19815 Bay Branch Rd
Andalusia, Alabama 36420
(334) 222-2523
HELPLINE: 1-877-530-0002



SCAMHC is an approved Mental Health site for the National Health Service Corps Loan Repayment program.  Find out the program details and see if you qualify by visiting: http://nhsc.hrsa.gov/

SCAMHC is an Equal Opportunity Provider and Employer and maintains a Drug-Free Workplace.

SCAMHC serves all individuals regardless of inability to pay. Discounts for essential services are offered based on family size and income. For more information, contact (334) 222-2523 or our 24/7 Helpline at 1-877-530-0002.



powered by centersite dot net
Child & Adolescent Development: Overview
Basic InformationMore InformationLatest NewsQuestions and AnswersVideosLinksBook Reviews
100 Things Guys Need to Know3 NBS of Julian DrewA Guide to Asperger SyndromeA Tribe ApartA User Guide to the GF/CF Diet for Autism, Asperger Syndrome and AD/HDA Walk in the Rain With a BrainAdolescence and Body ImageAdolescent DepressionAfterAggression and Antisocial Behavior in Children and AdolescentsAll Alone in the UniverseAmelia RulesAmericaAnother PlanetAntisocial Behavior in Children and AdolescentsArtemis FowlAssessment and Treatment of Childhood Problems, Second EditionAutistic Spectrum DisordersBad GirlBetween Two WorldsBeyond AppearanceBeyond Diversity DayBig Mouth & Ugly GirlBill HensonBipolar DisordersBody Image, Eating Disorders, and ObesityBody Image, Eating Disorders, and Obesity in YouthBoyBoysBrandedBreaking PointBreathing UnderwaterBringing Up ParentsBullying and TeasingCan't Eat, Won't EatCatalystChild and Adolescent Psychological DisordersChildren Changed by TraumaChildren with Emerald EyesChildren’s Dreaming and the Development of Consciousness City of OneConcise Guide to Child and Adolescent PsychiatryConquering the Beast WithinContentious IssuesCrackedCutDancing in My NuddypantsDemystifying the Autistic ExperienceDescartes' BabyDilemmas of DesireDirtyDoing ItDoing SchoolDying to Be ThinEating an ArtichokeEducating Children With AutismElijah's CupEllison the ElephantEmerald City BluesEmotional and Behavioral Problems of Young ChildrenEvery Girl Tells a StoryFast GirlsFeather BoyFiregirlForever YoungFreaks, Geeks and Asperger SyndromeFreewillGeography ClubGeorgia Under WaterGirl in the MirrorGirlfightingGirlsourceGirlWiseGLBTQGood GirlsGoodbye RuneGranny Torrelli Makes SoupGrowing Up GirlHandbook for BoysHealing ADDHeartbeatHelping Children Cope With Disasters and TerrorismHelping Parents, Youth, and Teachers Understand Medications for Behavioral and Emotional ProblemsHollow KidsHow Children Learn the Meanings of WordsHow to Keep Your Teenager Out of Trouble and What to Do If You Can'tHug MeIntrusive ParentingIt's Me!It's Perfectly NormalJake RileyJoey Pigza Swallowed the KeyJuvenile-Onset SchizophreniaKeeping the MoonKilling MonstersKim: Empty InsideKnocked Out by My Nunga-NungasLaura Numeroff's 10-Step Guide to Living with Your MonsterLearning About School ViolenceLeo the Lightning BugLet Kids Be KidsLiberation's ChildrenLife As We Know ItLisa, Bright and DarkLittle ChicagoLord of the FliesLoserLove and SexLove That DogManicMastering Anger and AggressionMind FieldsMiss American PieMom, Dad, I'm Gay.MonsterMore Than a LabelMyths of ChildhoodNew Hope for Children and Teens with Bipolar DisorderNo Two AlikeNot Much Just Chillin'Odd Girl OutOdd Girl Speaks OutOn the Frontier of AdulthoodOne Hot SecondOne in ThirteenOphelia SpeaksOphelia's MomOur Journey Through High Functioning Autism and Asperger SyndromeOut of the DustOvercoming School AnxietyParenting and the Child's WorldParenting Your Out-Of-Control TeenagerPediatric PsychopharmacologyPeriod PiecesPhobic and Anxiety Disorders in Children and AdolescentsPINSPraising Boys WellPraising Girls WellPretty in PunkPrincess in the SpotlightProblem Child or Quirky Kid?Psychotherapy As PraxisPsychotherapy for Children and AdolescentsRaising a Self-StarterRaising BlazeRaising Resilient ChildrenReclaiming Our ChildrenRedressing the EmperorReducing Adolescent RiskRethinking ADHDReweaving the Autistic TapestryRineke DijkstraRitalin is Not the Answer Action GuideRunning on RitalinSay YesSexual Teens, Sexual MediaSexuality in AdolescenceShooterShort PeopleShould I Medicate My Child?Skin GameSmackSmashedStaying Connected to Your TeenagerStick FigureStoner & SpazStop Arguing with Your KidsStraight Talk about Your Child's Mental HealthStrong, Smart, & BoldStudent DepressionSurvival Strategies for Parenting Children with Bipolar DisorderSurviving OpheliaTaking Charge of ADHD, Revised EditionTaming the Troublesome ChildTargeting AutismTeaching Problems and the Problems of TeachingTeen Angst? NaaahThat SummerThe American Psychiatric Publishing Textbook Of Child And Adolescent PsychiatryThe Arctic IncidentThe Bipolar ChildThe Buffalo TreeThe Bully, the Bullied, and the BystanderThe Carnivorous CarnivalThe Depressed ChildThe Developing MindThe Dragons of AutismThe Dream BearerThe Dulcimer Boy The Einstein SyndromeThe EpidemicThe Eternity CubeThe Explosive ChildThe Field of the DogsThe First IdeaThe Identity TrapThe Inside Story on Teen GirlsThe Little TernThe Mean Girl MotiveThe Men They Will BecomeThe Myth of LazinessThe New Gay TeenagerThe Notebook GirlsThe Nurture AssumptionThe Opposite of InvisibleThe Order of the Poison OakThe Other ParentThe Present Moment in Psychotherapy and Everyday LifeThe Real Truth About Teens and SexThe Rise and Fall of the American TeenagerThe Secret Lives of GirlsThe Sex Lives of TeenagersThe Shared HeartThe Spider and the BeeThe StepsThe Thought that CountsThe Unhappy ChildThe Vile VillageThe Whole ChildThen Again, Maybe I Won'tTherapy with ChildrenThings I Have to Tell YouTouching Spirit BearTrauma in the Lives of ChildrenTreacherous LoveTrue BelieverTwistedUnhappy TeenagersWay to Be!We're Not MonstersWhat about the KidsWhat Would Joey Do?What's Happening to My Body? Book for BoysWhat's Happening to My Body? Book for GirlsWhen Nothing Matters AnymoreWhen Sex Goes to SchoolWhen Your Child Has an Eating DisorderWhere The Kissing Never StopsWhose America?Why Are You So Sad?WinnicottWorried All the TimeYes, Your Teen Is Crazy!You Hear MeYoung People and Mental HealthYour Child, Bully or Victim?
Related Topics

