Child Mental Health
Children can be affected by many of the same mental health challenges as adults, such as anxiety or depression. However, these problems can be difficult to identify in children, who don’t always have the communication skills to tell us how they are feeling.
Untreated mental health concerns can have long-term impacts on the health and wellbeing of children. As a parent, it’s important to know the signs so that you can seek early assessment, diagnosis, and treatment. This can make a huge difference to the rest of the lives of children.
Types of child mental health issues
Many mental health disorders can occur during childhood, including:
- Obsessive compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Oppositional defiant disorder
- Conduct disorder
Children may experience neurodevelopmental conditions that affect their behavior and emotions, such as:
- Attention-deficit/hyperactivity disorder (ADHD)
- Autism spectrum disorder (ASD)
- Intellectual disabilities
- Communication disorders
- Learning disorder
- Motor disorders such as Tourette’s disorder
Prevalence of mental health challenges in children
National survey data suggests that between 14 and 20% of children in America experience a mental health disorder in any given year (1). Some of the most common mental health conditions diagnosed in children are (2):
- Behavior or conduct problems (7.4% of children aged 3-17 years)
- Anxiety (7.1% of children aged 3-17 years)
- Depression (3.2% of children aged 3-17 years)
Signs of mental health challenges in children
It can be hard to know if children are experiencing mental health challenges because they can’t always tell us what they’re feeling. The following symptoms in your child may benefit from a visit with your pediatrician:
- Complaints about feeling sick or have physical symptoms like stomachaches (that don’t have a medical explanation)
- Frequent crying, distress, or tantrums
- Clingy behavior or distress with separation from their caregivers
- Excessive active behavior and difficulty being still
- Difficulty paying attention
- Nightmares, appearing sleepy during the day, sleeping more or less than usual
- Frequent mentions of worries or fears
- Lack of interest in playing with other children, or difficulty forming friendships
- Difficulties at school or struggles with their schoolwork
- Aggressive behavior
If you are concerned about your child’s mental health, seek an evaluation from a pediatrician or child therapist. This is of particular importance if the symptoms last longer than two weeks or are interfering with their daily lives at school or home.
Treatment options for children with mental health challenges
If you think your child is experiencing behavioral or emotional challenges, consider one or more of the following options:
- Therapy: Therapy is an important part of a treatment plan to improve mental health. A specialized child therapist with training in the particular condition your child is experiencing will be able to help, usually with the parent’s involvement. See more tips below on types of therapy and selecting a therapist.
- Check-ups: It’s important to have a check-up with your child’s doctor or pediatrician. They can refer you for an evaluation with an appropriate specialist, help you to get treatment, or rule out physical conditions that may contribute to your child’s symptoms.
- Medication: Depending on your child’s diagnosis, medication may be prescribed. If you think medication may be necessary, consider arranging a review with a child psychiatrist, who is a specialized mental health professional with advanced medical and psychiatric training. They will be able to evaluate your child and prescribe any appropriate medication.
- School supports: Schools usually have a counselor who can help identify if your child is struggling at school. They may also be able to provide assessment, therapy, and support your child at school practically and/or emotionally. Depending on the problem, schools may be able to adjust your child’s program or make accommodations
- Parent training: Participating in parent training does not mean that you are a bad parent! It’s just another way that you can learn how to best support your child. If your child has a diagnosis of ADHD or disruptive/conduct disorders, parent training can help you learn new skills to improve your ability to manage their behavior. The Center for Parent Information and Resources website has a list of Parent Training and Information Centers and Community Parent Resource Centers across America.
- Hotlines: If you need immediate support, call the National Suicide Prevention Hotline at 1-800-273-8255. Some helplines specialize in specific childhood disorders, such as the ADHD Information line at 1-800-233-4050. If you think a child is in danger or at risk, contact the Childhelp National Child Abuse Hotline at 1-800-422-4453.
