Unlike common childhood physical injuries, where a band-aid or brace may be an obvious solution, parents often wonder whether behavioral changes and emotional ups and downs are expectable parts of the developmental progress, or signs that additional care might be needed.
Just as you’d be there to provide first aid for a cut or scrape, there are important steps to take when a child experiences a rough patch or crisis in their emotional life. Knowing what to do in these moments could make a huge difference in a child’s life.
What are signs that support and help may be needed for mental health concerns in children and adolescents?
- Significant changes in mood or behavior, such as loss of self-confidence, increased irritability, problems sleeping, declining school performance or loss of interest in previously valued activities
- Increasing isolation or withdrawal from family, a dramatic transition in the child’s group of friends or avoidance of school or other activities typical of similarly aged peers (such as sleepovers or other social activities)
- Deterioration in self-care, like not eating or neglecting hygiene
Step one: Talk about it together
Let your child know you’ve noticed a change and are concerned. It’s important to clearly convey that this is an expression of caring, not criticism. Ask if there’s something going on that is worrying them at school, home or elsewhere. Is anyone hurting or mistreating them? Make clear your willingness to listen without judging. It’s important to listen sympathetically rather than initially challenging their perspective or jumping in to offer advice.
You can and should ask directly if they’re having thoughts of hurting or killing themselves. Threats of self-injury or suicidal urges warrant immediate intervention, and you should bring your child to their primary care physician, a community mental health clinic (in Virginia, most have walk-in urgent care appointments) or to an emergency room for evaluation.
Step two: Take action
If there’s an identifiable problem, such as conflicts with friends, bullying, a troubled romantic relationship, anxiety about schoolwork or worries about family issues, appropriate interventions may become clear. Although parental action may turn out to be necessary to address the problem, it’s important to talk with the child about what they’d like to see happen, and what strategies they believe will accomplish that change.
It may be that parental support in the background can enable the child or teen to take steps to handle the problem themselves, for example asking a teacher for additional help outside of class, joining (or resigning from) an extracurricular activity, or reporting a concern about another student to the school counselor.
It may be appropriate for the parent to schedule a meeting with the child’s teacher to discuss the problem and what is needed for positive change or to talk about the issue with a coach or other adult leader.
Step three: Access professional help
If there’s not a clearly identifiable problem, or if the strategies you try first don’t resolve the problem, it’s reasonable to seek additional help. Your child’s primary care provider, a school counselor or your pastor/religious leader are people who can recommend trusted mental health professionals to guide your next steps. Our Virginia Treatment Center for Children also offers family navigators through the Cameron K. Gallagher Mental Health Resource Center who can assist in locating therapists in your community. You can call (804) 828-9897 to access this free service.
Building your mental health first aid kit
Parents and caregivers can lay the groundwork for being able to provide mental health support if and when it’s needed. Just as healthy habits are important to support physical growth and development, so is attention to healthy mental and emotional development. Your child’s pediatrician will assess these developmental milestones during regular checkups,
Parents can stay attuned to their child’s mental and emotional development by staying aware, or becoming more aware, of what expectable challenges face kids at various ages, keeping in mind that social media may expose kids to these challenges at an earlier age then what we may recall from our own experience.
Developing/nurturing good communication with your kids and conveying openness to hearing about what’s going on in their lives and respect for their concerns sets the stage for kids to be willing to ask for help if they feel they need it. This will also allow parents to better recognize red flags like the signs listed above, should they occur.
The American Academy of Child and Adolescent Psychiatry publishes a Facts for Families Guide, a series of brief articles covering common problems that children and families encounter, which can be a helpful resource.
As the people who care most deeply about the child’s well-being, and who are most familiar with their personality and preferences, parents will often be the first to recognize that something has changed. Like other health issues, mental health problems can be resolved most easily when they’re recognized early, before additional complications set in. Mental health professionals know that families are the foundation of the child’s earliest development and parents are likely their child’s strongest and most dedicated advocates.
By Dr. Dorothy O’Keefe, psychiatrist