CCTV Beijing April 25th (Reporter Zhang Shengpo) In the clinic, Li Ting’s mother raised her daughter’s sleeves and revealed more than a dozen knife marks on the two arms, with different depths.The day before the doctor, Li Ting almost jumped from the 15th floor, and the family was frightened.
Li Ting was just 12 years old, her face was handsome, and she was wearing a red necklace on her neck.It is her age who loves beauty and cares about her image.During the consultation, Li Ting lowered his head halfway and did not say a word, but stepped on his mother’s feet from time to time.The family hopes that the doctor will arrange her to be hospitalized as soon as possible.
Qi Junhui is the attending physician of the Children’s Children’s Children’s Children’s Children’s Children in Beijing. This is not the first time she has seen Li Ting.A week ago, my mother took her for the first time and told her daughter to stay at home since June last year. When her mood was not good, she would fall, quarrel with her family, and even dismissed herself.
“Depression”, this is the preliminary diagnosis of Qi Junhui to Li Ting.Last time, she had suggested that Li Ting was hospitalized, but her mother did not agree.This time, Li Ting’s idea of jumping off the building made her change her mind.
Qi Junhui immediately contacted his colleagues to arrange the hospital number for Tingting. How long does it take to wait, she said it was not good.There are more than 80 beds in the general ward of the Pingfeng Hospital. They are full of beds all year round. Nearly half-hospitals are 10-16-year-old children with depression at varying degrees of depression.
In May 2021, the first influx report on the prevalence of mental disorders in Chinese children and adolescents was published in the magazine of Children’s Psychology and Psychiatry.The flow was launched at the end of 2012, and about 74,000 children and adolescents in five provinces (cities) of Beijing, Liaoning, Jiangsu, Hunan, and Sichuan were selected as samples.
The survey results show that among the students 6-16, the total prevalence of mental disorders of children and adolescents is 17.5 %, of which depression obstacles account for 3.2 % and anxiety disorder accounts for 4.7 %.
Zheng Yi, chief expert and chief doctor of the Children’s Psychiatry and Chief of the Capital Medical University, led Zheng Yi to conduct this flow.”Based on the number of Chinese students in China, this number is already very large, and the objects selected when we do flowing at that time are students at school, and they have not covered those children who cannot learn for various reasons.The rate will be even more “Zheng Yi said.
In his opinion, children’s mental health problems have become a serious public health problem, and this is not solved by doctors. It requires home, school, medical, and social integration.
Youth: “There is only a sad feeling in your mind”
When Li Ting was going to be hospitalized, Chen Rui had lived here for 18 days.
She was sitting on a galaxy chair and said that she wanted to cure the disease, but she didn’t want to cure it. Strictly speaking, it was not too dare to cure.”Most of my illness is due to family reasons,” she said.
Chen Rui was sitting on a chair in a galaxy and said that she wanted to cure the disease, but did not want to cure it very much.
14 -year -old Chen Rui is from Beijing. Her parents are “very traditional” in her eyes: my father has a bad temper and likes to preach. Typical masculinity, often speaking with an order tone.Mother’s education was strict. She reported her various tuition classes since she was a child. She didn’t even have free time on weekends.
The environment in her home made her feel depressed.Chen Rui felt that she began to have psychological problems in the third or fourth grade.At that time, she was able to pass the top of the class, but her mother would scare her if she would use “bad primary schools, there would be no high school”.”She thinks I am stable in the first grade, and I think it is impossible, but she really hopes.”
After the fuse was promoted to junior high school, her friends broke with her for many years.Some classmates took this gossip, and her relationship with her classmates became nervous, so that she wanted to “avoid these students.”Later, her emotional problems became more and more serious, sometimes irritable, and sometimes they suddenly felt sad. They couldn’t help crying twice after class.
