When a child is sick, needs a vaccination or gets bumped or bruised, most parents don’t hesitate to make a trip to the doctor’s office. But what happens when a child’s feeling blue, overly anxious or struggling to focus in school? This month, in recognition of Mental Health Awareness Month, doctors offer tips for parents to keep kids mentally and emotionally well, and explain what to do when there’s a problem.
Carol M. Rockhill, MD, PhD, and Ian M. Kodish, MD, PhD, child and adolescent psychiatrists at Seattle Children’s Hospital, say first and foremost, we need to relearn the way we view mental health.
Being mentally healthy doesn’t mean a child will never experience times or days when they feel sad, anxious or upset. Mental health is being free from symptoms of significant mental illness, symptoms that disrupt a child’s normal life. Rockhill explains that it’s normal to experience some degree of mental health symptoms, whether it’s anxiety, depression or distractibility.
“Part of the goal of Mental Health Awareness Month is to decrease the stigma that only a minority of people are affected by mental illness. It’s a ubiquitous problem, one that all of us have susceptibility to,” says Rockhill.
Talk to your kids about their emotions
It starts with interaction and conversation.
Parents play a pivotal role in a child’s mental health. “Parents are often the most in tune with the emotional tone of a child,” says Kodish. “Kids express their emotions much more through their behaviors, and may have a poor understanding of their own emotional states.”
Because mental health issues are more common than we often acknowledge, “parents need to have an ongoing conversation with children: learn how to be in tune with a child, experience life with them and understand when something isn’t going right in their life,” says Rockhill.
It’s important for parents to recognize when there is a problem and address the issue, without judgement. Don’t be afraid to ask how a child felt about a certain situation or event that occurred at school or at home. Asking a child if they’re feeling sad or down may open up conversation, which can lead to a better understanding of their emotions.
Tips for improving mental health
Kodish and Rockhill explain that the same basics principles that promote good physical health are also important for kids’ mental health: adequate sleep, regular exercise and open lines of communication with trusted adults.
In addition, says Kodish, parents should provide regular opportunities for connecting and making sure they’re modeling good priorities for emotional health through their own behavior. Parents should also be comfortable setting limits that nurture a sense of resilience and responsibility and try to reinforce behaviors that show good awareness of a child’s needs and the needs of others. For instance, some families benefit from a visual schedule of activities through the week, which should include not only choices directed by children, but also expectations of their responsibilities. This can highlight the role that all family members play in supporting each other, provide a consistent opportunity for parents to connect with their kids over enjoyable activities and convey the importance of making time for activities that enhance connectedness and quality of life.
Parents should also help children develop skills for filling unscheduled time, limiting screen time to 1- 2 hours per day, advises Rockhill.
For teens, set a curfew, have open conversations about drugs and alcohol and let them know they are welcome to call home without punishment if they are in a situation where other people are participating in unsafe activities and they don’t want to participate.
How to know when something is “off”
Mental health issues can be hard to identify because they can vary so much, depending on a child’s age or mental illness. “It may be hard for a parent to determine whether a child is just going through a phase, where they’re just sad or stressed, as opposed to when it crosses the line to a clinical level,” says Rockhill. When in doubt, seeking the consultation of a trusted professional such as a primary care provider is recommended.
There are, however,parents can look out for in children, signs that can help parents identify when they need additional help.
“When kids begin to withdraw, reject formerly supportive means of help, or exhibit a significant change in their interests or functioning, these signs may warrant attention,” says Kodish. But identifying when something isn’t normal can be a challenge, says Rockhill. “I have treated kids who have had psychotic symptoms such as hearing things that others don’t hear for years, but thought it was normal because they didn’t realize that other people don’t have similar experiences. That’s why having an ongoing conversation that includes asking about your child’s experiences is so important.” If a parent feels like something is “off” with their child, they shouldn’t hesitate to contact a primary care provider. Often, “primary care doctors are the first line of treatment for psychiatric management,” says Kodish.
Warning signs in children and teens:
- Increased difficulty regulating emotions
- Often appearing sad
- Avoidance of normal activities, like going to school or participating in sports
- Difficulty complying with the demands of school – sitting or obeying a teacher
- Difficulty making or sustaining friends
- Being distracted by something that is hard to identify – paying attention to something manifested in the child’s own head
- Avoidance of eating, significant loss of weight
- Erratic behavior, such as anger outbursts in a child who has not had anger issues previously
Even though May is Mental Health Awareness Month, Rockhill and Kodish advise parents to check in on a regular basis with their kids. Having a month dedicated to raising awareness for mental health is wonderful, says Rockhill, but it’s a conversation that shouldn’t end come June 1.
- Snohomish County Crisis Line: 425-258-4357 or 800-584-3578
- Pierce County Crisis Line: 800-576-7764 or 253-396-5180
- Alcohol Drug Help Line: 206-722-3700 or 800-562-1240
- Alcohol Drug Teen Line: 206-722-4222 or 877-345-8336: teens can talk to another teen about drug and alcohol use
If you’d like to arrange an interview with Kodish or Rockhill , please contact Children’s PR team at 206-987-4500 or at [email protected].