Mental Health Challenges in Children

Nearly half of all mental health disorders begin before the age of 14, and three quarters begin by the age of 24. And since early intervention is crucial to the successful treatment of any challenge or diagnosis, it is critical we understand how children are affectedand common symptoms to pay attention to.

Alarming Behaviors

All children develop differently and not every problem is serious. Some children experience delays in cognitive, physical, social and emotional development and that is not necessarily indicative of an impending diagnosis. That being said, parents should be aware of thefollowing behaviors, seen across a variety of settings, which could indicate the emergence of a mental health challenge:

  • Changes in appetite or sleep
  • Social withdrawal
  • Fear of things that normally do not frighten the child
  • Regression in behaviors appropriate of younger children (such as bedwetting)
  • Sadness or tearfulness
  • Self-destructive behavior (such as head-banging)
  • Repeated thoughts of death

If you notice any of these behaviors, consider finding out if your child would benefit from further evaluation by a specialist. Specialistsinclude psychiatrists, psychologists, social workers, psychiatric nurses, and behavioral therapists. Educators may also help in the evaluation of your child.

It is important to note that it can be difficult for young children to express themselves and therefore, identifying their challenges and assigning a proper diagnosis may be complex. In addition, the symptoms of a mental health diagnosis in a young child may differ from those in an older child or adult.It may also beimportant to involve your pediatrician with any specific concerns.

Stress in Children

Often, children experience a change in behavior after a stressful event such as a death in the family, parent illness, divorce, financial problem, and more. It’s normal for stress to cause a child to be upset. However, if it takes a significant period of time for your child to acclimate to a situation, or if your child has severe reactions, consider if your child has something else that is bothering them.

Generally, watch your child’s ability to respond and cope with stress and involve a professional where needed. Stressful events can be challenging, though they can give you an opportunity to teach your children coping mechanisms as well.

What To Do If You Are Concerned

If you are concerned, the first steps is to talk with your child’s school and ask the teacher if your child hasshown worrisome changes in behavior. You may want to share this information with your child’s doctor or health care provider. If you take your child to a specialist, ask if they have experience with the problems that you see in your child. Don’t be afraid to interview more than one specialist to find the right fit. Continue to learn everything you can about the challenge or diagnosis. The more you learn, the better you can work with your child’s clinicianto make decisions that feel right for you, your child, and your family.

Diagnosing a Disorder

While diagnosing mental health challenges in young children can be difficult, it can be an important component to getting them the help they need. A diagnosis can be used to guide specific treatment based on research pertaining to the diagnosis. Like adults, children with mental health challenges are diagnosed after a mental health professional carefully observes their symptoms and collects all relevant information. This includes:

  • Ruling out other possibilities
  • History of important medical problems, including the presenting challenges
  • Family history of mental health diagnosis
  • Past physical or emotional trauma experienced by the child
  • General information and concerns from parents, teachers, caretakers

Some children’s symptoms improve without the need for intervention. For others, ongoing professional help is needed. Be sure to talk to your child’s doctor or specialist about problems that are severe, continuous, and affect daily activities. Most importantly, don’t delay seeking help. Early treatment may result in better outcomes.

Treatment for a Mental Health Challenge or Diagnosis

There are two main vehicles that can be used as treatment for a mental health challenge in children: Psychotherapy and Medication. Sometimes, these treatments are used in concert with one another.


Psychotherapy, often referred to as “talk therapy”,can help children with mental health challenges. When working specifically with children and parents, these therapies teach effective coping strategies.

Cognitive behavioral therapy (CBT) is a type of psychotherapy that can be used with children. It has been widely studied and is one of a number of effective treatments for conditions, such as depression, obsessive compulsive disorder, and social anxiety. A person in CBT learns to change distorted thinking patterns and unhealthy behavior. Children can receive CBT with or without their parents, as well as in a group setting. CBT can be adapted to fit the needs of each child and is especially useful when treating anxiety disorders.

Some children benefit from a combination of different approaches, but psychotherapy often takes time, effort, and patience. In all cases, children can learn new skills that may have long-term benefits as they age.


For some children, psychotherapy alone is not enough to support and manage challenging symptoms and medication becomes the recommended next step. In fact, many children would suffer serious and dangerous consequences without medication. In all cases, your child’s mental health professional can guide you towards the best treatment plan – involving both therapy and medication where applicable.

If medication is something you are interested in, be sure to:

  • Ask your doctor about the risks of starting and continuing your child on medication
  • Learn about the medications prescribed for your child- including possible side effects
  • Understand the details of the treatment and what the expected results should be
  • Follow up with the doctor if the results are not seen within the expected time frame
  • Avoid changes to the medication regiment without speaking to the doctor – there are risks associated
    with stopping a medicationand this may not be conducive to one’s long term good health
  • Share current medication lists with the doctor. Drug interactions can impact the efficacy of the
    medication or lead to serious side effects

Despite possible challenges in finding a medication that works, for some children, the risks of an unmanaged diagnosis outweigh the possible side effects of medication. For these children, an appropriate, well-managed treatment plan involving medication, under the supervision of a mental health professional is a great option.

The Family: The Challenge for Loved Ones

The interactions between a child with a mental health disorder and the family can offer its own set of challenges. Before a child is diagnosed, frustration, blame, and anger may have built up within a family. Parents and children may need special help to undo these unhealthy interaction patterns. Also, taking care of a child with a mental health disorder is hard on the parents, family, and other caregivers. Caregivers must tend to the
medical needs of their loved ones while also balancing their own health and needs. The stress that caregivers are under may lead to missed work or lost free time. It can strain relationships with people who may not understand the situation and lead to physical and mental exhaustion.