Her body began to appear abnormal: sometimes the brain was chaotic and could not hear the outside voice; sometimes after waking up, she also distorted things and returned to normal after half an hour.When she often vomits and frequently, every stop of the subway had to get out of the car to vomit.She later learned that this was the physical symptoms in the state of depression.
Academic performance is naturally declining.It is difficult for her to concentrate on listening to the class, she can understand the words on the blackboard, but she can’t understand what the teacher is talking about.Memory has also become poor. After eating at noon, I forgot what to eat in the afternoon.Even the thoughts of lightning began to flash. She would want to take a fruit knife to stab herself, but did not dare, because she was not willing to be willing to have a kitten at home.She also hoped that someone would suddenly give herself a knife on the street.
She told her mother that she was afraid of depression.But her mother did not believe it, because she compared the content of “adolescence performance” in the middle school textbook, thinking that she was just in line.It wasn’t until she cut her wrist with a knife and hit the wall with her head and hit her.
“Why do children do this?” This is a question that most parents can ask about He Fan when they see He Fan.He Fan is the chief physician of the Children’s Psychiatric Department of Anding Hospital. Often after some inspections and explanations, she will gently tell parents: because he is sick!
He Fan introduced that depression disorders are an objective disease, just like people will fracture, not as many parents think: children become stupid, obedient, lazy, or adolescent rebellion.
She said that in fact, adolescent rebellion will have some emotional problems and oppositional violations, but they are within the acceptable range and will not be self -harm, suicide, losing social and school social functions.From the results of epidemiological surveys, the prevalence of depression disorders in children and adolescents is almost equivalent to adults, which is an international consensus.
Qi Junhui said that for teenagers, 12 years old is a watershed.At this age, they are facing the pressure of the early test. After entering the junior high school, they will face the pressure to adapt to the new environment and deal with new interpersonal relationships. The academic pressure will be greater. If you cannot deal with these pressures, you may have psychological psychology.question.In addition, physiological speaking, the age of 12 is also the beginning of adolescence. It is a period when the level of hormones in the body has changed drastically. They are becoming more and more adults in appearance, but psychological maturity is not enough to deal with various problems in life.
Parents: “How can children get sick?”
Zhang Ye’s head was shaking slightly. She could feel it, but couldn’t control it.
After her daughter Zhao Yue was sick, she was under pressure.At the end of last year, she felt that she was not right and always wanted to cry. The doctor said that she was depression and anxiety.
In March this year, Zhao Yue was hospitalized for the third time in the past year.When she was hospitalized for the first time, she had just finished her 14th birthday.At the age of 36, Zhang Ye became a mother. She thought that she had been spoiled to her children since she was a child, and her expectations were very high, but she did not excessively “chicken baby” as in some urban parents.
“I feel a lot of companionship to the child. My dad and I have always been as much as possible to accompany her. Before the child was sick, I never felt that she felt her feelings, and she hadn’t treated her in material and spiritual.” ZhangYe said, but after her daughter was sick, she felt that it became a “appearance.”
Zhao Yue learned very well. At the beginning of Xiaosheng, he was admitted to a local key middle school, but the transformation also followed.Zhang Ye recalled that Xiaoyue’s self -awareness gradually increased, but she and her lover did not pay attention to the changes of the child in time, and she still had more “control” and “constraints”.”It is mainly on electronic products. The method is not right and rude.”
During the summer vacation, Zhao Yue’s emotions began to be significantly low. They did not want to contact their classmates, nor did they want to learn, and had self -injury.Zhang Ye felt that he was not right, so he took the child to see the psychologist.
At a local psychological counseling center designated by a local psychiatric hospital, the consultant said that Zhao Yue was just a normal adolescent issue and it was not a big deal.She felt that since it was a puberty problem, it was slowly adjusted, so let her daughter do a psychological counseling, but it was found that it was useless.Later, Zhao Yue said that she could not speak openly to a stranger.
In the second grade of junior high school, Zhao Yue began to become irritable, his learning interest decreased, his attention and memory severely declined, insomnia, and upside down day and night.