Therapy for children
Many effective types of talk or play therapy can help improve the emotional, social, and behavioral wellbeing of children. Some involve the child alone, while others involve the parent or the whole family. Almost all therapy types for children require that parents incorporate learnings from sessions into the home environment, where children spend the most time.
Therapy types to consider include:
- Play Therapy, such as Sand Tray Therapy: Play therapy approaches, such as sand tray therapy, can help enable children to find new ways of expressing themselves nonverbally and learn skills for interacting appropriately with others. This can be of particular benefit to children who have a developmental disorder diagnosis, but is typically the recommended treatment approach for most children in therapy.
- Cognitive Behavioral Therapy (CBT): CBT improves the mental health of children by helping them become aware of and then change their unhelpful thoughts, feelings, and behaviors. CBT is effective in both individual or group contexts, and is particularly helpful for children having difficulty with anxiety, depression, or PTSD.
- Trauma-Focussed Cognitive Behavioral Therapy (TF-CBT): This is a specialized type of CBT that can help children who have experienced trauma. Trauma may include loss of a sibling or parent, abuse or neglect, a serious accident, or witnessing domestic violence, for example. Both the child and parent (or caregiver) are participants, and the goal is to help reduce the child’s trauma symptoms. Other types of trauma-informed therapy can also help.
- Family therapy: The involvement of the whole family in sessions through family therapy provides a forum for family members to understand and learn how best to support the child.
- Parent-Child Interaction Therapy: This helps parents of children with behavioral issues. More suited to younger children, both the child and parent/caregiver participate in therapy. The therapist observes interactions between the two and coaches the parent to help develop the relationship and respond effectively to challenging behavior.
- Applied Behavior Analysis (ABA): ABA is an evidence-based type of therapy commonly used for Autism Spectrum Disorder (ASD). ABA helps build positive behaviors and discourage unhelpful behaviors. It provides skills training to aid communication, social interactions and engaging at school.
- Behavior Therapy: This therapy can help improve the behavior of children struggling with ADHD, for example. The therapist often focuses on teaching parents skills and strategies to help modify their child’s behavior.
What to look for in a child therapist
There are several factors to keep in mind when selecting a child therapist, including:
Specialization: Look for a therapist who has experience and specialized training in working with children as well as the particular challenge your child is experiencing. Therapists for young people often identify themselves as “child and adolescent therapists,” or will have “children”, “adolescents”, or “teenagers” indicated as a clientele type on their website or online profile. If you are seeking medication management for your child, look for a psychiatrist who is board certified in child psychiatry.
Qualifications: With so many different provider types available, it can be difficult to decide which type of mental health professional to see. The most important thing is to look for a currently licensed therapist. That said, if you think medication might be necessary, make sure you see a child psychiatrist, as this particular type of mental health professional is able to prescribe.
Personal fit: The trusting relationship between client and therapist, known as the “therapeutic alliance” can have a huge impact on the efficacy of therapy. As such, it’s important to look for a therapist with whom your child feels comfortable.
The best way to judge how you might feel about a therapist is to ask for a preliminary phone call. This also allows you to ask about:
- Their experience working with children
- Whether they involve the parents or family
- What therapy with them will be like
Try to speak to a few different therapists before deciding on a provider.
Sources and references
- (1) “Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities”. Accessed online December 2019 at https://www.ncbi.nlm.nih.gov/books/NBK32776/
- (2) Ghandour, R.M., et al., 2019, “Prevalence and Treatment of Depression, Anxiety, and Conduct Problems in US Children”, The Journal of Pediatrics. Accessed online December 2019 at https://www.jpeds.com/article/S0022-3476(18)31292-7/fulltext
- National Institute of Mental Health, “Children and Mental Health”. Accessed online December 2019 at https://www.nimh.nih.gov/health/publications/children-and-mental-health/index.shtml
- Centers for Disease Control and Prevention, “Children’s Mental Health”. Accessed online December 2019 at https://www.cdc.gov/childrensmentalhealth