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 speak up about what it is that they are feeling.
According to the Guardian – One in eight people aged under 19 in England have a mental health disorder
Approaching the subject of mental ill health
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 than asking questions that are closed and can only be answered with ‘yes’ or ‘no’.
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 what is troubling them with someone else. 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.
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:
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.
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.
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 where 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.
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.
- Family crisis.
- Serious illness or hospitalisation.
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.
Medication is sometimes offered 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 tranquilisers 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.