Licensed psychologist Alissa Briggs, PhD, discusses how to recognize mental health concerns in children
Mental health is an issue that has historically been overlooked and neglected in the United States. Thankfully, that seems to be changing as the stigma surrounding discussion of mental health lessens.
Maintaining sound mental health is an important part of child development. Mental health disorders are common in young people, and it’s important these issues are addressed as early as possible.
Alissa Briggs, PhD, recently discussed with us when to be concerned about mental health in children. Dr. Briggs is a licensed psychologist and associate professor of pediatrics at the University of Kentucky specializing in suicide prevention and assessment of neurodevelopmental disabilities.
What are some important things parents should understand about mental health related to children?
Mental health concerns need to be addressed early. Hoping that a child will “grow out of it” will only allow the emotional and behavioral patterns to worsen and persist. For example, children whose anxiety was left untreated often go on to develop depression in adolescence and adulthood. Distress in children may manifest differently than in adults. While an adult with depression may appear slowed, sad, and withdrawn, a child with depression may seem irritable and/or oppositional. Children may have a difficult time understanding and naming their feelings. However, they recognize their internal discomfort, which may result in them acting out.
If your child seems irritable, prone to severe and extended temper tantrums (lasting more than 20 minutes or inclusive of aggression/running off), and generally uncooperative – especially if this represents a gradual or sudden change in their attitude and behavior – they may be struggling with mood.
What type of disorders are most common with children?
Anxiety and neurodevelopmental disorders (like Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder) are the most likely threats to mental health in childhood. Obsessive Compulsive Disorder and Tic Disorders also emerge in childhood. Behavior disorders observed in childhood likely have mood as a root cause. For example, anxiety about meeting demands/completing tasks can look like Oppositional Defiant Disorder, but the root issue is an overwhelming feeling of internal pressure.
As mentioned before, earlier identification and treatment leads to better long-term outcomes. If your gut tells you your child is not themself, seek the advice of a medical or mental health professional.
What does research tell us about the prevalence of mental health issues within the younger population?
The widely cited statistic is that about 20% of children will experience a mental health disorder at some point. The Annie E Casey Foundation has a nice summary of our current knowledge regarding the prevalence of various mental health concerns in children and adolescence.
There is one important and scary point that I want to draw attention to, and that is suicide risk in this population. Children are expressing suicidal thoughts at younger ages. We have started screening for suicide risk in some pediatric outpatient clinics, and we are finding that 14% of our at-risk population is below age 12. In general, about 10% of our pediatric population is at-risk for suicide. I know we don’t want to think of our babies feeling this way, but it is important pay attention to statements about being better off dead or wanting to die and seek help from 988, the primary care provider, and/or a mental health professional. Inquiring further about these statements and addressing them communicates to the child that you take their distress seriously and does not increase risk or place the thought in their head.
What are some more warning signs a child might be suffering from mental health issues?
- Irritability
- Changes in sleep and appetite
- Loss of skills previously attained (regression in ability to do things for themselves and toileting accidents)
- Temper tantrums that are either long lasting or aggressive
- Harming themselves, harming others, or harming animals
- Lack of interest in play
- Lack of interest in activities that used to give them joy/excitement
- Excessive movement, running, and climbing (beyond what would be expected for the developmental level)
- Repeating actions over and over again
What steps should a parent take if they are concerned about mental, behavioral, or emotional issues with their child?
Make an appointment to discuss concerns with your pediatrician and reach out to your school mental health professional.
Be aware of 988 and share this resource with your child, if appropriate. 988 is a valuable resource for anyone of any age experiencing a mental health crisis or who knows someone in crisis (either as a parent or peer). 988 can be called or texted. Anyone can call for a mental health concern or concern about a loved one. If you want your child to access 988 and use a downtime feature, you will need to program in 988 as a contact and set it as an always allowed contact.
