Teen Mental Health Is Worse Than Ever. How to Help Your Child

The latest report from the Centers for Disease Control and Prevention (PDF) has found that teen girls are experiencing record high levels of sadness. Fifty-seven percent of girls said they feel persistently sad or hopeless. That's a 60% increase over the last decade. 

The report calls for immediate investment in school mental health resources to give teens the support they need. But school isn't the only place that intervention can happen. Mental health is a crucial part of overall health and should be regularly discussed in all homes.

We know that talking about emotional or mental well-being isn't always easy. You can start by using these five tips to discuss how your child is feeling. 

Why should you talk to your kids about what they're feeling?

Coping mechanisms and emotional regulation don't develop overnight. Childhood and adolescence are crucial stages where kids build their coping mechanisms and resilience. Sometimes challenges come along that children will have trouble handling, like a pandemic that changed one of the biggest parts of their lives -- school. According to a C.S. Mott Children's Hospital study, 46% of parents said they have noticed new or worsening mental health challenges in their children since the start of the pandemic. 

"We know that during the pandemic, there was an increase in depression and anxiety in both adults and children, an increase in emergency room visits and an increase in suicidality in adolescents and children," says Dr. Gabrielle Shapiro, chair of the American Psychiatric Association's Council on Children, Adolescents and their Families. "This crisis creates an opportunity for parents to speak to their children about mental health so that we can erase stigma and normalize mental illness as being just like physical illness."

Though it's not just a concern isolated to pandemic times, many mental disorders like anxiety disorders, depression or other mood disorders start in childhood. According to the CDC, approximately 5.8 million children aged 3 to 17 years old live with anxiety, 2.7 million suffer from depression and 8.9% have behavioral problems. 

When is the best time to start talking?

The million-dollar question: When should I worry about my child's mental health? Admittedly, the answer is a little complicated as your child's circumstances are unique. There is no one size fits all answer for this question. 

"Mental health challenges were already the leading cause of disability and poor life outcomes in young people, with up to one in five 3- to 17-year-olds in the US having a mental, emotional, developmental or behavioral disorder," says Tramaine EL-Amin, client experience officer with Mental Health First Aid. "Today, nearly 10% of youth under 25 experience major depression, and 75% don't receive any mental health treatment. And the impact of that is tragic. Suicide is the second-leading cause of death for youth ages 10 to 24."

Mental health troubles affect all ages in varying ways. Because of this, it's never too early to introduce the topics in an age-appropriate way.

If your child is exhibiting any of these symptoms, then it's time to talk:

• Withdrawing from social situations or actively avoiding them. 
• Focusing on fears and worries. 
• Extreme irritability or out of control behavior. 
• Significant changes in mood or personality. 
• Changes in their grades or ability to concentrate. 
• Regression in behavior -- wetting the bed or sucking their thumbs. 
• Frequent stomach aches or headaches.
• Destructive or self-harm behaviors.

"Start the conversation early and frequently," suggests Alvord. You want to observe their behavior and then respond accordingly, putting together an action plan to deal with the situation. As your child matures, the conversations will become more complex as their needs and understandings change. 

5 tips for talking about mental health for kids

We've established that it's best to talk to your children about mental health topics early and as often as you see fit. But that's often easier said than done. If you don't know where to start, you can use these tips to have a healthy conversation with your child.

1. Use straightforward communication

They aren't easy conversations to have, especially when you're concerned about your child's safety. You'll need to use an immense amount of self-control and tact. 

"It's important to know that showing that you're concerned about their behaviors will not make things worse; it'll help acknowledge what they've been thinking and feeling, making you both more connected. Your role isn't to diagnose your child; keep your message simple: You've noticed behaviors that you are concerned about. You want to support them," says Jennifer Rothman, senior manager of Youth and Young Adult Initiatives at the National Alliance on Mental Illness. 

Using a straightforward and calm communication style is essential when talking about mental health topics. Rothman also mentioned that it's important to ensure that the language and detail you got into is appropriate for your child's age and developmental stage. 

You can expect to listen more than you talk. You want to avoid the urge to compare your experiences at that age to theirs. And always allow for silence during the conversation and listen.

2. Give examples and help them identify what they are feeling

Giving your children the vocabulary to identify what they are feeling is crucial. And this can start as early as board books for toddlers. There are numerous books on the market that cover topics like feelings, anxiety and self-esteem. According to Alvord, you want to help your child see the connection between their emotions, thoughts and feelings. Books are a great place to start. 

Another way to give your child an example is talking through situations and how they made you feel. You want to model positive behaviors and show that sharing your feelings is good. "You want to give the big message that mental wellness is as important as physical wellness. You really can't have one without the other," says Mary Karapetian Alvord, clinical fellow of the Anxiety and Depression Association of America and co-author of Conquer Negative Thinking for Teens.

You can do this at the dinner table, during their bedtime routine or any time it works for your family. The point is to make it a part of normal conversation, so they always feel comfortable bringing their thoughts and emotions to you. 

3. Listen to their feelings and reassure them

During conversations with your child, you want to make sure they're comfortable and ready to share.

"Find a comfortable place to speak with your child and keep the discussion straightforward, honest, and appropriate for the developmental age of the child. Parents can reassure their children and teens that it's ok to talk about their feelings and emotions and ask questions," says Shapiro.

You should also pay close attention to how they respond to the conversation. If they are confused or upset, you can slow the conversation down. Let them ask you questions or take a break and pick the conversation up another time. The last thing you want to do is accidentally invalidate any feelings. You want them to know you hear their feelings and understand them.

According to EL-Amin, many parents fear that talking about these topics will make their children feel alienated. However, listening to their feelings and letting them know that mental health challenges are common will likely bring them relief. 

4. Ask and answer questions

Asking your child questions is the easiest way to spark the conversation about mental health. Just remember, you want to keep them simple. 

Mock questions that you can ask about kids' mental health from Rothman:

• How are you feeling?
• Tell me more about what's happening. Maybe if I understand better, we can find a solution together.
• Sometimes you need to talk about your feelings. I'm here to listen. What would you like to talk about?

You also need to be ready to answer the questions they ask you. Especially with young children, they will have questions -- probably quite a few. They might have questions about how they are feeling or potential treatment options. Reassure them and answer what questions you can. Remember, no one expects you to have all the answers. It's ok to say that you don't know the answer. You can find it for them or you ask someone who can.

5. Know when to ask for help

There are times when you'll need additional support to work through certain situations. Teens will likely share less, Alvord mentions. So if your child doesn't want to talk to you, make sure you have counselors or doctors to turn to. Things can escalate to the point where you need additional help. If your child's behavior lasts for weeks or impedes their function, seeking outside help is a good idea.

Start now

You don't have to wait until there is an issue to start the conversation about mental health with your children. It's a good idea to start regularly checking in early in their lives and continue doing so. That way, mental health doesn't have to be some mountain to climb to get help; they'll feel more comfortable coming to you. 

It doesn't have to be formal. You can ask questions to gauge their feelings. The more you talk, the less stigma there is. You want to talk often, be open and support whatever their needs are.