“Looking back, she was sick at that time.” Zhang Ye said that in March last year, Zhao Yue was initially diagnosed as “depression, anxiety, and bipolar emotional disorders” at the Anding Hospital.However, she and her daughter were very anxious at that time, and they were more disgusted with hospitalization. After staying for one and a half months, they were discharged from the hospital.She acknowledged that from now on, Zhao Yue did not have the conditions for discharge at the time.
In the courtyard of the Pediatrics and Hostal District of Anding Hospital, this is where the children’s games and fun are placed (the interviewees of the interviewees of the CCTV)
Chen Xu and Zhang Ye, chief physicians of Children’s Psychiatric Department of Daeding Hospital, are already old acquaintances.She recalled that at that time, Zhang Ye, like many parents, had a lot of misunderstandings about the disease itself and the child’s condition, and did not quarrel with the doctor.
Zhang Ye admitted that at first, neither she and her lover accepted, “How can children get sick?”
They once blamed themselves and felt that they had done a lot of mistakes during the growth of the child, and even felt that they had ruined the child.”When you see other children studying happily, no matter what he is studying, at least healthy. But seeing his child always feels too much guilty, whether it is physical or mental.”
“Parents must learn to accept their children. Only by accepting their children and changing themselves first, the child will change, instead of just seeing the child, simply let the child change,” she said.
It is not easy to let parents from “accepting children” to “changing themselves”.Wang Gang, the dean of the Anding Hospital and the director of the depression therapy center, mentioned in an interview with the media that some parents have a strange psychology, as if the disease does not happen, but the doctor “distributed”.Trimming as no disease.Some parents came to him to treat their children, but hoped that he would declare that the child was not sick, so they could tell the child that the experts said that you were not sick. You should study hard and don’t think about it.The essence of this mentality is that parents are worried that their children are diagnosed with mental illness, and they are buckled on a hat. They feel the social stigma of depression, which has a sense of shame.
“Now there is another problem. Parents’ sense of shame is much heavier than children.” Qi Junhui found in the consultation that the parents of the children were divided into two types. One was to be aware of the seriousness of the child’s problem and was willing to cooperate with the doctor for treatment.The other category is to “pull the hind legs”. The parents come and say, “I don’t know what’s wrong, I think it’s okay, that is, there are too many mobile phones to play, all he wants to come. …” In short, Try to find various explanations to prove that the child is not sick.
He Fan had diagnosed a pair of mother and daughter, a thirteenth -year -old girl, was diagnosed with depression.Before being diagnosed, the girl delayed at least two years in other comprehensive hospitals. The physical symptoms were very serious and could not go to school. However, her mother felt that she had been inspected in various departments. Without a problem, she kept her school.
After learning the diagnosis, the mother was completely unacceptable, and the fierce response surprised He Fan.”I rarely see parents who responded such a fierce response.” He Fan said, seeing the child crying about his medical history, and seeing the mother’s reaction, she was particularly pitiful that child.
Later, she never saw the mother and daughter again.
Doctor: “Democracy is often the beginning of treatment”
“Each month, a dozen children have a dozen children in the pediatric ward and were discharged from the hospital in advance by the parents when they were not discharged.There are not a few parents who have changed doses and do not discharge according to the doctor’s order.
Qi Junhui did not deal with such parents.She remembers that a child is the “old patient” in their department, but she has only seen this child once, and then her grandfather came to prescribe medicine.She guessed that the old man should be a senior intellectual, because every time he brought a lot of information to guide her how to use medicine.
“As soon as I asked for a child, he said that the child was busy going to school. He didn’t let you speak, just said his judgment, and then let you admit that his judgment was right.” Qi Junhui said.
As a doctor, she needs to repeatedly emphasize with her parents that the face diagnosis of psychiatry is irreplaceable and must bring the child.He Fan said that all diseases of the psychiatric are clinical diagnosis, which means that the accuracy of the diagnosis depends more on the experience and professionalism of doctors. Among them, it is particularly important through the spiritual examination of direct conversation with patients.