ADHD: Attention Deficit Hyperactivity Disorder
Childhood Mental Disorders and Illnesses

by John S. Lyons
Praeger, 2004
Review by Gerda Wever-Rabehl, Ph.D. on Mar 7th 2006

Redressing the Emperor

John S. Lyons' thoughtful commentary on children's mental health care systems, as well as his contemplations on the ways in which these systems can improve, makes Redressing the Emperor. Improving Our Children's Public Mental Health System a source of information and deliberation for parents, mental health care workers, teachers and other advocates for kids who need mental health care. He steers clear of that what would be all too easy- taking potshots at a spectacularly troubled system. Instead, he delivers a vision. Lyons supports his vision not only with a set of principles but, more importantly, with an abundance of pragmatic and often simple solutions to specific problems and contexts. The realities of children who need mental health care cannot be reduced to an academic or theoretical question, but can only be dealt with in the context of concrete situations. It has to do, as Gabriel Marcel would have it, with the effort to imagine the particular. Lyons' work embodies this imaginative effort, and connects it with a reconsideration of children's public mental health care.  This is the strength of Redressing the Emperor -- Lyons' ability to imagine the particulars of the context of the children, their families and communities, enables him to step across the traditional boundaries of disciplines and to offer a remarkably refreshing, novel, pragmatic and multidisciplinary vision.

Not surprisingly then, many of the topics discussed by Lyons are grounded in a solid understanding of their complexities and backgrounds. Moreover, in discussing the various aspects of children's mental health care, Lyons often departs from community-based contexts. For example, Lyons describes evidence-based practices in their historical as well as community contexts. Based on these contexts, Lyons suggests that evidence-based practices for kids can include many "things that are not traditionally thought of as treatment" (p. 40), for example, funding music lessons. Yet knowing that music lessons or other strength-building interventions work for kids can be -and is- at odds with the ways in which health insurance works.   Beginning in chapter 3, but throughout the text, Lyons offers a number of principles as well as pragmatic ideas and suggestions to foster working with practices such as evidence-based practices in more flexible and therefore more advantageous ways.

Lyons develops these and other principles and implications in chapter 5. In this chapter, titled, The Measurement and Management of Outcomes in a Total Clinical Outcomes Management Approach, Lyons presents a process, or a set of strategies, that allows for the management of service delivery across all levels- from children and families to the structural level of programs to the institutional level of organizations and further. Lyons' transparent and common sense approach shows that community development and a more effective Clinical Outcomes Management has the potential to alleviate many of the tensions identified in chapter 2, Problems with the Current System: Tensions and Syndromes. While presented with a healthy dose of modesty, Lyons' Clinical Outcomes Management Approach is a process that has the potential to do so, and as a consequence, to manage mental health care for kids more effectively.

