This booklet outlines for parents and carers the things that keep children and young people in good mental health and suggests what can help when children are troubled. It describes the mental health problems that can affect children and young people and outlines the help that is available.
The booklet generally refers to ‘children’ when they are aged 5 to 11 and ‘young people’ when they are aged 12 to 18. But much of the information applies to any young person up to age 18.
“As long as it’s well and happy I don’t mind what sex it is”
We all want our children to get a good start in life and grow up to be happy, well-adjusted adults who are comfortable in their own skin and in society.
When we talk about how our children think and feel and their ability to cope with whatever life throws at them, we are talking about their mental health. Some people call it emotional health or wellbeing and, like physical health, it can change as children’s circumstances change and as they move through different stages of their life.
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When your child is in good mental health, they can:
- develop into well-rounded, healthy adults
- start and keep up satisfying relationships with family and friends
- enjoy their own company
- recognise and describe their feelings and work out what can change the way they feel
- relate to other people and how they may be feeling
- play and learn
- develop a sense of right and wrong
- handle rejection by other children or young people
- cope with problems and learn from them
Children and young people’s mental health is influenced by many different factors:
- relationships in the family
- parenting styles
- the culture of their school
- social factors like poverty or crime
- the genes they inherit
- life events like the death of someone close to them
Things that can help keep children and young people mentally well include:
- being in good physical health, eating a balanced diet and getting regular exercise
- having time and the freedom to play, indoors and outdoors
- being part of a family that gets along well most of the time
- going to a school that looks after the wellbeing of all its pupils
- taking part in local activities for young people
Other factors are also important, including:
- feeling loved, trusted, understood, valued and safe
- being interested in life and having opportunities to enjoy themselves
- being hopeful and optimistic
- being able to learn and having opportunities to succeed
- accepting who they are and recognising what they are good at
- having a sense of belonging in their family, school and community
- feeling they have some control over their own life
- having the strength to cope when something is wrong (resilience) and the ability to solve problems
Children and young people who are resilient are more likely to thrive even if life doesn’t run smoothly.
Some of the ways that you behave as parents can help build your child’s resilience, for example:
- giving them affection and praise
- supporting their education
- setting them boundaries that provide them with discipline that’s consistent and fair.
Babies who develop a strong bond with their parents tend to grow into resilient children. Other things like your standard of living and the culture of your child’s school will be largely outside your control. Growing up in some communities is harder than in others, but mentally healthy children and adults can overcome all sorts of difficulties and hardship.
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Most children grow up mentally healthy, but evidence suggests that more children and young people have problems with their mental health today than 30 years ago. That’s probably because of changes to the experience of growing up and to the way we live now. Many of these changes bring both benefits and pressures.
The internet and mobile phone technology, for example, have created new ways that children and young people are bullied as well as bringing us benefits. Today, there is also a lot of pressure to do well which may not suit all children.
There are certain ‘risk factors’ that make some children and young people more likely to experience problems than other children, but they don’t necessarily mean difficulties are bound to come up or are even probable.
A child or young person is more vulnerable to poor mental health if they:
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have a long-term physical illness
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have a parent who has had mental health problems
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problems with alcohol or has been in trouble with the law
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have experienced the death of someone close to them
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have parents who separate or divorce
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have been severely bullied or physically or sexually abused
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are living in poverty or are homeless
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experience discrimination, perhaps because of their race or religion
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act as a carer for a relative, taking on adult responsibilities
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have long-standing educational difficulties
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Like adults, children and young people all have days when they feel down, worried, restless or angry. They sometimes show these feelings in different ways to adults. They may:
- throw temper tantrums
- cling to you, not wanting to leave your side
- behave badly, aggressively or be rude
- withdraw from family life or from other children
- be unable to settle to an activity or to sleep
- have bad dreams
- experience aches and pains
- cry a lot
- refuse food
The things that trouble children and young people and the way that they respond may both vary with their stage of development.
For example, when children start school, they can feel anxious or distressed.
Teenagers often experience emotional turmoil as their minds and bodies develop. Rows with them won’t be easy for either of you, but they are a normal part of growing up. At any age, children and young people can find it tough to deal with change and to cope with the pressure to do well in exams.
