Archive for March, 2018

Firearm Storage in Homes with Children At Risk For Self-Harm

Gun Storage, Youth Suicide And Reducing Risk for Children Prone to Self-Harm

Texas suicide lawyerMost often, the weapons are left unlocked, within reach, or loaded. If a child with very little knowledge of what it means to hold a gun can fire and harm themselves, what damage could be in easy reach for a child at risk for self-harm? Depression and other mental health conditions affect thousands of children and adolescents. According to the National Alliance on Mental Illness, 1 in 5 children between the ages of 13-18 have, or will have, a serious mental illness. A two year Suicide Prevention Resource Center study of firearm suicides in victims under 17 found that 82% of those who had died from suicide had used a firearm that belonged to someone in their family. A significant amount of those firearms had remained unlocked. Even with locked safes, many youths knew the combination or had the key to access their contents.

The Law Offices of Skip Simpson has helped many families in the wake of tragedy. These losses are preventable, and we aim to shed light on the factors that contribute to them, namely negligence.

Home Alone: At Risk Youth

Guns and mental health often intersect in a nationwide conversation. Who should or shouldn’t have access? What of our amendments? How do we keep our children safe in their own homes? The rate of youth firearm suicide has only increased over the years, and firearms in the home only create a larger risk of death by suicide to all who reside in it. Parents and caretakers have a unique responsibility in keeping their weapons out of reach from children. Any adult with access to where guns are kept should ensure that it is locked, and codes should not be revealed with children. A study in a recent issue of Pediatrics addressed whether or not gun storage differed between homes with at-risk youth, and those without. According to its findings, firearms were present in roughly 42 percent of households surveyed, and the ownership prevalence did not differ between homes with at-risk youth, and homes without at-risk youth. One third stored their guns locked and unloaded, and the storage methods didn’t seem to differ between households of various risk status, either.

This means that a child or teenager with serious mental health concerns has a fair chance of accessing a weapon, which could then kill them. A chilling story from Michigan in 2013 details how one thirteen-year-old child died by firearm suicide in a school bathroom with a handgun found at home. Though legally owned by the family, the question of whether or not the gun was stored properly comes into play.

Hanging, exsanguination, and other forms of suicide death can take minutes, sometimes hours to take a victim’s life. A firearm leaves little hope of survival. 90 percent of firearm suicide attempts end in the victim’s death.

Loaded, Improperly Stored Potential

Five-hundred and sixty-five children and adolescents died by firearm suicide in 2015. These deaths were preventable. Being able to assess and raise awareness for the presence of at-risk youth in the home should play a deciding factor in gun storage, or gun ownership to begin with. These deaths beg the question: why do caretakers not show a higher rate of safe gun storage when they house at-risk youth? Recognition of behaviors that could indicate a mental illness such as depression or early onset schizophrenia could save a life. Perhaps they believe their children or dependents simply won’t touch firearms as a house rule, or their knowledge of safe gun storage is out of date.

Currently, there are no federal laws for Child Access Protection, another issue that could lead to a death toll. In addition, storage laws vary from state to state, with common ground being that a firearm not in use should be stored unloaded, separately from ammunition, unassembled, and locked in a secure location such as a safe. When caretakers are lax with these regulations, or if they are not enforced in a particular state, the unthinkable can happen.

Accidental youth shootings are on the rise as well, some involving a home weapon and some involving a family member’s weapon. Children and firearms do not, and should not, mix.

Our Children Are Sick

Child suicide occurs more frequently in rural areas of the country, where a lack of access to mental healthcare has been noted. Adolescents in rural areas are far less likely to receive mental healthcare than those in urban areas, according to the U.S. Department of Health & Human Services. This could mean that at-risk youth aren’t even being identified at school, by a family physician, or by their caretakers. Our healthcare systems are failing our youth, and we are going to funerals as a result. Even in families with at-risk youth who store their firearms properly, there is no guarantee that a child can access one at a friend’s house, or another place where their access remains more open than it should be.

Suicide is the third leading cause of death for young people between the ages of 10-24. Cultural, environmental and mental factors all come into play when evaluating risks, and none should be ignored. Signs of depression in children and teens can include:

  • Withdrawal from social activities
  • Loss of appetite and increased fatigue
  • “emotional flatlining”
  • A preoccupation with death
  • Hostile behavior
  • Neglecting hygiene
  • Risk-taking behaviors such as crossing the street without looking, or the use of substances
  • Giving away belongings, especially those with sentimental value

 We’re Here For You

Responsible gun-owning families and caretakers should take precautions in how they store their firearms, specifically in restricting their access to children. However, we cannot know for certain that a friend or family member who is hosting the youth is storing their firearms properly. Caretakers may not know how to spot risky behavior and red flags for one’s mental health.

We do know that these fatal injuries are still a leading cause of death, and that they are preventable. Negligence on a caretaker’s part must be addressed. If you or a loved one are in need of legal support after a devastating loss, contact us today. We can help.

Are We Making Our Children Sicker?

SSRI activation in children and the misdiagnosis of Bipolar Disorder

Texas mental health attorneyDid you have a good day today? Are you filled with energy, enthusiasm and motivation one day, only to crash the next? These mood shifts are normal for many. The bipolar person experiences them too, but on a more extreme scale. Spending money irresponsibly, delusions of grandeur and engaging in risky or unsafe behavior is a bipolar person’s true manic Monday, one that could last for weeks while they survive on barely any food, sleep or quiet escape from loud, racing thoughts. Depression may quickly follow, confining the sufferer to a shuttered life where even getting out of bed is almost physically impossible.

