Children and Mental Health: What You Need to Know

Raising a child can be very challenging.  Parents constantly want to be there for their children no matter what.  Taking into account their mental health is one of the most important things you can do as a parent. It is important to know the signs and symptoms of mental health issues so that they are treated as soon as possible and don’t get worse. 

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Many young people in America struggle with mental health issues. At times, childhood symptoms of mental health disorders are not taken seriously due to various reasons. However, specific signs and symptoms may indicate that something more serious is going on. 1 If a child displays any of these signs, an evaluation by a mental health professional can determine if treatment is necessary. 2

What is Mental Illness?

Mental health refers to the level of wellness associated with how someone thinks, regulates feelings, and behaves. A mental illness, or mental health disorder, refers to changes or patterns in thoughts, feelings, and behaviors that negatively impact individuals’ functioning or cause distress.1 Mental illness in childhood is defined as disruptions or delays in developing thoughts, regulation of emotions, behaviors, and social skills that are age-appropriate. These issues distress children and can impact their ability to function at home, school, or other social situations. 1

Mental Health in Children

Mentally healthy children possess age-appropriate social skills and coping mechanisms and reach the same developmental and emotional milestones as their peers. Their quality of life is positive, and they can function well at home, school, and other social settings.3

Children with mental health disorders experience serious differences in how they learn, behave, and process emotions. These differences can cause distress and negatively impact daily functioning. Most children experience fears and worries and engage in disruptive behaviors at times. Severe symptoms that interfere with school, home, and other activities may indicate a mental health disorder. 3

The quality of a child’s mental health may vary from child to child, even in those who are not diagnosed with a mental health disorder. Children who do not have a mental illness experience different levels of well-being, and children with the same mental health disorder may have different strengths and weaknesses regarding their development, coping skills, and quality of life. 3

Childhood Mental Health Statistics

  • Approximately 15 million US young people can currently be diagnosed with a mental health disorder 4
  • About 7 percent of youth with possible mental health disorders receive appropriate help from mental health professionals 4
  • Most mental, behavioral, and developmental disorders develop in early childhood. 5
  • Behavior problems are more common among children aged 6-11 than children of any other age. 5
  • Depression and anxiety diagnoses become more common as age increases. 4
  • The most commonly diagnosed mental health disorders in children are ADHD (9.4% of children aged 2-17), behavior problems (7.4% of children aged 3-17), anxiety (7.1% of children aged 3-17), and depression (3.2% of children aged 3-17). 5
  • About 3 in 4 children aged 3-17 with depression also have anxiety, and almost 1 in 2 have other behavior problems. 5
  • Over 1 in 3 children aged 3-17 with anxiety also have behavior problems, and about 1 in 5 also have depression. 5
  • Over 1 in 3 children aged 3-17 with behavior problems also have anxiety, and about 1 in 5 also have depression. 5

Causes

Professionals are not sure of the exact cause of most mental illnesses. However, the development of mental health disorders may include a combination of genetics, biology, psychological trauma, and environmental stress. 6

Genetics

Mental health disorders typically run in families. Children with parents who have a mental illness are more likely to develop one. 6. It's more accurately referred to as, being more vulnerable to developing mental health disorder.

Environmental Stress

Any stressful or traumatic event can trigger a mental health disorder in a child who may already be vulnerable to one. 6 These events can include moving, changing schools, or the birth of a new sibling. 7

Biology

Mental health disorders may occur as a result of off-balance neurotransmitters. Neurotransmitters are chemicals in the brain that help the cells in the brain communicate. When these are out of balance or aren't working correctly, the brain may not receive messages correctly. Injuries in the brain can also lead to mental illnesses. 6

Psychological trauma

Different forms of psychological trauma can trigger a mental health disorder. Examples of trauma include severe emotional, physical, or sexual abuse, the early loss of a close friend or family member, and emotional or physical neglect. 6

Risk Factors

Certain risk factors can make some children more likely to experience a mental illness than others. Having these risk factors does not predict with certainty that a child will develop a mental health disorder. These risk factors include: 7
  • Long-term physical illness
  • Having a parent who has had mental health issues, problems with alcohol, or trouble with the law
  • Experiencing the death of someone close
  • Having parents separate or divorce
  • Experiencing severe bullying, physical abuse, or sexual abuse
  • Poverty or homelessness
  • Experiencing discrimination
  • Caring for a relative, or taking on adult responsibilities
  • Long-lasting difficulties at school