Some children develop at a different pace to others. For instance, some children only have tantrums when they are toddlers; others have tantrums when they are older. Child development experts say that the normal age range for tantrums is 1 to 8 years so you can expect your children to have tantrums at some time when they are young.
Our children will annoy us at times and stretch our patience, but in most cases that doesn’t mean there is anything wrong. Feeling stressed ourselves can influence how we both influence and react to our children’s behaviour.
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- Reassure your child that, whatever happens, you still love them and you will do all you can to help them
- Try to understand what is troubling them – talk to your child, talk to your partner, talk to other people who care for your child or know them well
- Encourage your child to talk about their feelings, but also notice changes in their behaviour that may show you how they’re feeling
- Play with them - play can be a good way for children to relax, deal with their feelings and for you to nurture your relationship with them. Young people may also benefit from time spent doing something you both enjoy.
- Think about the way you’re responding to your child – would changing how you behave make a difference to them?
If you have a warm, open relationship with your children they will usually feel able to tell you if they are troubled. Children and young people don’t want to be preached at. One of the most important ways to help is to listen to them and take their feelings seriously. They may want a hug, they may want you to help them work out what they themselves could change or they may want practical help from you.
With your help, children and young people’s negative feelings usually pass. Most of the time, you will be able to help your children on your own, although you may want to enlist the support of their teachers or other relatives like grandparents.
Sometimes, children and young people prefer to talk to someone they trust outside their family about how they are feeling, especially if they want an independent view from someone who is not involved.
Talking about mental health
Mental health is everyone’s business. Everyone has times when they feel troubled and for any one of us there is the chance that our difficult feelings will develop into a more serious problem.
Just as you explain to your children how their bodies work, it is a good idea to talk to them about mental health. Get them used to the idea that sometimes they or the people they meet won’t feel good and that sometimes that can make a difference to how people behave. The words ‘mental health’ can be frightening so you could talk about emotional health or wellbeing, feeling strong or feeling able to cope.
Many people don’t understand mental health problems and the stigma attached to them means that people don’t talk about them much. Children and young people don’t want to feel different from their friends and young people themselves tend to be more prejudiced about people with mental health problems than adults.
The stigma around mental health problems can make it more difficult for young people to ‘admit’ they have a problem. Reassure your children that having a problem doesn’t make someone ‘weird’.
Terminology
Mental health problems are often described in medical language because that helps professionals to refer people to the support they need. But what you or the professionals call your child’s problem is less important than understanding what is troubling them and working out how to help them. Whether or not their problems are diagnosed as ‘mental health problems’, the majority of children and young people who experience difficulties get over them, especially if they get help early on.
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The things that happen to your child won’t usually lead to problems with their mental health on their own, but traumatic events, such as the death of someone in the family or parents separating or divorcing, can trigger problems for children and young people whose mental health is not already robust.
Other kinds of change that can act as triggers include:
It’s a good idea to get help if your child is distressed for a long time, their negative feelings are stopping them from getting on with their lives, their distress is disrupting family life or they are repeatedly behaving in ways you would not expect at their age.
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Depression affects more children and young people today than in the last few decades, but it is still more common in adults. Teenagers are more likely to experience depression than young children who rarely face depression. Children and young people who are depressed have an intense and persistent feeling of sadness.
They may be:
- irritable
- feel hopeless
- lose interest in all the activities they used to enjoy
- have problems with eating or sleeping.
If it is untreated, depression can lead children and young people to suicide.
Self-harm is a very common problem among young people. It describes the different ways that people deliberately harm their bodies, usually secretly, to help them deal with intense emotional pain.
Self-harm can involve young people:
- cutting
- burning, scalding or scratching themselves
- breaking their bones
- pulling their hair
- swallowing poisonous substances
Many more girls than boys self-harm, but boys’ self-harm is more likely to look like they have had an accident or been in a fight.
Children and young people are often anxious, but if they experience a generalised anxiety disorder, they become extremely worried, perhaps about their performance at school or on the sports field or about their appearance.
Very young children or children starting primary school or moving up to secondary school may have separation anxiety and fear being apart from you.
Phobias are fears out of proportion to real dangers. Children and young people can develop phobias about anything. Common phobias include social phobia which involves anxiety in everyday social situations, fear of certain animals and fear of the dark.