March 29 is the opening day of the Parent Parents of the Pediatric Hospital of Daeding Hospital.On the same day, parents can visit their children and visit the ward, but the most important part is a symposium. The hospital hopes to improve the communication with parents through this form.
At the parental symposium, Shi Daoming shared the educational concept with parents (Zhang Shengpo/Photo)
On this day, Chen Rui’s mother came.She told one thing at the symposium that her daughter suddenly collapsed because she didn’t buy a concert ticket.After speaking, she proposed a confusion of many parents: how can parents get along with their children after the child is sick, and how can she adhere to the principles of education in front of their children?
The psychotherapist, Mr. Tian, gave everyone an example. A child told her that since she was sick, the family had all the requirements for her requirements.”When they were satisfied, I was stunned. My request was obviously wrong. Why did they promise, don’t they have their brains? I did something wrong, they also said that I was right, they did not have the basic right or wrong viewIs the child said, in fact she knows why, because the family thinks she is sick.
Teacher Tian wants to tell parents through this case that due to age, children sometimes have the psychology of “disease benefits”, which is also testing the wisdom of parents to raise.Parents should keep the basic bottom line under the principle of “life safety first and minimize damage”.
Shi Daoming is an intermediate psychotherapist and the host of the symposium.He suggested that parents should maintain basic right and wrong judgment when facing their children.For example, what should be done, what should not be done, what can be bought, and how much money is exceeded.
“To convey these bottom lines to the children, under the premise of ensuring his life safety, stick to the bottom line, and the whole family wants to reach this bottom line, otherwise it is invalid, But in fact, because the situation of each family is different, the child’s condition is constantly changing. Parents should reach a dynamic balance like a seesaw interaction with their children.
Many doctors said that to some extent, mental disorders, including depression disorders, are a chronic disease, just like diabetes and hypertension. In addition to long -term medication, patients must improve their lifestyle and adjust their mentality.Family care is crucial.
“Democracy does not mean the end of the treatment. It may just start. After the child is discharged, a family still has a long way to go.” This is a word that Shi Daoming and his parents said.
Chen Xu said that parents need to face up to the disease of depression, neither despise nor panic.Can’t despise, that is because more than 50%of mental illness is the first disease in youth, there is no need to panic, that is because during this period, it is often in the early stages of the disease. Early identification and standardized intervention can prevent diseases and chronic in the disease.As long as they are treated with sufficient treatment to ensure stable condition, all children have a great hope to return to a healthy state.
Expert: Insufficient and deviation of parental cognition
After Chen Xu graduated, he had been working in pediatrics.In the past ten years, she has witnessed the change in the number of patients with pediatric disorder.She remembers that around 2007, the number of pediatric monthly clinics was about 300 people, and the annual outpatient volume was less than 10,000, and the 20 beds were enough.
“At that time, the polarization of pediatric patients was polarized, and part of the patients with dynamic diseases and twitching diseases could be processed. The other part was severe patients, such as schizophrenia.” Chen Xu introduced that in 2018, the year of the Pediatrics of the Pediatric Hospital, the Pediatrics of the Pediatric HospitalThe outpatient volume has reached 60,000 to 70,000, and the bed was increased from 20 to 57, which was full within a week. Since then, there is no situation of dissatisfaction.Starting that year, Pediatric patients at the Anding Hospital began to surge. Last year, the number of outpatient clinics had reached 100,000, and the bed was increased to 80. It is still difficult to find a bed.
“Although there are some children with some developmental problems, more than 50%of children are emotional problems, including depression, anxiety, bipolar emotional disorders, childhood emotional disorders,” she said.
Xu Tao is an adult psychiatrist at a certain district hospital in Beijing. This year, he went to the pediatric ward of the Anding Hospital to study this year.In recent years, there are more and more relatives and friends who have asked him to consult the psychological problems of children and adolescents. Due to professional knowledge, he cannot answer many questions.However, there are many people who ask, and he is curious, why are there more and more children with emotional problems?
