How can you Support a Child Facing Mental Health Problems?

This blog will explore how you can help and support a child that is struggling with their mental health.

Sadly, a lot of stigma about mental ill health still prevails and so speaking up about a mental health problem is something that can cause significant difficulties for both adults and children. Children in particular may struggle to speak about their mental health because they don’t fully understand what is happening to them,  or they may be too afraid to speak up if they think that they won’t be believed or that someone will judge them.

It is accepted that speaking up as quickly as possible once a mental health difficulty is suspected is essential in making sure that the problem does not worsen and that the child feels fully supported and therefore able to talk about what it is that they are feeling.

Children’s mental health statistics in the UK

According to the NHS:

• One in eight 5 – 19-year olds have at least one mental disorder.
• Young people aged 14-19 who identify as lesbian, gay, bisexual or with another sexual identity are more likely to have a mental health disorder than those who identify as heterosexual.
• Girls and young women aged 17-19 are more than twice as likely to have a mental health disorder than boys in the same age group.
• Boys are more likely to have a mental health disorder than girls until the age of 11.
• One in 18 women aged 17 to 19 had body dysmorphic disorder.
• One in 18 women aged 17 to 19 have body dysmorphic disorder.

Now more than ever we need to know how we can support out our children and their mental health. Mental health problems can affect any child and no one is immune from mental health problems.

Approaching the subject of mental ill health

It is important that children feel they can talk openly about their feelings. Here are some tips you can put in place to help children feel comfortable discussing openly how they feel.

Speaking at an age-appropriate level

Children need to be able to understand what they are being told and asked, and they also need to be able to respond in a way that reflects that they have understood. Therefore, when speaking with a child about their mental health or about their feelings in general, it is really important to make sure that they are not asked questions that contain complex terms or jargon, or that they are not bombarded with a lot of information or questions all at once, which would undoubtedly be overwhelming for them.

Enabling children to express themselves

Asking open questions such as those that start with “how do you feel about…” will give children a better opportunity to speak about how they are feeling rather than asking questions that are closed and can only be answered with a ‘yes’ or ‘no’.

Actively listening

Children need to know that the person to whom they are speaking is listening to them properly and this means that adults should speak to them in an area where there are no distractions and where they can show the child that they have understood what they are saying, by asking pertinent questions and paraphrasing what has been said.

Not reacting negatively

Arguably, the worst thing that a parent can do in response to a child disclosing a mental health difficulty is to react in a way that shows shock, fear or acute distress, even if they may be feeling all of these things. If the child feels as though they are upsetting a parent, this would almost certainly mean that they would stop speaking or dismiss the true level of how they are feeling, both at the time and in the future as well.

Having a third person intervene

Some children may not want to speak to a parent but may be happy to speak to someone else about their feelings. In this instance, this may mean speaking to an informal individual, such as a teacher or family friend, or a more formal individual such as a counsellor, any of whom may be able to help the child discuss their feelings and then pass this back to the parent, if the child is happy for them to do this.

Letting children know that they are supported

Ultimately, speaking about a mental health difficulty is not easy and children must know that they have done the right thing by discussing with someone else what is troubling them. Parents should let the child know that they are fully supported, that they are not in trouble for how they feel and, if appropriate, that they will help the child to get any help that they need.

Parental help

The diagnosis or suspicion of a mental health problem for a child can be a distressing time for parents who may not have any previous experience of mental ill health and who may not know what to do for the best. Parents therefore must be supported otherwise they too become susceptible to their own mental health difficulties that can be brought on by the stress that comes from trying to support someone who is mentally unwell

If a child has a diagnosis of a mental health problem and the parent is acting in the role of carer, they become entitled to a carers’ assessment in line with the Care Act 2014, where their own needs are identified and fulfilled so that they are fully able to carry out their caring responsibilities.

Less formally, parents would likely benefit from reading up as much as they can about their child’s condition so that it is less frightening to them and they are better equipped to help the child manage the symptoms that it brings at the time, and in the future as well.

A lot of parents try to blame themselves for their child’s mental health problem and the guilt that comes about from this can cause them considerable distress. Parents should therefore use their support networks where they can, which may mean speaking to friends, relatives or colleagues about how they are feeling and the kind of support that they need to manage how they are feeling.

