What Families Can Do When a Child May Have a Mental Illness
If you are worried about your child’s mental health, follow your instincts. Unexplained changes in your child’s behavior and/or mood may be the early warning signs of a mental health condition and should never be ignored. There are many different types of mental illness, including anxiety, depression, bipolar disorder, eating disorders, ADHD and autism spectrum disorder, and it isn’t easy to simplify the range of challenges children face. One way to begin if you are concerned is to get an evaluation for your child or teen by a licensed mental health professional. Because all children and youth are unique and local mental health services, insurance coverage and school services vary from community to community, it is a challenge to find the right kind of help for your child.
As a parent, there are things that you should be concerned with if you see them, such as:
• A sudden or persistent drop in school performance.
• Persistently aggressive behavior.
• Threats to self or others.
• Substantial mood swings.
• Hallucinations, paranoia or delusions.
• Acting very withdrawn, sad or overly anxious.
• Extreme difficulty interacting with friends and/or siblings.
• Extreme changes in sleeping and eating patterns.
• Increased or persistent use of alcohol or drugs.
Several factors contribute to the challenge in getting an accurate diagnosis, including:
• Symptoms, which include difficult behaviors and dramatic changes in behavior and emotions, may change and continue to develop over time. A clinical interview should gather a full history, a “movie,” as well as a “snapshot” in the interview process.
• Diagnoses may co-occur. A teen with an anxiety disorder may be using alcohol extensively. A teen with major depression may also have problematic eating behaviors.
• Children and adolescents undergo rapid developmental changes in their brains and bodies and face multiple social role changes at the same time.
• Younger children may be unable to effectively describe their feelings or thoughts, making it harder to understand their experience. They may “show” distress more than “tell” about their distress. They may be seen frequently in school nurse offices with headaches or stomachaches but may have an undiagnosed psychiatric disorder.
• It is often difficult to access a qualified mental health professional to do a comprehensive evaluation because of the shortage of children’s mental health providers and because some health care providers are reluctant to recognize mental illnesses in children and adolescents.
Despite these challenges, there is plenty families can do to help their child get an accurate diagnosis and receive the most effective treatment, supports and services.
What should parents do if they suspect a mental health condition?
Talk with your pediatrician. Early identification and intervention are important. If you are concerned about your child, start by talking with your pediatrician, share your concerns and ask for a comprehensive check-up. A comprehensive physical examination should be done to rule out other physical health conditions that may be causing a child’s symptoms, such as an endocrine problem, recurrent head injuries in sports or other conditions. If the pediatrician believes your child is exhibiting early signs of a mental health condition, the pediatrician may either talk with you about treatment options or may recommend a referral to a mental health professional or may offer to provide some of the services herself.
Get a referral to a mental health specialist. If you are referred to a mental health professional, ask your pediatrician to help by calling for you to help get an appointment scheduled for your child. Many mental health professionals have long waiting lists and may not be taking new patients, so a call from your pediatrician can help get an immediate appointment for your child. To find a child psychiatrist, visit the American Academy of Child and Adolescent Psychiatry website (www.aacap.org) and click on “Child and Adolescent Psychiatrist Finder.”
Work with the school. Meet with your child’s teacher or other school officials to request an evaluation for your child for special education services. Work with the school to identify effective interventions that promote positive behaviors, social skill development, academic achievement and prevent challenging behaviors in school. Ask your child’s treating mental health provider to identify interventions that can be used at school and at home to help you and your child cope with challenging behaviors and related issues.
Connect with other families. Never underestimate the importance of connecting with and working with other families. There are many seasoned families who have walked the walk and are happy to share their wisdom and experience with you. Contact NAMI at www.namistl.org to learn how you can connect with other families in your community.
For some children, having a diagnosis is scary and they may be resistant to accept it. Others are relieved to know that what is happening to them can be addressed and that they are not alone. It is important to find ways to use the strengths and interests of your child to help him or her cope with current and future challenges.
Reviewed by Ken Duckworth, M.D., December 2012