How to talk to children about mental health

Heather M. Jones writer headshot By | November 22, 2019
Medically reviewed by Scott Dershowitz, LMSW, CMC

We tend to think of mental illness as being a “grown up” issue. Whether it’s lack of information or wishful thinking, we hope that conditions like depression are things our kids won’t need to deal with until they are much older—or, even better, not at all. The truth is that children’s mental health issues are common.

“Worldwide 10%-20% of children and adolescents experience mental disorders. Half of all mental illnesses begin by the age of 14 and three-quarters by mid-20s,” according to the World Health Organization. With rates this high, it’s important we know how to talk to our children about mental health.

What mental health problems are common in children and teens?

Children and adolescents can experience the same mental health struggles that adults do; but some of the more common conditions include:

  • Anxiety
  • Depression and other mood disorders
  • Addictions
  • PTSD
  • Eating disorders

How do you know if your child has mental health issues?

New York City licensed psychologist Jephtha Tausig, Ph.D., suggests parents ask themselves these questions:

  • Have there been significant changes in the child or adolescent’s behaviors?
  • Are moods different?
  • Have there been changes in:
    • personal hygiene?
    • personal friendships?
    • relationships with family members?
    • participation in activities that they used to enjoy?
    • sleeping and eating?
  • How is your child doing in school?
  • How is your child doing with extracurriculars?

Marie Kueny, M.S., licensed school counselor in Kenosha, Wisconsin, suggests also looking for:

  • Physical symptoms such as frequent headaches, stomachaches, trouble sleeping
  • Increased difficulty concentrating
  • Concerns from your child’s school about behaviors not typical of your child
  • Substance use
  • Self-harming behaviors or talk of self-harm

How can parents improve children’s mental health?

“Parents should first speak to their child about what they have observed in a loving and compassionate way,” says Kueny. “When you become aware that there is a potential concern, make time immediately to have a private one-on-one conversation with the child, free from distractions. Establish to your child that the child is a priority in your life and it’s your job as a caregiver to help ensure their safety. Make sure the child is aware of your concern and that you are there to listen wholeheartedly to any challenges they are facing.”

Seeking professional help is also important. “Contact a licensed, trained professional (pediatrician, guidance counselor, school psychologist, clinical psychologist, psychiatrist etc.) who is specifically trained and works with children and adolescents, and ask for a mental health evaluation or check-up to see what may be going on,” says Tausig. For symptoms that are particularly worrisome, you might want to look for inpatient or partial hospital programs in your area.

How can parents talk to their children about mental health?

First and foremost, it’s understandable if you don’t know the best way to talk to your child. Many parents don’t—and that’s why it’s important to seek help and follow the advice below. Alternatively, you may have a child who doesn’t want to discuss certain issues with you as parents. Don’t be discouraged if this happens.

“It’s helpful to explain [to children struggling with mental health concerns] that they are not alone, that they are not “stupid” or “weird” or “crazy” for feeling the way they do,” says Tausig. “It may also be helpful for parents to connect with other parents whose children or adolescents are struggling with the same or similar issues, just as it may be helpful for the child or adolescent themselves to meet peers who are also experiencing the same or similar symptoms.”

Relating mental health to physical health can also be helpful, suggests Kueny. “A parent can tell the child, ‘some children have asthma, which can make it difficult to breathe. A child with asthma may have to see a doctor to talk about their breathing. The doctor may tell them things they can do to feel better. Sometimes medication is helpful, too. What you are experiencing right now is kind of like that. We may need to talk to someone who knows how to help you feel better.’”

Parents don’t need to wait until their children are experiencing issues to teach children about mental health. “Teaching children the basic emotions, the function of emotions, how the emotions often manifest in our bodies and associated action urges with appropriate coping skills can go a long way,” says Nicole Garber, MD, chief of psychiatry at The Meadows Ranch in Wickenburg, Arizona.

Mental health education can start right from birth, according to Kueny. “The foundation for understanding one’s mental health should begin immediately. For example, a crying baby can be told, ‘I see you are sad right now, I will do my best to help’; a parent can say to a frustrated toddler, ‘You seem frustrated, let’s try to solve this problem’; as the child gets older, the parent can routinely check in with their child by asking what makes them excited, nervous, sad, overwhelmed, etc.”

How can parents talk to their children about suicide?

It’s something no parent wants to think about, but as the second leading cause of death in youth age 10-24, it is an important component to discussions about mental health. Contrary to popular belief, discussing suicide does not increase the likelihood of someone committing suicide—in fact, it opens the door for your child to discuss thoughts or feelings they have had and have been hesitant to share.

The Society for the Prevention of Teen Suicide (SPTS) has these recommendations for talking to teens about suicide:

  • Pick a time when you have the best chance of getting your child’s attention.
  • Think about what you want to say ahead of time and rehearse a script if necessary.
  • If this is a hard subject for you to talk about, admit it!
  • Ask for your child’s response. Be direct!
  • Listen to what your child has to say.
  • Don’t overreact or under-react.

SPTS encourages parents to look for for the “FACTS” warning signs:

A— Actions

See here for more in-depth details of each recommendation and for an expansion on the FACTS warning signs, or download the PDF here.

Take any of these indications seriously, and consult with a medical professional if you observe troubling thoughts or behavior surrounding suicide.

Make sure your child has access to the number for a suicide/mental health hotline such as Lifeline, a 24-hour service that can be reached by calling 1-800-273-TALK (8255)

Seeking help for the whole family

Having a child who is struggling with mental health issues can be challenging for the entire family. Parents can sometimes feel that they have done something wrong. Tausig offers this reassuring reminder:

“Mental illness of any kind is not a reflection upon the individual or their family. It is not a judgement from the divine, nor is it a litmus test as to someone’s worth. It has always been part of the human condition, and as such, individuals who experience symptoms of mental illness and their families deserve to be treated with compassion as well as the very best of care.”

It’s also important for parents to remember to monitor their own mental health. Parents can become overwhelmed by their child’s difficulties and could benefit from seeking help for themselves. Seeing a therapist would help parents manage their own stresses and help the family as a unit. Another great resource for children and parents is the National Alliance on Mental Illness (NAMI), which offers family support groups.

With love, care, and help from professionals, parents can help their children navigate the sometimes daunting world of mental health.