Bipolar disorder is a devastating mental illness that affects over 5 million adult Americans every year. This mood disorder has been found to run in families, suggesting a possible genetic link and leaving children predisposed to what is often a violent onset of a manic or depressive episode. Many manic episodes require hospitalization, and the disorder’s extreme highs and lows are often the culprit for people losing jobs, relationships, homes and overall stability.

A misdiagnosis of bipolar, however, can be devastating. Medication can backfire. Diagnosis can be made too soon. While the adult and senior mentally ill population are at risk, children carrying a misdiagnosis are vulnerable brains in vulnerable bodies, and the medication they’re prescribed can do more harm than good. SSRI’s in particular can cause symptoms of hypomanic or manic states, leading to a bipolar diagnosis. This is called “SSRI-activation” and is not healthy for a child’s brain.

The Law Offices of Skip Simpson strives to protect the rights to proper care for mentally ill people, and we know how damaging a misdiagnosis can be, especially to children.

Diagnosing Bipolar Disorder

Bipolar disorder is actually somewhat difficult to diagnose correctly. Diagnostic criteria often involve noting the occurrences of episodes over a long period. These “episodes” are characterized by extreme “highs” and “lows” and usually come with a host of behaviors just as extreme, erratic and dangerous as their hosting moods. While lifelong and without a cure, bipolar disorder can thankfully be treated with medication and therapeutic methods.

In adults, bipolar disorder in one of its varying forms (as the disorder exists on a spectrum) typically reaches a full diagnosis in late adolescence into the mid-twenties. Due to a developing brain, it should be cautioned against to diagnose children with such a severe mental illness, though pediatric bipolar exists. Criteria fall into two categories, one for “manic” symptoms, and the other for “depressive” – the two “poles” of the illness. To be diagnosed, these two distinct mood states need to exist for certain lengths of time. These criteria are cited from the Juvenile Bipolar Research Foundation:

Symptoms of a Depressive Episode:

  • Depressed mood most of the day, nearly every day
  • Diminished interest in hobbies or activities
  • Speech may become slow, delayed and even slurred
  • Physical symptoms such as pain, hypersomnia or extreme fatigue
  • Reoccurring thoughts of death or suicide
  • These symptoms must occur every day for at least a week

Symptoms of a Manic Episode:

  • At least one week of abnormal and persistent elevation in mood, including irritability.
  • Decreased need for sleep
  • Delusions of grandeur
  • Potential psychotic symptoms-hallucinations and disconnect from reality
  • Racing thoughts, sometimes to where a sufferer may feel like their head is “crowded” or “loud”
  • Speaking so rapidly that others cannot understand them and speech may not even follow a coherent train of thought
  • Inability to focus or sit still
  • Excessive spending, substance abuse, irresponsible sexual activity or unsafe driving

Bipolar disorder is separated into Bipolar I and Bipolar II, based on the severity and duration of episodes. In addition, there are other criteria that must be met, making bipolar disorder something a professional should not diagnose lightly in a child.

The right medication for the wrong diagnosis

The absence of mania or hypomania is often overlooked when children complain of depressive symptoms and are prescribed selective serotonin reuptake inhibitors, or SSRI’s. Commonly known as antidepressants, when given to children they can relieve symptoms of unipolar depression. However, SSRI’s “activate” roughly 10% of children, meaning they can cause symptoms eerily similar to hypomania or mania. Irritability, fast speech, hyperactivity and even suicidal ideations can occur. Children with ADHD and anxiety are often given SSRI’s, and their “activated” effects can easily lead to a bipolar diagnosis.

Children with developmental disabilities are particularly at risk. Someone who is a “slow metabolizer” of SSRI’s will see problems even on the lowest dosage. Parents often panic when their child reacts to medications, or seems treatment resistant. Being the legal guardian, they can easily misdirect therapy and medication, sometimes demanding a higher dose for a child that seems unresponsive.

Medication should be carefully monitored, as should the child’s symptoms. Parents who believe their children are treatment resistant may simply not be treating the proper condition, such as ADHD or anxiety, which responds better to an atypical antipsychotic drug. Making “one change at a time” in a child’s medication is heavily stressed, according to Dr. Birmaher of the Western Psychiatric Institute and Clinic in Pittsburgh. The brain is a delicate instrument, and providers who switch multiple drugs at once are putting children at risk.

The risks of a misdiagnosis

Suicide in our youth is no new statistic. One suicide every five days is the current standing rate, a 40-year high, for suicide rates in children under 13. Medication may alleviate symptoms but can also put child patients at risk. In 2004, the FDA issued a public warning of an increased risk of suicidal thoughts or behavior in children being treated with SSRI’s. The SSRI’s reviewed included:

  • Fluoxetine (Prozac)
  • Zoloft
  • Paxil
  • Celexa
  • Lexapro
  • Luvox

The black box warning noted that children should be monitored closely. Bipolar disorder is often treated with a “cocktail” of medications. SSRI’s, mood stabilizers and antipsychotics are popular, and all carry warnings. Even so, the use of SSRI’s in children over 10 has increased considerably over time, and those medications persist in their popularity. We can take no chances when treating our youth for psychiatric conditions. We cannot afford to lose any more sisters, brothers, daughters, sons and friends.

We help protect their rights

Every child has the right to be treated with dignity and respect when addressing potential psychiatric concerns, and this includes adhering to the same strict evaluation that adults must endure to properly diagnose a serious mental illness. Combining therapy with medication and lifestyle changes can be particularly effective, whereas prescribing potentially dangerous medication for a condition that is, in fact, something else can be devastating.

If you or a loved one have suffered the terrible consequences of a child misdiagnosed and mistreated, contact us. We may help.