Several children’s psychiatrist said that in the medical community, the cause of depression disorders cannot be clear, but it is certain that this is a mental illness related to biological factors, social psychological factors, and environmental factors.Biological factors are more related to genetic factors, non -human controlled, and theoretically, it will not become the main factor for the surge in the surge in children and adolescent depression in the society.
Zheng Yi said that the biggest reason for the psychological health of children and adolescents is that there is a problem with family relationships.The World Health Organization has done a survey. The impact of family factor on human mental health accounts for 70%, while biological factors and genetic factors have only 15%-25%.
He Fan’s feelings are that in recent years, in general, diseases with high association with genetic factors have not increased significantly, but the number of diseases with high social psychology and family environment has increased significantly.”In these years, there are obvious children with emotional problems. Among them, anxiety and depression emotional issues are more prominent.”
Some parents once told Zheng Yi that they were panicked when they saw their children’s psychology, because others were learning.
Shi Daoming believes that the reason why some parents have such high requirements for their children is because they feel a lot of competitive pressure in society, and these pressures will naturally pass to children.
At the Pediatric Ward of Daeding Hospital, a girl’s bed is placed on textbooks, toys, and extra -curricular books (Zhang Shengpo/Photo)
“With the development of society, the school’s tolerance for children is getting smaller and smaller. ‘Phenomenon of not freedom of less than ten minutes during class, frequent call for parents, opening parental meetings, and school burdens.The pressure of stress on people is a U -shaped type. Proper pressure will promote the psychological development of the child, but if the pressure is too large, it will be counterproductive. This pressure cannot be resolved in their psychological age. It may be possible.It will lead to various emotional problems and behaviors. “He Fan said.
Streaming shows that the total prevalence of mental disorders of children and adolescents is 17.5%, but less than 20%of teenagers who have obtained the appropriate diagnosis and treatment.
“This is a big problem. Why do so many children have not been diagnosed?” Zheng Yi said, one of the most important reasons is parents. One is that they do not know enough. The other is that they have a deviation in the society.Discrimination and sense of illness.
He Fan’s observation is that compared with the child’s mental health, many parents pay more attention to their children’s functions. As long as they can go to school and learn well, everything is good.Only when children cannot go to school can they really pay attention to their psychological problems.In fact, it has been a long time since a child has depression to unable to go to school. This is the main reason for delaying early identification and diagnosis of children and adolescents.
Medical and teaching cooperation is an important part of prevention and treatment
Zheng Yi has been working in this field for 40 years.He recalled that in the 1980s and 1990s, the children’s psychiatrist was freshly valued, and the income was not as good as many departments. The children’s psychiatry of the hospitals in many large cities opened the door and closed and opened.Even in the medical system, there are many cognitive misunderstandings in children’s mental illness.He had heard a leader of a medical system and said, “Do children still have mental illness?”
Chen Xu said that in recent years, with the increase in medical treatment in society, many provincial spiritual hospitals have also begun to add pediatrics to increase the bed. Pediatric clinics and wards have sprung up.In the pediatric ward, there are 200 pediatric beds in a local municipal hospital in Southwest.
Zheng Yi said that some hospitals have opened children’s psychiatric department, but there are no doctors, so many previous children’s and adult psychiators transfer to postponestrate clinics, and they are likely not to have sufficient professionalism.When he recently investigated a solitary treatment center, he found that two children were misdiagnosed as autism.
According to the article of Professor Wu Jinlan, the Pediatric Department of the First Affiliated Hospital of China University of Science and Technology in 2019, in the “Liuye Knife · Psychiatry” article in 2019, Chinese children’s psychiatrists are scarce, the number of children’s psychiatrists in the country is less than 500, and the distribution is extremely unbalancedEssenceMany doctors said that in that year, there were only a lot of estimates, but it is difficult to estimate the accurate figures now, mainly because China has not yet established an independent children’s psychiatrist practice system.Even like Zheng Yi and He Fan, their physician qualification certificate only wrote “psychiatrist”.
