What to do if your child is struggling: Steps healthcare professionals can take to help children and adolescents with their mental health

Emerging research suggests that mental health problems among children and adolescents are on the rise. For example, one in four children report experiencing clinically elevated rates of depression, and the rates of emergency room visits for attempted suicide have increased by 22% in recent years.

As clinicians and researchers, we have interacted with thousands of healthcare professionals, many of whom have asked us how they can better understand and support their children’s mental health.

Below we offer a step-by-step guide to recognizing the signs of mental distress and responding with support and resources to help foster recovery and resilience in children and adolescents.

Recognize the signs of distress

Children and adolescents have different reactions to experiences and events, and signs of mental distress may appear different among young people (and may also appear different than in adults).

Changes are normal in children and adolescents, but dramatic and sustained changes are not. Typically, healthcare professionals should look for a combination of:

1. Increased distress, such as increased sadness, irritability, worry, or risk-taking.

2. Changes in daily functioning, such as changes in sleep patterns, diet, physical activity, energy levels, and/or interests, that may subsequently impact their relationships with peers or family members, extracurricula, or academic performance.

Talk to your kids about mental health

We encourage healthcare professionals to have conversations about mental health early and often, whether or not their child or adolescent is struggling. This helps normalize the conversation and helps kids and teens know they can reach out to you when they’re in trouble.

Conversations are especially important when children or adolescents seem to be struggling. You can start by letting them know you care, and then pointing out what you’ve observed in terms of changes in their distress and daily functioning, for example I’ve noticed you’ve been sleeping way more than usual. Have you noticed these changes too? Then ask if you can discuss it further together to deepen the conversation.

If you feel the strategy isn’t working for your child, or if you often get positive responses about how you feel, try the third-person strategy, which can reduce distress during tense conversations.

In this scenario, make a statement about children’s mental health in general, as I’ve heard there are many children and adolescents who are struggling with their mental health right now, and then ask open-ended questions, such as: What do you think? or what have you noticed about your mental health lately?

When having conversations about mental health with your child or teenager, try to minimize any potential discomfort. It’s best to find a time that works well for your child. For example, when they are rested, fed and relaxed.

Also, some children find it difficult to have face-to-face conversations about their mental health. If this is the case for your child or teenager, you could ask them for a walk and strike up the conversation then or when you’re doing something else, like loading the dishwasher or driving to an extracurricular activity. This can relieve the pressure on what might be perceived as stressful face-to-face conversations.

When children and teenagers open up, express empathy for what they are going through, using phrases like that sounds really difficult and/or I understand how painful it can be. Often as a caregiver, we want to move into problem-solving mode, but the most effective approach to supporting children and adolescents is often to listen and validate their feelings and/or discomfort.

Communicating and connecting with children and adolescents, and confirming that they have our support, can foster resilience in times of adversity.

Talk to their teacher

If you remain concerned about your child and would like to gather more information, you may want to speak to their teacher or guidance counselor. Up to 80% of children gain their mental health knowledge from schools. Guidance counselors are specifically trained to deal with mental health issues, and other school staff are used to having mental health conversations with students. They generally welcome these conversations with healthcare professionals.

Teachers can also provide valuable perspective on how a child’s mental health may have changed and what may have precipitated these changes. For example, children may be experiencing learning disabilities or bullying, which they haven’t disclosed to you yet, but which is causing them some discomfort. Guidance counselors and teachers can also help exchange ideas for building coping strategies for children and supporting their success in school.

If possible, ask your child to participate in these conversations so that they feel involved in discussions about their mental health and develop coping action.

Talk to your doctor

Healthcare professionals are trained to assess mental and physical health issues equally. They can formally examine and evaluate mental health problems by asking the caregiver and child questions about changes in mood, behavior, and functioning, and by matching symptoms of distress and impairment with diagnostic criteria for various mental health disorders.

With this knowledge, health professionals can offer strategies and resources to support children and health professionals. They will work directly with healthcare professionals and children to decide on the best approaches to addressing a child’s mental health struggles.

It is also important to inform children of other services they can access for support, such as the Kids Help Phone, which is available by text or telephone 24/7.

Address urgent mental health issues immediately

The above strategies can occur when children and adolescents are not in immediate danger. But when your child is showing warning signs of suicide or engaging in self-harming behavior, get help as soon as possible, including:

• Taking them to the nearest acute hospital.

• If your child won’t go to the hospital or you’re not sure if this is the right thing to do, get help from a healthcare professional as quickly as possible. You can call the health care team or an emergency line.

• If your child is attempting or is about to attempt suicide, do not leave them alone and call 911 immediately.

While supportive in nature, caring for our children’s mental health can also be taxing and/or triggering for many caregivers. To better support children and adolescents, we must also take care of ourselves. We encourage healthcare professionals to prioritize their own mental health, so they can feel energized and empowered to care for their children’s mental health.

If caregivers have concerns about their mental health, we recommend the following resources:

• Wellness Together Canada is a free and confidential service available to Canadian residents. They can give you information about mental health, offer free confidential sessions with health professionals, and provide peer support services.

• Talk to your doctor.
• If you are in crisis, contact Talk Suicide Canada.