Obsessions are distressing, repetitive thoughts which may seem irrational. Compulsions are actions which people feel they must do to feel less anxious or stop obsessive thoughts. It is common for children to have mild obsessions and compulsions for a time, often when a situation is making them feel anxious. When their obsessions and compulsions upset them or stop them getting on with life, they may have obsessive compulsive disorder (OCD).
Post-traumatic stress disorder can follow physical or sexual abuse, witnessing something extremely frightening, being the victim of violence or severe bullying or living through a disaster.
It can involve:
- flashbacks
- re-enacting the experience
- repetitive play
- avoiding thinking about the traumatic event
- being unable to sleep
- bad dreams,
- other signs of depression or anxiety
Some people describe bad behaviour as a conduct disorder when it lasts for several months or more or goes far beyond what is acceptable in your family or community. It can make family life very difficult and may involve your child breaking the law.
Children and young people are more likely to behave like this if they have learning or reading difficulties, have problems communicating, are depressed, have been bullied or abused or are overactive.
Children who are consistently overactive (‘hyperactive'), behave impulsively and have difficulty paying attention may have Attention Deficit Hyperactivity Disorder (ADHD). Many more boys than girls are affected, but the cause of ADHD isn’t fully understood.
Eating disorders usually start in the teenage years and are more common in girls than boys. The number of young people who develop an eating disorder is small, but eating disorders can have serious consequences for their physical health. If people with an eating disorder are not treated, they can sometimes die.
People with eating disorders often see their weight or body shape as central to their identity and happiness. Many young people find it hard to cope with growing up and may be easily influenced by images in the media. Some people think that this is one of the reasons that their self-esteem can become linked to their weight.
Young people with eating disorders may have:
- an intense fear of weight gain and severely cut down the amount they eat
- hide food
- make themselves vomit
- misuse laxatives or over-exercise to lose weight
Controlling their weight can become a way of gaining a sense of control when they feel unable to control other areas of their life.
People with anorexia nervosa starve themselves by avoiding food. People with bulimia nervosa have periods of binge eating and periods of starvation.
Schizophrenia and bipolar disorder are severe mental illnesses, but they aren’t common. Genetics and brain chemistry may make some people more vulnerable to them and difficult life events can then trigger these illnesses. Misusing drugs may also be a factor in who develops them.
Schizophrenia often involves confused thinking, problems with feelings, behaviour, motivation and speech and seeing, hearing or believing things no-one else does. It most often begins when someone is in their 20s, but can affect teenagers.
Bipolar disorder (manic depression) is associated with severe mood changes veering from the overactive high of ‘mania’ to periods of depression. It can occasionally start in childhood, although the symptoms usually begin between the ages of 15 and 24.
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Children and young people with learning disabilities experience the same emotions as other young people when they are growing up, but it is more common for them to be diagnosed with a mental health problem.
It can be difficult for them to communicate that they are troubled or to understand that it’s important to tell you about these feelings. If your child has a severe learning disability or can’t use words, changes in their behaviour may show how they are feeling. You are probably the best person to recognise something is wrong.
If you think that your child needs professional help, your first point of contact should be their GP or their school Special Educational Needs Co-ordinator. Mental health services for young people with learning disabilities vary depending on where you live. For example, in different parts of the country, a 16 year old could be referred to the local Child and Adolescent Mental Health Service (CAMHS), the Community Team for Learning Disability (CTLD) or the Adult Mental Health Service.
Further reading
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If your child is having problems at school, a teacher, school nurse, school counsellor or educational psychologist may get in touch with you. They are the best people to speak to about your child’s wellbeing at school. Otherwise, go to your GP or speak to a health visitor.
Your child may not need to see anyone else, but if they do, these professionals will be able to refer you to help that’s more suitable for your child’s age, problem or circumstances.
Professionals your child may see:
- art therapist
- child psychiatrist
- clinical psychologist
- drama therapist
- educational psychologist
- family therapist
- GP
- health visitor
- mental health nurse
- music therapist
- occupational therapist
- paediatrician
- play therapist
- psychotherapist
- school counsellor
- school nurse
- social worker
- speech and language therapist
- youth worker
The professionals who may help your child work in different settings:
Many different factors influence mental health problems so the involvement of professionals with different jobs means each one can help your child with a different aspect of their problem.