“Without standards, it will cause confusion.” Therefore, Zheng Yi has always called for the establishment of a children’s psychiatrist certification system as soon as possible.
Qi Junhui discussed the treatment plan with colleagues (Zhang Shengpo/Photo)
In Zheng Yi’s view, like many diseases, early sieve and early treatment are the key to prevention and treatment, and children’s mental illness is no exception.Among them, the synergy of medical education should be a very important part of the prevention and control process.
This has been reflected in a number of policies and regulations formulated by the state over the years.For example, in 2019, the 12 departments jointly issued the “Action of Healthy China -Plan for Children and Adolescent Psychological Health (2019-2022)” proposed that by the end of 2022, it is necessary, Family, media, medical and health institutions and other linked psychological health service models; the revised and implementation of the Minor Protection Law in June 2021 clearly stipulates that the education administrative department shall strengthen the psychological health education of minors and establish psychological issues of minors.Early discovery and timely intervention mechanisms; in 2023, the 17 departments including the Ministry of Education and other seventeen departments jointly issued the “Special Action Plan for the Student Health Work in the New Era (2023-2025)” in the “comprehensive strengthening and improving the new era of the new era of the new era” is “health education, monitoring, monitoringEarly warning, consulting services, and intervention disposal of the “four -in -one” student mental health work system is more sound, and the psychological health work pattern of students’ psychological health in collaboration between schools, families, society, and related departments is more complete.
Letting hospitals, schools, families, and society participate in the process of children and adolescent depression, it is also Zheng Yi’s view.At an Asian Education Forum, he once pointed out the necessity of improving the “mental health service system”, allowing school psychological service platforms, community psychological service platforms, minor psychological health growth counseling centers, social psychological health service agencies, and children’s specialistsThe hospital participated, coordinated support, and built a strong guarantee network.
“In fact, the hospital can play a good role in piercing a needle.” Zheng Yi said.
Zheng Yi admits that in the past, psychiatrist was very popular with the school. In recent years, with the release of some national policies, the school’s attitude towards psychiatrists has changed., But the current problem is that the school’s awareness of the mental health of children and adolescents is still simplified.
“The document is issued, and the school has to pay attention to. But some school leaders do not really accept psychiatrists from the heart. They are often respected on the surface, but their discrimination and fear of the mental illness itself are still ingrained.Method. “He said.
A children’s psychiatrist said that from the perspective of public health, they want to do a lot of things, but often the more they want to do, the more frustration.”We want to do some early screening, sieve those high -risk children out, and intervene in advance, thereby reducing the occurrence and development of the disease, but the school is unwilling to cooperate with us.Pay attention to the mental health of children and adolescents, but there are many difficulties at the specific implementation level.
In his opinion, few principals of schools are willing to let doctors sieve out how much depression and mental disorders have, and they feel that they can not solve the problem when they know the data.There are any accidents, and you can also say that you do n’t know. If there is an accident again, the nature will be different.
“Really sieved, who would tell the parents? How to do subsequent intervention? How to say that the child is in a high -risk state and needs to pay attention? It must have the doctor’s final interpretation responsibility. Since ancient times, there has been a ‘doctor who do not hold the door” in my country. In tradition, how can a doctor take the initiative to find someone to say ‘your child is sick’! “The doctor said.
Zheng Yi said that medical cooperation should be an overall cooperation, how should the responsibilities and power of the functional departments divide, how to mobilize the enthusiasm of the doctor, and how to help the children after discovering problems during the early screening process. These should be at the institutional level.Guarded.”In this way, there can be a sustainable development mechanism, rather than a few doctors to promote work by private relationships and personal interests.” Zheng Yi said.
