Is autism a form of mental illness?

imagesI came across this opinion piece from Priscilla Gilman in the New York Times earlier this week after the link was tweeted by Autism Speaks…one particular section jumped out at me…

Whether reporters were directly attributing Mr. Lanza’s shooting rampage to his autism or merely shoddily lumping together very different conditions, the false and harmful messages were abundant.

Let me clear up a few misconceptions. For one thing, Asperger’s and autism are not forms of mental illness; they are neurodevelopmental disorders or disabilities. Autism is a lifelong condition that manifests before the age of 3; most mental illnesses do not appear until the teen or young adult years. Medications rarely work to curb the symptoms of autism, but they can be indispensable in treating mental illness like obsessive-compulsive disorder, schizophrenia and bipolar disorder.

There were at least two misconceptions in this attempt to clear up the misconceptions… mental illness is very common in children and teens. According to the National Institute of Health,

Mental illness is not uncommon among children and adolescents. Approximately 12 million children under the age of 18 have mental disorders. The National Mental Health Association has compiled some statistics about mental illness in children and adolescents:

  • Mental health problems affect one in every five young people at any given time.
  • An estimated two-thirds of all young people with mental health problems are not receiving the help they need.
  • Less than one-third of the children under age 18 who have a serious mental health problem receive any mental health services.
  • As many as 1 in every 33 children may be depressed. Depression in adolescents may be as high as 1 in 8.
  • Suicide is the third leading cause of death for 15- to 24-years-olds and the sixth leading cause of death for 5- to 15-year-olds.
  • Schizophrenia is rare in children under age 12, but it occurs in about 3 of every 1,000 adolescents.
  • Between 118,700 and 186,600 youths in the juvenile justice system have at least one mental illness.
  • Of the 100,000 teenagers in juvenile detention, an estimated 60 percent have behavioral, cognitive, or emotional problems.

The other “misconception” was the statement that autism is not a mental illness. Again, per the National Institute of Health

A mental illness can be defined as a health condition that changes a person’s thinking, feelings, or behavior (or all three) and that causes the person distress and difficulty in functioning. As with many diseases, mental illness is severe in some cases and mild in others. Individuals who have a mental illness don’t necessarily look like they are sick, especially if their illness is mild. Other individuals may show more explicit symptoms such as confusion, agitation, or withdrawal. There are many different mental illnesses, including depression, schizophrenia, attention deficit hyperactivity disorder (ADHD), autism, and obsessive-compulsive disorder.

Do I think this distinction is important? Not really. Are there people in the autism community who think the distinction is important? Absolutely. And that’s the point of this post.

Because of extensive media coverage and public education, the stigma associated with autism has largely disappeared. But the stigma associated with mental illness has largely remained. And that’s especially true in the church.

The public gets that kids and adults who have autism aren’t at fault for their condition. But problems with mental illness are widely attributed to poor or indifferent parenting, sloppy diagnosis or nefarious behavior on the part of pharmaceutical companies. And in the aftermath of the Sandy Hook shooting, media reports that the perpetrator had been diagnosed with Asperger’s Disorder led to fear that persons with autism would be tarred with the same brush used to stigmatize persons with mental illness and their families.

The reaction of many in the autism community says far more about the stigma that continues to be associated with mental illness in our culture. While the church has made great progress in serving kids with developmental disorders like autism in the past ten years, the greatest failing (and biggest piece of unfinished business) for Key Ministry from our first ten years is that we haven’t been effective at doing more to advance the cause of kids with mental illness and their families in the church.

Families impacted by mental illness are our modern day lepers in the church. And we all know how Jesus felt about lepers.

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About drgrcevich

Dr. Stephen Grcevich serves as Director of Strategic Initiatives and Medical Director of Key Ministry, a non-profit organization providing free training, consultation, resources and support to help churches serve families of children with disabilities. Dr. Grcevich is a graduate of Northeastern Ohio Medical University (NEOMED), trained in General Psychiatry at the Cleveland Clinic Foundation and in Child and Adolescent Psychiatry at University Hospitals of Cleveland/Case Western Reserve University. He is a faculty member in Child and Adolescent Psychiatry at two medical schools, leads a group practice in suburban Cleveland, and continues to be involved in research evaluating the safety and effectiveness of medications prescribed to children for ADHD, anxiety and depression. He is a past recipient of the Exemplary Psychiatrist Award from the National Alliance on Mental Illness (NAMI). Dr. Grcevich was recently recognized by Sharecare as one of the top ten online influencers in children’s mental health.
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5 Responses to Is autism a form of mental illness?

  1. SNAPPIN' MINISTRIES says:

    Thank you, thank you, thank you! While it frustrates the heck out of me that the media blame Lanza’s massacre, it equally frustrates me how those with a mental illness are still marginalized. The church still has MUCH to do in this area of love and acceptance!

