Interview with Dr. Aditi Garg – Child and Adolescent Psychiatrist
Rohil: Can you please describe your clinical background and how you work with people who suffer from mental health illness?
Dr. Aditi Garg: Yes, I am a child and adolescent psychiatrist. For that, I did medical school from India, psychiatry residency at Hennepin-Regions training program and Fellowship in Child and Adolescent Psychiatry from University of MN. I completed my training in 2016 and have been working with Allina Health at their West health location since then. I work at 2 different levels of service, outpatient psychiatry clinic and Partial Hospital program (PHP). While in clinic, I see children from age 4yo onwards and in PHP I see adolescents from 12 – 18 yo age. To further explain what PHP is, it is intensive groups therapy to target severe mental health including 4-6 hrs of daily group therapy for 3-4 weeks. School is usually a part of the program, unless someone chooses to attend their regular school. Since this is very intensive treatment and requires absence from school, it is usually reserved for severe cases that cannot be treated by once-a-week therapy or seeing a psychiatrist once / month and are also not an imminent risk to themselves or others and don’t need to be admitted in a hospital.
Rohil: So I know there is a difference between a psychiatrist and a psychologist. Could you talk about that?
Dr. Aditi Garg: The difference between a psychiatrist and a psychologist is the training they have and the kind of treatment they do. We all treat the same kind of mental health issues. A psychologist is more a master’s level provider or a PhD while a psychiatrist is a physician specializing in the field of psychiatry. Psychiatrist can prescribe medications, in addition to doing therapy vs a psychologist does therapy and , in some cases, psychological testing.
Rohil: What sort of mental illnesses do you treat?
Dr. Aditi Garg: The main diagnoses I treat are depression, anxiety, bipolar disorder, schizophrenia, PTSD, ADHD, autism, developmental disorders with comorbid psychiatric illness.
Rohil: I know COVID has increased the problem, but how would you describe the current state for teenagers in the US and Minnesota and how has it changed during COVID 19?
Dr. Aditi Garg: While I don’t know all the stats by heart, what I do know from personal experience is that the number of kids who are waiting in the ER to get into hospitals has gone up. I also read one research paper from the CDC that supported this point. Overall, there has been a higher need for higher levels of treatments.
Rohil: What are some signs that parents or kids can look for if they suspect mental illness?
Dr. Aditi Garg: Some of the signs of depression or anxiety are not sleeping well, not eating well, not interacting with family and friends as much, wanting to isolate, losing interest in things. These can also present as irritability, which can come across as disrespect / defiance to parents. As teenagers, some mood variation, sleep routine changes, appetite variations and need for privacy is normal but when this comes in the way of functioning or normal parent child interactions, parents should try to intervene. One of the things that often comes to light for parents is when the kids start struggling in school. Parents often notice that their academically bright kid is and start to intervene. That’s one thing we see that there’s a big increase in the number of patients being referred to mental health providers as school starts. In fact, one reason that the number of cases has gone up in the past year is because kids weren’t in school and were doing distance learning. So a lot of things that would become evident in a school environment went unnoticed. Now kids are returning back to in-person school, and this is a big adjustment after not being in school for more than an yr. It is also allowing school staff to observe children who are struggling and provide them with supports and other resources for help and refer them to ER as and when appropriate. Both these factors are seeing an increase in mental health referrals to our ER’s.
Rohil: Is it usually parents who recognize mental illness or is it parents and counselors?
Dr. Aditi Garg: It’s both. Oftentimes, teachers and counselors notice that there’s something wrong or that children are struggling in school. Often, children go to the school counselor because they’re having issues in school and then the counselor goes to the parents and tells them this is what they’re noticing and make suggestion to have them see a therapist. On several occasions, the first time someone finds out about a child struggling with mental health is when they tell someone about feeling suicidal and in those cases, they are usually referred to the ER for further assessment.
Rohil: If parents do find out that their kid is struggling in school or they’re changing, what are some things they should do, any resources or professional treatment you recommend?
Dr. Aditi Garg: First should be getting them assessed. Depending on severity, if they’re starting to see they’re struggling, they should look for a therapist to begin with. The other source could be the primary care, the pediatrician. The pediatrician can then make some referrals for other resources that are available to them. People can usually go through their insurance to find a therapist. Therapists and primary care are normally the best people. If someone is risk of harm to self or others, then they should go to the ER.
Rohil: Also, obviously kids are different ages. So, if you’re a younger kid, parents must do all of this. But if you’re older, what do you think kids can do to seek this help?
Dr. Aditi Garg: I think they should reach out to an adult, whether that be a school counselor or whether that’s a parent. They can even send a message to their Primary Care provider and access mental health treatment, without their parents knowing, if they are above 16 yo. They should reach out to someone they can trust that can get them help. The response of the adult matters a lot. If parents are not responsive, reach out to an adult in school, a teacher, a school counselor or even another adult family member.
Rohil: I don’t have any more questions, but I know you have mentioned stigma as an important issue. So, if you’d like to elaborate on that.
Dr. Aditi Garg: Stigma comes from the beliefs we have around mental health. Mental illness is seen as a sign of weakness and not a disease and children are often told to “buck up” and “deal with it “ . Also, since mental health was not treated in the past, a lot of parents might have dealt with similar issues themselves and struggled through them without any treatment and feel their kids should be able to do the same. Another issue I have encountered recently is fear of mental health diagnosis impacting future career prospects. We address these issues by educating families about mental illness and various available treatments.
Rohil: That portion of future prospects is really interesting and a concern I haven’t really heard about. Does it affect future opportunities?
Dr. Aditi Garg: Not at all. That’s what we educate kids and parents about. I tell them about various successful professionals who have mental illness and are functioning well with treatment.