Another key element of helping parents to be supported when their child is mentally unwell is making sure that they know that their child will not recover from a mental health problem overnight and that this may take some time even to see a small improvement. Parents who expect their child to be back to normal within a few days may then experience the disappointment that this brings as well as additional worry that their child is not responding and will therefore never be well again.

Support and guidance

If parents feel as though they need a more formal level of support, they should contact any of the following who will be able to offer them guidance and support:

• GP.
• Counsellor.
• Their child’s mental health professional, e.g. someone who works for Child and Adolescent Mental Health Services (CAMHS).
• Charities such as Mind or Young Minds.
• Children’s mental health services.

Seeking formal help is not easy for a lot of parents, who may feel as though they have failed if they cannot support their child on their own, but this is not the case. Most often, children will recover much more quickly with expert input from various different sources, all of whom work together for a positive outcome.

Sometimes, children may feel they don’t want to talk to someone they know about how they are feeling. It can be easier for children to talk to someone that they don’t know. Here are some charities that you can recommend children use. It is also important that parents and staff take advantage of the free resources available for them to use to help support children at home and in the classroom.

Childline – Is a free service that is private and confidential where you can talk about anything. 1-to-1 support is available over an online chat, through email or on the phone for anyone in the UK under the age of 19. Childline counsellors are trained staff and volunteers. There is also a chat forum for children to talk with other children over message boards. This can help them as they will realise they aren’t alone in how they feel.

Child and Adolescent Mental Health Services – Focus on the needs of children and young people. They have multidisciplinary teams of psychologists, social workers, support workers and psychological therapists. Most CAMHS services have their own websites so it is best to explore the website of the CAMHS closest to you if you are wanting to refer a child.

Young Minds – Offer support for children, parents and practitioners. They have a text messaging service that offers support when a child needs urgent help. For professionals there is a toolbox to help you support children and families who need mental health support the most. You can sign up for free e-newsletters that have resources, videos and tips for mental health.

Diagnosis

A diagnosis is a formal identification and recognition of an illness, which is determined by a health professional.

It may be more difficult for professionals to diagnose mental illnesses in children because sometimes symptoms can be mistaken for a different condition, and because children are often not as able to explain how they are feeling and what effects their feelings are having on their life. Parents and other adults, such as teachers, may have some input in a diagnosis such as explaining what the child’s symptoms are, but this does not guarantee that a diagnosis will be made any easier for the child.

Typically, when a diagnosis is being made, healthcare professionals will look at three key factors:

• The individual’s experiences such as their feelings, behaviours and physical symptoms.
• How long the experiences have been occurring.
• The impact that the experiences are having on the individual’s life.

To diagnose a child, health professionals will ask questions about moods, thoughts and behaviours and will base a diagnosis on what is being described. For example, if a child described not wanting to get out of bed and feeling sad, they may diagnose depression based on these symptoms.

Getting a diagnosis of a mental health problem can be a relief for some parents who are pleased to know that they can get formal care for their child and that someone will be able to help them to support the child as well. However, for some parents, a diagnosis of a mental health condition will be devastating to them, as they will worry about how their child will be judged and may feel overwhelmed by the responsibility of caring for a child who has been officially diagnosed as being mentally unwell.

It is important once a diagnosis is made that a parent informs the school if they haven’t already informed them of their concerns. The school is not there to judge and will be able to put things in place in the school setting to support the child. Such as assigning a teacher for the child to talk to, referring them to the pastoral team in a school setting, helping them manage their school work so they don’t feel overwhelmed and helping them during exam season.

Schools are trained in mental health awareness and will be able to provide the best possible support for the child, which may help them feel better about dealing with their mental health problems.

Responding in a crisis

A mental health crisis occurs when an individual no longer feels able to cope or feels in control of their current situation.

Children who are most likely to experience a mental health crisis are those who:

• Are at immediate and significant risk of self-harm.
• Are an immediate and significant risk to others because of their mental health.
• Are being considered for admission to a mental health inpatient unit.
• Are in acute psychological distress in relation to their daily activities.

