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A Quick Guide on How to Talk to Children About Mental Health

Posted: February 12, 2018

The following guide was written by Louise Theodosiou, a child and adolescent psychiatrist.

The parents and care takers I meet through my job as a child and adolescent psychiatrist often tell me about young people in their lives who are suffering from anxiety or low mood. I can sometimes hear an element of desperation or hopelessness in their voice, which may come from the fact they have no idea what to do or how to seek help. They want to be able to support the young person in their life, but without having the tools to do so, their confidence as care-givers diminishes and that can have an enormous impact on the whole family unit. 

Schools and community centres have taken steps to ensure that children and parents recognise the value of physical health, from the promotion of fresh fruit and vegetables to the need for regular exercise. But where are the messages about mental health?

This Children’s Mental Health Week we need to do several things: advocate for ways to improve child mental health, encourage children to have time to talk to parents and care takers, as well as encourage them to make friendships and develop interests. There is also a need to understand the signs that children may be experiencing mental health issues in the first place.

These might include feeling anxious or unhappy, concerns about eating or weight and struggling to manage one’s behaviour. Age and maturity are obviously important factors, but signs to watch out for at any age include behaving like a younger child, withdrawing socially, losing interest in activities, struggling to learn or complete schoolwork, tearfulness and not eating or drinking. We know that children need to be safeguarded at all times, and providing a space for a child to say that they are experiencing neglect, bullying or abuse is a key part of maintaining wellbeing. 

Each child has unique strengths and needs that can impact on how they function at home or at school. If a child or young person is displaying signs that they are struggling, it is helpful to consider several different dimensions. Addressing these difficulties at an early stage can reduce secondary difficulties, for example, an impact on self-esteem, learning or school attendance.

Can the child explain that they feel sad or anxious? Listen when they talk to you. These are sensitive topics and words are important. Children may talk about feeling stressed or “not right”: use the language they do to show that you understand. Talking to a teacher, a parent or carer about emotions can be a great relief. There is information available about anxiety and low mood for teachers, parents and care takers in sources such as MindEd, which offers free online training, or the free information sheets on the Royal College of Psychiatrists website. 

If difficulties remain, parents can talk to GPs and teachers. Schools are working increasingly closely with mental health and wellbeing services. Often there are counsellors in school, and teachers and GPs can signpost families to voluntary sector counselling and to child and adolescent mental health services if difficulties are severe. Signs that children may be more unwell include struggling to leave the house, losing interest in their appearance, losing weight, hurting themselves or talking about not wanting to be alive. 

Does the child have a specific difficulty with learning or concentration or social understanding? 

There are situations where learning needs are not picked up and children can develop coping mechanisms that may stop working as they move into high school. The same is true for children who struggle to concentrate or who are very active. Children with social communication difficulties may manage in primary school but struggle as they get older and relationships become more nuanced. 

For difficulties with learning there are often educational psychology services to assess the needs a child may have in school. Many schools and GPs will now have training in how to recognise problems with concentration, overactivity or social communication difficulties. This will include when to refer to paediatrics or child mental health services for a more detailed assessment.

Parents, care takers and teachers know the children in their lives well and will be instinctive in their caring through years of experience. Often, they will know when something is not right and should feel empowered to act on their instincts.

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