Common Mental Health Issues in Children

Common mental health disorders in children include attention deficit hyperactivity disorder (ADHD), anxiety, behavior disorders, mood disorders, eating disorders, elimination disorders, schizophrenia, and tic disorders. 6

ADHD

ADHD is the most common mental health disorder for children. Children with ADHD are hyperactive and find it more challenging than other children to control their impulses and pay attention. 6

Elimination Disorders

These disorders involve behaviors related to body waste elimination, including feces and urine. 6

Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neurological condition that usually develops before age 3. The severity of ASD varies from child to child; however, most children with ASD find it challenging to communicate and interact with others. 1

Psychological trauma

Different forms of psychological trauma can trigger a mental health disorder. Examples of trauma include severe emotional, physical, or sexual abuse, the early loss of a close friend or family member, and emotional or physical neglect. 6

Behavior Disorders

Symptoms of behavior disorders often manifest in defying rules and causing disruptions in structured environments like school. 6

Tic Disorders

These disorders are characterized by repeated, sudden, involuntary, and typically meaningless movements and sounds that are referred to as tics. 6

Mood Disorders

Mood disorders include disorders like depression and bipolar disorder. Depression is characterized by persistent sadness that can impact a child's ability to function and interact. Bipolar disorder is characterized by intense mood swings. 1

Schizophrenia

Schizophrenia is a severe disorder characterized by distorted perceptions and thought processes. 6 This disorder usually appears in the late teens and early 20s and manifests in symptoms including hallucinations, delusions, and disordered thoughts and behaviors. 1

Anxiety

Children with anxiety disorders respond with fear and dread to certain situations. They can also experience physical manifestations of anxiety or nervousness, such as sweating and a rapid heartbeat.6 Children with anxiety may find that it disrupts their ability to engage in play, school, and other social situations. 1

Eating Disorders

Eating disorders are characterized by unusual behaviors associated with weight and food.6 They often involve a preoccupation with attaining the ideal body type, disordered thoughts regarding weight and weight loss, and unsafe eating habits. 1 Eating disorders can result in intense emotions and attitudes. 6 They can even create life-threatening complications. 1

Is it Just a Stage?

Unfortunately, childhood mental illness is not always taken seriously. A child’s mental health symptoms may be perceived as a part of a “stage” they are going through. Because of this belief, many children with mental health disorders go without necessary treatment longer than they should.1 Understanding a child’s mental health can be difficult, considering childhood development naturally involves change. Children may also find it challenging to express their feelings or articulate why they behave a certain way. 1 Parents may also avoid seeking treatment for their child because of the stigma associated with mental health disorders, medications as a treatment method, and the cost or other logistical challenges related to treatment.1 Children without mental health disorders struggle periodically and experience slight changes in behavior due to everyday stress, making it even more challenging to seek treatment.8 However, there are signs to look out for that indicate something more serious.1

Symptoms of Something More Serious

Signs that a child has a mental health disorder include:
  • Persistent sadness lasting for two weeks or more 1
  • Withdrawal from or avoidance of social interactions 1
  • Repeated refusal to go to school 9
  • Harming oneself or talking about doing so 1
  • Self-destructive behavior, such as head-banging 8
  • Talking or thinking about death or suicide 1
  • Outbursts or severe irritability 1
  • Impulsive and harmful behavior 1
  • Drastic changes in mood or behaviors 1
  • Changes in eating habits 1
  • Weight loss 1
  • Difficulty sleeping 1
  • Persistent nightmares 9
  • Frequent headaches or stomachaches 1
  • Difficulty paying attention or concentrating 1
  • A decline in academic performance 9
  • Staying home from school often 1
  • Problems in one or more settings, including school, home, and other social settings 8
  • New fears or constant worry 9
  • Hyperactivity or fidgeting 9
  • Persistent disobedience or aggression 9
  • Frequent temper tantrums 9

Childhood Mental Health Issues During COVID-19

The COVID-19 pandemic has brought about a surge in mental health issues for children of all ages. Between March and October of 2020, the percentage of children who visited the emergency department of hospitals for mental health emergencies increased by 24% for children aged 5 to 11 and 31% for children aged 12 to 17. Among girls aged 12 to 17, visits to the emergency department for suicide increased 50% compared to 2019 visits. 10

