As parents and caregivers, we need to be attuned to children’s mental health by checking in with them, talking openly about ways of promoting mental health, watching for changes in their mood and behaviour, and seeking out help when they seem “stuck”.iStockPhoto / Getty Images
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Tracy Vaillancourt, Ph.D., Professor and Canada Research Chair in School-Based Mental Health and Violence Prevention, University of Ottawa
Sheri Madigan, Ph.D., Associate Professor and Canada Research Chair in Determinants of Child Development, University of Calgary
Daphne J. Korczak, M.D., M.Sc., Associate Professor and SickKids Chair in Child and Youth Medical Psychiatry, Psychiatrist, Hospital for Sick Children
Peter Szatmari, M.D., Psychiatrist, Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health
The pandemic has been hard and stressful on many. Despite the common view that children and youth are inherently resilient, they too have suffered. Indeed, over the past two years, children and youth have experienced profound life changes— their education and extracurricular activities have been disrupted or cancelled, they have missed out on milestones like ceremonies, school trips, and tournaments, and they have had fewer opportunities for formal and informal social gatherings. For some, these changes have also been experienced against a backdrop of worry about their own health and/or the health of their family and community members.
Understandably, parents and caregivers have been concerned about how these unique experiences may relate to their child’s or teen’s mental health. Studies have shown that children and adolescents have had varied reactions to these pandemic and life stressors. Some have fared better, some worse, and some have managed about the same as they did before the pandemic. For those whose mental health may have deteriorated, it is important for parents and caregivers to recognize the signs of trouble and how to access help if needed.
Mental health can be represented as a continuum from well-being to emotional and behavioural problems and concerns to mental disorders. What normally differentiates children and youth with a mental disorder from those who have problems and concerns is their level of distress and/or impairment. The distress (e.g., excessive worry, sadness, pain, or frustration) experienced by children and adolescents with a mental disorder often seems out of proportion to the severity or intensity of the stressor they are exposed to. The distress also leads to impairment in important areas of their lives, such as at school or work, or in their peer or family relationships. They may also have difficulty engaging or participating in community activities.
Parents and caregivers should pay attention to changes in their child’s or teen’s mood and behaviour compared to when they last seemed well or were their usual selves. This is often referred to as “baseline change”. A good example of a baseline change is when a child or teen who used to be described as happy and engaged (i.e., baseline behaviour) is now sad and withdrawn (i.e., change).
Children and adolescents who are experiencing mental health problems can show subtle or more overt changes in the following areas:
· · sleeping and eating patterns (e.g., more or less than usual)
· social habits (e.g., not seeing friends as often, declining invitations, or not wanting to leave the house)
· school (e.g., grades, attendance, motivation)
· physical health (e.g., stomach aches, headaches)
· concerns about body shape and size; weight gain or loss
· hygiene (e.g., not showering regularly, wearing soiled clothing)
· energy levels (e.g., seem slower, more tired, or have a lot more energy than before)
· mood (e.g., seeming more sad or tearful, irritable, or angry)
· interests (e.g., less interested and engaged in activities they used to enjoy)
· risk-taking or other concerning behaviour (e.g., stealing, drinking, self-harm, increased cannabis use)
Your child or teen might also tell you, significant others like teachers or friends, or post on social media that they don’t like themselves, that they feel everyone hates them, that there is no point in living. They may say that they feel guilty, helpless, or worthless.
Signs of mental health problems are often expressed across different contexts of children’s lives. For example, children and adolescents who are not doing well tend to be sad at home and at school. It is important to bear in mind that just like adults, kids have good days and bad days. Mental health problems are different from the occasional bad day; symptoms are typically sustained across weeks and months.
With this information in mind, when should parents and caregivers seek help? If you notice changes in your child or teen (more than one from the list above) or if two or more areas of their life are impacted (for example, not wanting to see friends or go to soccer games), we recommend you talk with your child about your observations, and ask them how they are feeling, and whether they have noticed these changes too. Consider speaking with your child’s or teen’s teacher or guidance counsellor. They can be very helpful by providing another perspective about how your child or teen is interacting with peers and participating academically. They can also provide suggestions and support to improve academic or social stressors that may be contributing to how your child or teen is feeling. Next, check in with your child’s or teen’s health care provider. They are in the best position to evaluate how your child is doing, offer strategies, resources, and services, and decide on the best next steps together with you and your child.
If your child or teen is not keen on the idea of talking to their health care provider, they can also access support from Kids Help Phone via chat or phone. This support service is appropriate for children and youth. Community-based supports are also available for parents and caregivers.
If your child or teen is struggling, they are not alone, many other children and adolescents are struggling too. As parents and caregivers, we need to be attuned to children’s mental health by checking in with them, talking openly about ways of promoting mental health, watching for changes in their mood and behaviour, and seeking out help when they seem “stuck” in their mental distress or risk-taking behaviour. We know that when children and youth draw on resources and supports and build up their coping strategies, it can improve how they feel and turn them toward more optimal mental health.