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  2. Max Forrey says:

    Steve, I would agree with you on most of these points, except one. To say that persons with autism are no longer stigmatized has NOT been the experience of many of our families. If we believed that we were on “solid ground” so to speak, there wouldn’t have been the overwhelming backlash from the autism community that has been witnessed in the last few days. Unfortunately, there still remains a general fear and marginalization of persons with autism in the greater community. Like other “mental illnesses”, we who live with autism daily are still struggling to have our children understood and accepted by the community at large. And what headway we have made we hate to see wiped out with one horrific incident such as this. Additionally, I would also venture to say that most of the population does not even realize that there ARE differences between “mental/developmental” categories…to too many of the misinformed, ANYONE with a “diagnosis” is simply “crazy”.
    However, I will be honest. I do not want my daughter painted with the same brush as a mass murderer based solely on the “name” of her condition, nor would you…whether it be autism, bi-polar disorder or any other neurological condition. As we know, degrees of severity and treatment are huge factors in projected outcomes for individuals with all types of disorders. THAT is where the misconceptions come into play…and again, where I blame the media. The media is generating a spirit of fear based on a “label” rather than the individual case, which we really know all too little about to even speculate. (I DO find it interesting that it has come to light that this young man spent countless hours playing violent “real life” video games…and in my opinion, THAT should be the first area of examination, as it appears to be a common thread between many of the recent perpetrators of mass killings, diagnosis or not.)
    But unfortunately, the “haters” and “fear-mongers” have NOT left the building…just read a few posts in national news forums that this young man’s “label” has generated toward people with ASD. It is frightening. And it would remain frightening if his label was Aspergers or another mental or developmental condition. Partly why we parents fight so hard against the labels and sterotypes that accompany them, that are put on our kids!
    In closing, I feel that we should all continue the fight….just not against others within the disability community, but against the mis-education of the world! I continue to applaud all that you do to promote God’s grace for ALL of those who yearn for greater acceptance and understanding. Thank you for this post…very thought provoking!

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  3. Priscilla says:

    Steve, I’m the author of the NYT piece, and I must that you misrepresented my article in your brief excerpts. First, I did not say that mental illness is uncommon in adolescents and teenagers- my point was that it does not usually emerge in infants or young children whereas autism is a disorder whose symptoms are present often from birth and always from before the age of three. Most of the statistics you cite refer to teenagers- over the age of 12- and they actually support my contention that mental illness typically emerges in the teen (13-19) or young adult (18-25) years.
    Moreover, autism is NOT considered a mental illness by virtually all professionals who treat children on the spectrum and certainly not in the sense the media was using the phrase.
    I couldn’t agree with you more about not wanting to split into factions and not privilege one disorder over another. I certainly did not intend to stigmatize people with mental illness, but merely to point out that treatment modalities are different than for autism as medications do work very well with most forms of mental illness but not with autism and symptoms tend to emerge much later than with autism, which is a disorder appearing within the first three years of life that affects everything from motor development to language acquisition to sensory processing. In addition, I took care to emphasize that only a tiny subset of the mentally ill are ever violent and that everyone needs our compassion. I emphasized that most people with mental illness are not violent and that all all all children deserve support and respect for their individuality. Thanks for your passion in supporting efforts to de-stigmatize autism AND mental illness.

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  4. drgrcevich says:

    Hi Priscilla,

    I’m honored that you replied to my post.

    Actually, mental illness is quite common, even in young children. Check out this study in the July, 2010 issue of the Journal of the American Academy of Child and Adolescent Psychiatry that was funded by the NIMH…

    http://www.jaacap.com/article/S0890-8567(10)00318-7/abstract

    To summarize:

    22 % of U.S. children entering first grade met criteria for at least one mental disorder. Kids with autism spectrum disorders or developmental disabilities were excluded from this sample. The most common condition experienced was Simple Phobia (9.0%). Other common conditions included ADHD (8.7%), Oppositional Defiant Disorder (8.4%), Separation Anxiety Disorder (2.1%) and Tic Disorders (1.7%).

    I’m also surprised that you’d think autism isn’t considered to be a mental illness. My peers in child and adolescent psychiatry would certainly consider autism to be a mental illness, and the outcry from the autism community when Asperger’s Disorder was eliminated from the Diagnostic and Statistical Manual of Mental Disorders would seem to suggest that many in the community would like Asperger’s to retain its’ place in the classification of mental disorders. While my sample may be skewed, experience suggests that kids on the spectrum with typical to above-average intelligence are more vulnerable to comorbid mental health conditions, including anxiety disorders, Obsessive-Compulsive Disorder and ADHD.

    Thanks again on behalf of your advocacy for kids with autism spectrum disorders and their families! Every voice is invaluable in battling the stigma that continues to exist in society for kids with brain-based disorders and their families.

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  5. Pingback: Downplaying the DSM | Counseling One Another

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