Similarly perceptive in scope and insight is chapter 7, Creating Solutions across the System of Care in which Lyons offers practical suggestions to enhance family involvement and accountability across the spectrum of care. Lyons does not approach the question of accountability, unlike a number of other prominent texts on children's mental health care, as a general or theoretical issue. Lyons approaches it instead as a very pragmatic and multidisciplinary question and provides a refreshingly practical array of ideas and suggestions, indeed for all of those across the spectrum of care.

I would like to make some critical comments regarding chapter 1, The History of Children's Public Mental Health Services. While the chapter intents to provide the reader with an overview of historical trends in public mental health care for kids, it does not live up to its title. Rather than presenting The history, the chapter presents a brief, and somewhat troubled, overview of the contemporary history of children's public mental health services.

Lyon begins his history of children's mental health care with the Renaissance and the beginning of the industrial revolution, since this is the time when, according to Lyon, efforts are first made to meet the needs of children. Lyon writes that during that time a variety of strategies to address problems of children were introduced, initially "to contain them and eventually to help them" (p. 1).

I would argue that these efforts started much earlier on in history. In fact, I would argue that they are as old as mental illness itself.  Furthermore, I would argue that efforts to "contain" or to "help" are not made in a linear movement toward progress, but that they rather swing back and forth throughout history, like the movement of a pendulum.

Greek, Roman and Spartan societies for example, sought by and large, to "contain" the problem of mentally ill children by infanticide and, in some cases, eugenics. One of the very few ways in which children with a mental disorder could fulfill some kind of public position in these societies was to perform a role as a clown and to provide entertainment for the wealthy (although as always, there are exceptions- the pocket of humanity offered by the Roman emperor Vespasian comes to mind).

The rise of Christianity, accompanied by proclamations against selling, killing and mutilation of children with a mental illness caused not only a decline in these practices but also a change in the way in which mental illness was perceived. This change was no doubt further influenced by the introspective work of the "father of psychoanalysis", Saint Augustine. And the pendulum swung from "containment" towards "help". The Bishop of Myra, for example, ran a residential care and treatment centre in the fourth century. Yet later, influenced by, amongst other things, the inquisition, the pendulum swung back again toward "containment" and many people with a mental illness, including children, died on the stake.

The Reformation offered little relief and for a while, the only hope for children with a mental illness to find a place in society was, once again, to perform as clown for wealthy citizens.

With the age of Romanticism, the pendulum swung toward "helping" again. It was during this time that Jean Jacques Rousseau, Maria Montessori, and Jean Marc Gaspard Itard left their mark on the ways in which mental illness was understood and treated. It is here where Lyon starts off his historical overview. I agree with Lyon that Itard's work has been very important and influential (much of the work done with children with severe developmental delays is still, by and large, based on the same sensory-training approach developed by Itard while working with the Wild Boy of Aveyron). Yet Lyon's observation that Itard's work "represents a critical event in beginning to turn public opinion toward a less stigmatizing view of mental illness" (p. 3) is a far too optimistic observation, misled by a common but false faith in progress.

Dangerously optimistic is Lyons comment that "in the past century we have appeared to make progress in reducing the unfairly negative views" (p. 3). In this past century, and not long after Itard's work, the pendulum did swing back hard toward "containment" when the Eugenics came along. In the late eighteenth and early twentieth century, they aimed once again to protect society from the "defective element" by removing it altogether (compulsory sterilization continued on a broad scale well into the 1950' and 1960s).

Perhaps one reason why Lyons' historical analysis falls short is that the social construction of mental illness almost defies a systematic socio-historical analysis of mental illness. Looking at this social construction, especially in a historical context, does not simply mean, as Lyons maintains, to presume that "mental health challenges reside outside of the individual" (p. 33). Instead, post-modern and critical perspectives, so easily dismissed by Lyons, emphasize that we don't just see: we see as. The way we construct, or see (and consequently treat) mental illness is rooted in the past and this construction goes hand in hand with presumptions about the world, humanity, human potential and equality. Seen that way, the past is a central concern- for individual lives as well as for our social institutions.

Notwithstanding this note of criticism, Redressing the Emperor's multidisciplinary pragmatism makes it a worthy read for all professionals and parents concerned with the mental health of children. Lyons tackles public mental health in its complexity and helps the reader navigate its complex webs of services, practices and systems. Redressing the Emperor is a powerful commentary on the state of affairs of public mental heath care for children and an even more powerful commentary on what can be done to improve it. Regarding the latter, Lyons' Total Clinical Outcome has the potential to see and supported children in need of mental health care effectively, responsibly and with accountability.


© 2006 Gerda Wever-Rabehl


Gerda Wever-Rabehl holds a Ph.D from Simon Fraser University, and has published extensively in the areas of social science, philosophy and philosophy of education.