Jan. 25, 2022 — This past fall, when major children’s health organizations declared a national emergency in child and adolescent mental health, health care providers felt validated.
The American Academy of Pediatrics and American Academy of Child and Adolescent Psychiatry “came together to put this statement out there because we’ve seen a rising volume of children and adolescents accessing mental health care, the rise and prevalence of eating disorders, substance-use issues, and the need for in-patient hospitalization,” says Anisha Patel-Dunn, DO, a practicing psychiatrist and chief medical officer at LifeStance Health, a provider of virtual and in-person outpatient mental health care.
It may seem obvious, but the COVID-19 pandemic has only worsened mental health issues that have affected kids socially and developmentally, she says.
“Just think: Kids who are 18 and college freshmen right now missed their senior year of high school, so they’re technically stuck in their junior year,” she says.
Still, how do parents know whether a problem will work out on its own or whether it’s time to consult with a therapist? Read on as Jen Dowd, a clinical social worker in Marblehead, MA, spells out the signs to look for, depending on your child’s age and stage.
Elementary School
What’s happening: While child development isn’t linear, the elementary school years are generally a big time of growth, and school-age kids are likely to explore an increased sense of independence, dressing themselves, tying their shoes, riding a bike, etc.
What to keep an eye on: If your child is backsliding, pay attention.
“This is a signal that something is up,” Dowd says. “Examples include changes in sleeping, eating habits, bed-wetting, isolating, excessive worrying, and withdrawing from things they used to find fun.”
Who to call: If you see these behaviors, call your pediatrician.
“This is the best place to start,” Dowd says. “They’re often our first line of defense and will rule out any medical concerns before they may suggest that your child consider seeing a therapist.”
Middle School
What’s happening: The years between elementary school and high school can be fraught, especially when it comes to social interactions.
“This is a time when we sometimes see an increase in anxiety as pressures on kids increase,” Dowd says.
What to keep an eye on: If you child is struggling with social interactions, can’t make friends, or they’re being bullied, these are red flags and may mean that your child needs help.
“In addition, watch for risky behaviors, which could include risky sexual behaviors or risky behaviors around substances,” Dowd says.
Who to call: You might want to consider reaching out to one of your child’s teachers to see if they have noticed any changes in behavior.
Next, speak with your child’s doctor, especially if your child has made self-harming or suicidal statements, such as, “I don’t see a purpose in me being here.”
“Middle school kids can be dramatic, but if your child’s behavior is worrying you, it’s worth a conversation with a health care provider,” Dowd says. “Also, parents’ attitudes about therapy matter. If you approach a conversation about therapy, as in ‘this is extra support for us,’ your child will likelier be on board.”
High School
What’s happening: At this stage of life, kids may be interested in romantic relationships, may show more independence from the family, and have a deeper capacity for caring, but may also feel a great deal of sadness or depression.
What to keep an eye on: Changes in social ties (for example, your once popular child suddenly says they have no friends), a drop in performance in school, a radical personality shift, or any other risky behavior.
“For example, if your child has always been quiet and serious and, all of a sudden, he is going out all the time or staying out until late hours, pay attention,” Dowd says.
Who to call: Consider reaching out to a mental health professional directly, especially if the situation is becoming concerning.
“Keep in mind that as kids get older, they can sometimes be more difficult to engage in therapy,” she says. “They’ll get crafty about hiding their behavior, so it’s very important to do your best to foster open conversations with your kids.”
Ultimately, if your child asks to see a therapist, honor the request because they’re likely asking for a reason, especially if there’s been a traumatic event, such as a death in the family, divorce, or abuse.
And never consider yourself a failure if your child requests therapy, Patel-Dunn says.
“We need parents to think of therapy in a different way,” she says. “They need to know that they’re going to be failures if they don’t stay open to getting their children the help they need.”
The goal? Think of therapy as preventive medicine, even if it’s just a handful of sessions with a licensed professional. This will give them the tools — and help — they need that will last a lifetime, Patel-Dunn says.