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Sunday, January 6, 2013

What Families Can Do When a Child May Have a Mental Illness

From NAMI - The National Alliance on Mental Illness

By Ken Duckworth, M.D.
December 22, 2012

If you are worried about your child’s mental health, follow your instincts!

Unexplained changes in a 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, and it isn’t easy to simplify the range of challenges children face. One way to get a handle on this is to get an evaluation of your child or teen by a licensed mental health professional.

Because all children and youth are unique and the local mental health services, insurance coverage and school services vary a great deal from community to community, it is a challenge to find the right kind of help for your child.

What are some things that should concern a parent?
  • 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  • Acting very withdrawn, sad or overly anxious.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.

What are some common mental health conditions in children and youth?

The onset of psychotic illnesses is not common overall, but the teen and young adult years are periods of higher relative risk.


Getting an accurate diagnosis for your child can be challenging. Several factors contribute to this challenge, including:

  • Symptoms, which often include difficult behaviors and dramatic changes in behavior and emotions. They 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, including anorexia, bulimia or binge eating.
  • 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 they may “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.

Insurance providers are heavily regulated entities at the state level and appeal processes to see out of network providers may be needed.

Despite these challenges, there is still plenty families can do to help their child get an accurate diagnosis and ultimately receive the most effective treatment, supports and services. Families know their child best and their expertise is essential in securing an accurate diagnosis for their child.

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’s mental health, 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 suspects that your child is experiencing 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. In some cases the pediatrician may offer to provide some of the services his or 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 the office for you to help get an appointment scheduled for your child. Many mental health professionals have long waiting lists and/or may not be taking new patients, so a call from your pediatrician can help get an immediate appointment for your child.

You can also ask for referrals from families involved with NAMI or other advocacy organizations. To find a child psychiatrist, visit the American Academy of Child and Adolescent Psychiatry 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 same path and are happy to share their wisdom and experience with you. Engage with others through social media on NAMI's Facebook page. It is important to know that you are not alone and to share in learning about programs and services.

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.

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