This surge in mental health emergencies results from the ongoing stress, fear, grief, and uncertainty related to the pandemic. Over 140,000 children have lost a parent or grandparent caregiver due to COVID. Additionally, many families have lost jobs and have temporarily lost necessary support from their school, health care services, and other community programs that could not meet in person. 10

The stress and trauma associated with COVID-19 can have long-lasting effects on developing children and teens, even with the availability of vaccines for children who are old enough. It is increasingly essential to check in on children, keep in mind the signs of mental health disorders, and seek treatment when necessary.10

Treatment for Children

If your child is exhibiting signs and symptoms of a mental illness, it is essential to seek a mental health professional for an evaluation.

Child Mental Health Evaluation

A mental health evaluation for your child can help clarify what is going on and provide recommendations for what to do next. The evaluation will also create an opportunity to understand your child’s strengths and weaknesses and determine the most beneficial plan of action. This evaluation will include: 2

  • An interview with parents to discuss the child’s development, temperament, relationships with family and friends, medical history, hobbies, abilities, and prior treatment. This interview will give the mental health professional a comprehensive idea of the child’s current situation.
  • A gathering of information about the child from their school, including standardized tests and any reports on behaviors, talents, and difficulties.
  • An interview with the child to observe their behaviors, if necessary.

Treatment Options

A mental health professional will review the evaluation results to determine if the symptoms your child is experiencing are a response to changes or stress at home or school or the manifestation of a mental health disorder. 2

If the mental health professional decides that your child has a mental illness, they will make specific treatment recommendations based on your child’s needs. Treatment recommendations may include psychotherapy, medication, family counseling, and support for parents. 2

Psychotherapy or “Talk Therapy”
There are various forms of psychotherapy, including those for specific conditions. For children, any form of psychotherapy needs to include: 2
  • Parent involvement
  • Teaching the child skills to practice at home or school between sessions Some way to measure the child’s progress in implementing these skills.
Medication
The type of medication a doctor prescribes a child depends on their diagnosis. Medications may include antidepressants, stimulants, mood stabilizers, or other medications. In most cases, child patients use the medication in conjunction with psychotherapy. If multiple mental health professionals are involved in a child’s care, they should coordinate to ensure the best quality of care.2
Family Counseling
Family inclusion in a child’s treatment can help them understand how the challenges a child experiences can influence how they interact with their parents and siblings. 2
Parent Support

Individual or group therapy sessions for parents provide them with training and support for managing their child’s problematic behaviors. In individual sessions, a therapist will often coach parents on communicating with their child, and help them gain access to accommodations at work and school. Group sessions allow parents to talk with other parents who may provide helpful strategies that have worked for them. 2

References

  1. American Psychological Association. (n.d.). Children’s mental health. American Psychological Association. Retrieved from https://www.apa.org/pi/families/children-mental-health
  2. Centers for Disease Control and Prevention. (2021, March 22). Data and statistics on children’s Mental Health. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/childrensmentalhealth/data.html
  3. Centers for Disease Control and Prevention. (2021, September 23). What is children’s mental health? Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/childrensmentalhealth/basics.html
  4. Children and young people. Mental Health Foundation. (2021, November 11). Retrieved January 4, 2022, from https://www.mentalhealth.org.uk/a-to-z/c/children-and-young-people
  5. Mayo Foundation for Medical Education and Research. (2020, February 26). Worried about your child’s mental health? Mayo Clinic. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/childrens-health/in-depth/mental-illness-in-children/art-20046577
  6. Mental health during COVID-19: Signs your child may need more support. HealthyChildren.org. (n.d.). Retrieved from https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Signs-your-Teen-May-Need-More-Support.aspx
  7. Recognizing mental health problems in children. Mental Health America. (n.d.). Retrieved from https://www.mhanational.org/recognizing-mental-health-problems-children
  8. U.S. Department of Health and Human Services. (n.d.). Children and mental health: Is this just a stage? National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/publications/children-and-mental-health
  9. U.S. National Library of Medicine. (2021, September 20). Child mental health. MedlinePlus. Retrieved from https://medlineplus.gov/childmentalhealth.html
  10. WebMD. (n.d.). Child mental illness: Schizophrenia, anxiety, behavior disorders, and more. WebMD. Retrieved from https://www.webmd.com/anxiety-panic/mental-health-illness-in-children