These different professionals often work together in Child and Adolescent Mental Health Services (CAMHS). CAMHS treat children and young people with more severe and complex mental health problems and most work with young people up to age 18. Services vary across the country and some CAMHS see children with less severe problems, too.
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Assessing and treating children and young people with mental health problems isn’t the same as for other health problems. There is more emphasis on talking and on understanding the problem to work out the best way to tackle it. For young children, this may be done through playing.
Most of the time, the action that professionals recommend is not complex. Your child may be referred to a specialist who is trained to help them explore their feelings and behaviour. This kind of treatment is called talking therapy, psychological therapy or counselling.
Professionals often involve the rest of the family because your child’s difficulties may only be solved by helping you all to understand and change the way you behave together. They may ask you to try out new activities and approaches at home and your support with this is important.
More research has concentrated on the effect on adults of drugs for mental health problems than on children. Children and young people need to be assessed by a specialist before they are prescribed any drugs. There is a lot of evidence that talking therapies can be effective for children and young people, but drugs may be also be important in some cases.
The professionals supporting your child will keep information about them and your family confidential. If your child tells a professional something about the family in confidence, the professional won’t tell you unless there’s a risk to your child or other children if they don’t.
Young people can seek help on their own, either by ringing a helpline or by approaching a professional directly, but your consent is usually needed for them to get medical care if they are under 16. Young people have a right to privacy if they do not want to talk to you about their conversations with professionals, but you should still respond sensitively if they seem to be upset.
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Most support for children and young people who are troubled is provided free by the NHS, your child’s school or your local council’s social services department. Many charities and other voluntary or community organisations also provide free support or run activities like youth groups which can help prevent mental ill health.
In some parts of the country, there are long waiting lists for children and young people to see mental health specialists or to have a talking therapy on the NHS. Some people choose to pay for their children to have treatment.
If you want to go private, your GP may be able to give you details of child psychiatrists and therapists in your area. Your GP will write to them describing your child’s problem and giving them relevant medical information.
Talking therapies provided on the NHS are given by trained professionals.
But there are no rules about who can advertise privately as a therapist treating children and young people and there’s no standard qualification to show that an independent therapist is properly trained.
Check that any therapist that helps your child is registered with one of these organisations:
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Local services
Find organisations in your area working for the wellbeing of children, young people and families in our organisation directory
Visit www.direct.gov.uk and go to ‘Directories’ for links to the website of your local council. Your council has information on local organisations and activities for children and young people.
Info & advice for parents / carers
You can often pick up free information about family life and health at:
- libraries
- town halls
- council (local authority) one stop shops or customer centres
- GP practices and clinics
- Sure Start Children’s Centres (for children under 5 years old and their families). Find your nearest centre by calling 0870 0002288 or visit Sure Start
Young Minds is a national charity committed to improving the mental health of all children and young people. Its Parents Information Service provides information and advice for any adult with concerns about the mental health of a child or young person.
- Call their helpline on 0800 018 2138. Their opening hours are:
The Royal College of Psychiatrists provides information on mental health issues and growing up.
www.rcpsych.ac.uk/mentalhealthinformation/childrenandyoungpeople.aspx
beat is a national eating disorder charity that campaigns, challenges stigma and gives people the help and support they need. www.b-eat.co.uk
Parentline Plus provides a free, confidential service which offers you the chance to get support on being a parent by talking things through with another parent.
- Call 0808 800 2222 24 hours a day
- Textphone 0800 783 6783 Monday to Friday 9am – 5pm
- Visit www.parentlineplus.org.uk for information and to use the confidential email support service
Kidscape is a national charity established to prevent bullying and child sexual abuse. It runs a helpline for parents worried about bullying.
NHS Direct offers confidential information and advice to the general public about health, illness and health services.
Info & advice for children and young people
Childline is a free, confidential helpline for children and young people to talk about any problem with trained counsellors.
- Call 0800 1111 24 hours a day
- Textphone 0800 400 222 weekdays 9.30am - 9.30pm and 9.30am - 8pm at weekends
- Visit www.childline.org.uk
There4me offers online help to 12-16 year olds worried about issues like abuse, bullying, exams, drugs or self-harm. Young people can contact advisors in real time or by email.
Information written for young people:
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