In 30 seconds…
Mental health problems affect about 1 in 10 children and young people. They include depression, anxiety and conduct disorder, and are often a direct response to what is happening in their lives.
Childhood and adolescence are critical stages of life for mental health. This is a time when rapid growth and development take place in the brain. Children and adolescents acquire cognitive and social-emotional skills that shape their future mental health and are important for assuming adult roles in society.
Half of all mental health conditions start by 14 years of age. Suicide is the third leading cause of death in 15-19 year-olds. The consequences of not addressing mental health and psychosocial development for children and adolescents extend to adulthood and limit opportunities for leading fulfilling lives.
Around 14 percent of children and young people aged 4–17 years are affected by mental illness at some time. This rises to 26 per cent for those aged 16–24. Seventy-five per cent of severe mental illness emerges before the age of 25 and accounts for 70 per cent of the total burden of mental illness among young people.
Alarmingly, however, 70% of children and young people who experience a mental health problem have not had appropriate interventions at a sufficiently early age.
The emotional wellbeing of children is just as important as their physical health. Good mental health allows children and young people to develop the resilience to cope with whatever life throws at them and grow into well-rounded, healthy adults.
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.
Most children grow up mentally healthy, but surveys suggest that more children and young people have problems with their mental health today than 30 years ago. That’s probably because of changes in the way we live now and how that affects the experience of growing up.
Dealing with change
Mostly things that happen to children don’t lead to mental health problems on their own, but traumatic events can trigger problems for children and young people who are already vulnerable.
Changes often act as triggers: moving home or school or the birth of a new brother or sister, for example. Some children who start school feel excited about making new friends and doing new activities, but there may also be some who feel anxious about entering a new environment.
Teenagers often experience emotional turmoil as their minds and bodies develop. An important part of growing up is working out and accepting who you are. Some young people find it hard to make this transition to adulthood and may experiment with alcohol, drugs or other substances that can affect mental health.
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.
Some of these factors include:
- having a long-term physical illness
- having a parent who has had mental health problems, problems with alcohol or has been in trouble with the law
- experiencing the death of someone close to them
- having parents who separate or divorce
- having been severely bullied or physically or sexually abused
- living in poverty or being homeless
- experiencing discrimination, perhaps because of their race, sexuality or religion
- acting as a carer for a relative, taking on adult responsibilities
- having long-standing educational difficulties.
What mental health problems commonly occur in children?
These are some of the mental health problems that can affect children and young people.
- 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.
- Self-harm is a very common problem among young people. Some people find it helps them manage intense emotional pain if they harm themselves, through cutting or burning, for example. They may not wish to take their own life.
- Generalised anxiety disorder (GAD) can cause young people to become extremely worried. Very young children or children starting or moving school may have separation anxiety.
- Post-traumatic stress disorder (PTSD) can follow physical or sexual abuse, witnessing something extremely frightening of traumatising, being the victim of violence or severe bullying or surviving a disaster.
- 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 aren’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 such as anorexia nervosa and bulimia nervosa can have serious consequences for their physical health and development.
What help is available?
If they have a warm, open relationship with their parents, children will usually feel able to tell them if they are troubled. One of the most important ways parents can help is to listen to them and take their feelings seriously. They may want a hug, they may want you to help them change something or they may want practical help.
Children and young people’s negative feelings usually pass. However, it’s a good idea to get help if your child is distressed for a long time, if their negative feelings are stopping them from getting on with their lives, if their distress is disrupting family life or if they are repeatedly behaving in ways you would not expect at their age.
If your child is having problems at school, a teacher, school nurse, school counsellor or educational psychologist may be able to help. Otherwise, go to your GP or speak to a health visitor. These professionals are able to refer a child to further help. Different professionals often work together in Child and Adolescent Mental Health Services (CAMHS).
Most support for troubled children and young people is provided free by the NHS, your child’s school or your local council’s social services department.
Talking it through
Assessments and treatments for children and young people with mental health problems put a lot of emphasis on talking and on understanding the problem in order to work out the best way to tackle it. For young children, this may be done through play.
Most of the time, the action that professionals recommend is not complex. and it often involves the rest of the family. 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 a talking therapy, psychological therapy or counselling.
Most research into medications for mental health problems has focused on adults, rather than 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 help in some cases.
The professionals supporting your child will keep information about them and your family confidential. 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.