Scientifically Reviewed
Last updated: 8 May 2018
Last reviewed: By a member of our scientific advisory board on 8 May 2018
Published on Psych Central.com. All rights reserved.