Children And Young People’s Mental Health: How Do I Know If My Child Has Mental Health Issues?
The children’s mental health dilemma: Something seems wrong but you can’t be sure what it is. Perhaps you’re noticing changes in your child’s behaviour or moods. You may struggle to recognise the child you know so well. Or perhaps you’ve long wondered if something is wrong but haven’t been able to decipher if your child is just quiet or hot-headed, or is suffering from a mental health issue. So what are the signs of children’s mental health problems and how might you approach the issue? Let’s take a look.
What is a children’s mental health problem?
Mental health is the general health of how a person thinks, behaves and governs their emotions. A person has a mental health problem when shifts or patterns of emotions, thoughts and behaviour create distress and disturb their ability to go about life.
Just as adults can have mental health disorders, so can children, although the symptoms may vary.
Mental illness in children is usually defined as delays or disturbances to the cultivation of age-appropriate cognition, social skills, behaviour and management of emotions. Such problems are very upsetting to children and impair their capacity to function well in school, in the home and in other social settings.
Mental illnesses in children
Mental health disorders (or neurodevelopmental disorders in children that mental health professionals deal with) might include:
- Anxiety disorders – Incessant fears, alarm and worries that disturb a child’s capacity to take part in education, play or common age-appropriate activities with others.
- Autism spectrum disorder (ASD) – A neuro-developmental disorder that begins to manifest itself early on, most often before a child turns three. Autism is a spectrum that will differ in severity from child to child, but a person with autism will find communication and interaction with others challenging.
- Depression and other mood disorders – Depression is incessant unhappy and miserable feelings and flat mood, usually accompanying a loss of interest and motivation which obstructs a child’s capacity to perform well in school and socialise with others. Bipolar disorders are made up of severe mood switches, alternating between highs in emotion and behaviour (that may involve risky acts) on the one hand, and depression on the other.
- Eating disorders – Eating disorders (like bulimia, anorexia, and binge-eating disorder) encompass rumination over one’s own body image and pursuit of an ideal body type, disordered and harmful patterns of diet and eating, and dysfunctional thinking about weight and weight loss. They can create enormous mental, emotional, social and educational disruption in a child’s life, and lead to physical repercussions that can be life-threatening.
- Attention-deficit hyperactivity disorder (ADHD) – This is a neurodevelopmental disorder that begins in childhood. Compared with the majority of their peers, children with ADHD struggle more with focus, impulsivity, and hyperactivity. The combination of these struggles varies, and there are different types of ADHD (hyperactive-impulsive type, inattentive type, and combined type), with girls more often presenting as inattentive, and boys more likely to be hyperactive-impulsive. The hyperactive-impulsive type is much more of a presence in popular culture and public imagination and as a result, ADHD may be more difficult to identify in girls.
- Schizophrenia – This is a serious mental health disorder of thinking, perception and behaviour that leads someone to become disconnected with reality (psychosis). It most commonly appears in late adolescence and early adulthood. Schizophrenia creates delusions, hallucinations and disordered behaviours, perceptions and thought patterns.
- Post-traumatic stress disorder (PTSD) – PTSD is a sustained emotional disturbance, agitation, upsetting memories and flashbacks, anxiety, nightmares and dysfunctional behaviours as a result of traumatic experiences such as injury, abuse, or violence.
The challenge of mental illness in children
Dr Radha Bhat, Consultant Child and Adolescent Psychiatrist says: “The problem with identifying children’s mental health issues is that healthy childhood development is by definition a process of change. Every stage in childhood development can present with a variety of mental health difficulties but the presentation can vary based on a child’s age. Furthermore, it is often more challenging for a child to identify and discuss their feelings and behaviours.
“The changes we might identify as mental health issues in a young person can cross over with a his/her healthy development – particularly in adolescence. The teenage years are a time of immense physical, mental and emotional upheaval purely in terms of growth and hormonal changes, before you even begin to factor in social pressures, increasing awareness of the world and its problems, and the academic pressures of exams. Even the most lovingly nurtured and well-adjusted child can struggle.”
So how do you know if the changes your child is presenting with are just growing pains or signs of children’s mental health issues? By observing and following your instincts as a parent, you can usually identify if something isn’t right and not in-keeping with the child’s age and maturity, you need to seek help.
Of course, no one knows your child better than you but even so, don’t try to diagnose them. Diagnoses can be complex, and mistakenly attaching a label to a child can in itself affect them emotionally.
Children’s mental health problems: signs and symptoms
It can be difficult to ascertain if a child’s behaviour is ‘just a phase’. Particularly if your child is entering teenagehood, they may be more reclusive as a matter of course, and you may worry about drawing them further into themselves if you ‘push it’. But still, this is your child and you need to know. So, what can you do and what is there to look out for?
Common signs and symptoms of children’s mental health problems include:
- Abrupt shifts in behaviour, personality or mood.
- Unexplained physical shifts, for example losing weight or gaining weight
- Abrupt poor school reports and academic performance
- Self-harm (you may notice strange marks on your child’s arms or legs for example) or talking about self-harm
- Trouble with sleeping
- Social behaviour shifts (for example avoiding spending time with friends and family)
- Continual sadness for a fortnight or more
- Talk of death or suicide
- Unusual eating habits
- Severe irritability and/or eruptions
- Uncontrolled, potentially harmful conduct
- Problems focusing on school work and mundane routine.
- Skipping or trying to avoid school
What to do if you think your child may have a mental health problem
One of the things children often want most is to be listened to and have their struggles taken seriously by their parents. They might want support in changing something, they might need practical assistance, or they might just need a hug. That is, if they are actually willing to talk. It can be very difficult for a parent to get a child to open up about what’s troubling them, not least because the child may not have the words themselves.
Yes, young people’s emotional struggles and unhappiness most often shift and pass. But if your child is experiencing ongoing problems lasting over weeks, it’s advisable to seek help and support. Early intervention can make all the difference so if you are worried, talk to your child’s healthcare provider and describe the signs and symptoms you’re seeing. It can also be a good idea to speak with other family members and care providers as well as your child’s teacher, to identify if they are noticing shifts too. Tell your doctor about any changes others have noticed as well.
In the UK, the NHS runs Child and Adolescent Mental Health Services (CAMHS) for children’s mental health problems, and if necessary, your GP can refer your child. CAMHS are made up of a range of different professionals (for example child and adolescent psychiatrists, therapists and nurses) who work together to assess, diagnose and treat children’s mental health problems such as depression, eating disorders, anxiety and so on. CAMHS does incredible work, but their waiting lists are often extensive, so in the interests of urgency, some parents opt to go private.
Here at The London Psychiatry Centre, our CAMHS team has decades of experience in effectively diagnosing and treating children’s mental health problems. We take self-referrals and referrals from GPs and other professionals, and can provide video and telephone appointments too. We work with you therapeutically as a family and individually, in order to understand the bio psycho social aspects, get to the root of the problem, and help put your child back on the path of healthy development and happiness.