Safety plans

Children who are susceptible to mental health crises will likely have a plan in place (referred to as a ‘safety plan’), which identifies how everyone should respond in order to bring about the best outcome.

The plan should list steps and strategies that have been put into place to help the child and their parents and these should have been developed with the input of the child.

The plan will include information related to steps and strategies that cover the following factors:

• Knowing when to get help – what signs indicate that a crisis may be starting?
• Coping skills – what can the child do to take their mind off the problem and what barriers may there be in using these skills?
• Social support – who can be contacted in a crisis such as trusted family members or friends?
• Professional help – where would the child go in a severe incident? For example, to A&E.

It is most useful if everyone who has contact with the child is able to access a copy of the safety plan so that the support that they receive is consistent and directly in line with their needs.

Cognitive behavioural therapy

This form of therapy works by enabling the child to look at their thinking patterns and readjust them so that they do not automatically fear the worst and can self-question in times when they may catastrophise. For example, if they are walking home and can see smoke in the air, many people prone to mental health difficulties will immediately ‘predict’ that their house is on fire. CBT will enable them to ask themselves how likely this actually is and so they are able to calm themselves when they realise how unlikely their prediction actually is.

Like in most situations there are advantages and disadvantages of CBT. Here are some:

Advantages:

• CBT does not take as much time to complete in comparison to other talking therapies.
• Children can benefit from CBT when used correctly.
• The skills learnt through CBT can be carried forward, helping children cope in the future.

Disadvantages:

• CBT is not useful for children with specific learning difficulties, so for certain children this form of therapy won’t help them.
• CBT relies on the will of the child, so if a child doesn’t want to do it, then it won’t help them get better.
• CBT can make children feel worse before they feel better, which may make children think it isn’t working and make them give up trying in the sessions.

Play therapy

Play therapy is most often used for children between the ages of 3 and 12 years, using play as a communication tool to enable children to understand their personal world and help them to successfully manage emotional distress.

Play therapy helps children to work through their difficulties without feeling interrogated or threatened, as they are able to work at their own pace and communicate at their own level. Children will be encouraged to play with specific types of toys that help them express themselves as well as using arts, crafts, dancing and storytelling.

It is thought to be most useful for children who are undergoing events such as:

• Domestic Abuse.
• Abuse.
• Trauma.
• Family crisis.
• Serious illness or hospitalisation.

Advantages:

• It helps offer a more relaxed setting for children, which will benefit them if they are already feeling anxious.

Disadvantages:

• It can be a long, drawn-out process that requires patience and for the child not to feel rushed into disclosing information.
• Some therapists can find it hard to adapt play time into meaningful discussions.

Counselling

Counselling gives a child the chance to speak about how they feel without the fear of being judged by anyone. Speaking to a counsellor away from their normal daily activities can take the pressure off a child and encourage them to open up about their feelings and to understand what may be causing them to feel how they do.

The methods used in counselling will depend on the child’s age, their circumstances and their personal development. Some children will benefit from talking therapies where they will simply talk to a counsellor who will listen, show empathy and help to empower the child to recognise the source of their difficulties and how they will take control of them and accept or change them as they see fit.

Advantages:

• There are different forms of counselling, so if a child isn’t benefiting from one form of counselling, they can try other forms.

Disadvantages:

• It can make children feel worse before they feel better.

Medical interventions

Medication is sometimes offered to children whose mental health difficulties may be affecting their daily activities. The most common type of medication that is prescribed is some form of anti-depressant. These usually work by increasing the amount of serotonin available in the brain. Serotonin is a ‘feel good’ hormone and its reduction is thought to be directly linked to low mood and depression.

Antipsychotic drugs may be prescribed to reduce distressing symptoms of psychosis, which is rare in children but for those who do experience it, can be very frightening and can significantly reduce their quality of life.

Sometimes, sleeping pills and tranquillisers can be used for children with severe anxiety and insomnia but this would again be in rare cases and children who were prescribed such medication would be subject to consistent review.

How can I make sure my knowledge is up to date?

It is important that your knowledge of children’s mental health is up to date due to new legislation changes and updated advice coming out. A short CPD course would show that you are up to date with your training.