Talking to Children About Mental Health
May 1st-7th is Children’s Mental Health Awareness Week. To raise awareness and education around children’s mental health, we interviewed Emily Vera, the Executive Director for Mental Health Association in DE.
1. Is it important to talk to children about mental health? If so, do you believe there is a certain age we should wait to do so?
I think it is important to speak with children about mental health, and that we can start doing that as soon as they have language. When they are very young, we can help them recognize and name their feelings when they begin to talk. For example, when my almost two-year-old sees a sibling crying (or cries herself), she will point at the person and say “feelin’ sad?” If there is a physical pain, we try to name it, and if it is an emotional pain, we say “feeling sad,” “scared,” or “mad.” Just as little children are taught about colors and shapes, they can be taught about a full range of emotions.
As children grow older, we should teach them what depression and anxiety are, and that there is help available when needed. I try to sometimes do this through age appropriate story books; for example, we recently checked out a story about a child going to therapy and taking medication for OCD from our local library called Mr. Worry. I also talk with my school-aged children about a loved one who died of suicide and how he had a sickness (depression) that caused trouble in his brain that made him feel sad most of the time. This provides an opening for me to talk with them about strategies for staying mentally healthy, and ways that healthcare professionals can help when needed. How much to share and what words to use are based on the age and maturity of the child; but it is important that they know that it is good to speak openly about our thoughts and feelings, and good to ask for help if we aren’t feeling mentally healthy.
2. What are some warning signs that a child may be struggling with their mental health?
Young children may not have the words to describe accurately how they’re feeling, and may instead act wild or defiant, have outbursts, regress in terms of bedwetting or other skills they’ve previously mastered, withdrawal from friends and family, have frequent bouts of irritability and/or crying, have many fears or worries, complain of physical pains in their tummies or headaches; and have marked changes in how much they eat or sleep. Of course, all children can act very emotional at times – that is part of growing up. But, if these behaviors are so significant that they are interfering with the child’s daily life, a mental health evaluation may be very helpful. For example, if the child is having trouble in school due to their behavior, trouble with friendships, or trouble doing the things that they normally do each day without issue, then it may be a good time to see a mental health professional.
3. How would you go about talking to a young child about mental health, as opposed to teenagers?
I think parents and adults who work closely with youth can often intuit how much a child will be able to process and understand comfortably, and should keep things as simple and straightforward as possible. For young children, you might compare mental health to some of the physical illnesses that they have experienced to help them understand, or you might use an activity book to help with the conversation. You don’t need to use diagnostic labels like depression or anxiety at this age, but focus on feelings and strategies to help us when we’re feeling sad, worried, etc.
It’s important not to talk down to a child in a condescending way, but this is even more important when talking with teens. Teenagers have certainly heard about depression, anxiety, mental illness, and suicide, but the information they have heard may not always be correct, so clarifying conversations can be very helpful. Make sure they know that you are comfortable talking with them about these topics.
Regardless of age, it’s important to be clear and direct, while also conveying that you care about them. The words you choose will be different for different ages – for example, you might say, “have you thoughts about hurting or killing yourself,” to a child you are very concerned about, while you might use the phrases “self-harm” and “suicide” with a teen. But while the words we choose may be different, being kind, caring, clear, and direct should happen regardless of the child’s age. Similarly, spend plenty of time listening without showing judgement or immediately jumping to finding solutions, so that they feel heard, not just talked-at. Again, this is true for any age.
4. What is most important for parents/guardians to remember, when discussing mental health with children?
I think the main message we send should probably be that if they are concerned about their own mental health, or that of a friend, they should speak to a trusted adult about it. Of course, parents can and should offer to be that trusted adult, but kids should also know that they can talk to a coach, a relative, an older sibling, a school counselor, etc. They may not want to disappoint or hurt their parent, so it’s important for them to know that they should talk openly to a trusted adult of their choice if they have a concern about mental health. If that person isn’t helpful, they should go to a different trusted adult until they feel they have been heard and assisted.
5. Are there any resources that parents/guardians can refer to get information and services for their children?
You can text DE to 741741 for the Crisis Text Line, or call 1-800-273-TALK (8255) for the National Suicide Prevention Lifeline if you are in a crisis situation. In Delaware, you can call 1-800-969-HELP (4357) for an in-person evaluation for a child under 18. On our website, mhainde.org, you can click the resources tab to find counseling centers and other local services. Our Community Resource Guide has a section for children and adolescents. Here are a couple of helpful websites about children’s mental health and how to speak to your kids about mental health, from the National Institute of Mental Health and the National Alliance on Mental Illness:
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Staff Blogger: Emily Vera
Emily Coggin Vera is the Executive Director at the Mental Health Association in Delaware, where she has worked since 2009. She was formerly the Deputy Director and the Project Director of Suicide Prevention, during which time she facilitated the Delaware Suicide Prevention Coalition, coordinating suicide prevention efforts by multiple agencies throughout the state. She collaborates with other agencies to provide advocacy and enhanced understanding of mental health in the community, and is responsible for maintaining financial accountability, sustainability and operational effectiveness at MHA. Emily received her Master’s in Social Work from Virginia Commonwealth University in 2007, and is a Licensed Clinical Social Worker.