COVID-19 disrupted our lives at almost every level, from home to school to work. Dr Lorelle Drew, Consultant Psychiatrist at The Victoria Clinic, shares some useful ideas for how parents can help children cope with mental health challenges.

How has COVID-19 affected young people’s mental health?

Across all age groups, young people are more vulnerable to anxiety and feelings of not coping with uncertainty about the future. Part of the challenge for parents is managing how you, yourself, react to changes in your world caused by a big challenge.

We’ve seen mental health issues triggered by big changes to day-to-day life, such as social isolation and increases in problematic social media activity. During tough times like the pandemic, it’s especially important to check in with your children about mental health.

What is the right age for parents to start talking with their children about mental health?

Technically, there’s no “correct” age to start talking with children about their mental health or mental health issues in general. It’s very much about how you approach it, keeping in mind their age and stage of development, and the circumstances driving the conversation.

Younger children who are verbal: Use simple language. Talk more about what they’re noticing, rather than abstract ideas. You could start with, “You seem upset”, or, “That person is very upset”, and then monitor their reactions and questions carefully.

Younger children and pre-teens: Let them know they haven’t caused the issue, because at that stage of life they might think they’re responsible for everything.

Teenagers and older children: Teenagers generally think more like adults, therefore you can talk about more complex issues. Reassure them that mental health issues are common and it’s OK to talk about them.

For all ages, it’s important that you – as the adult in their life – make sure it’s a safe and comfortable environment to have the conversation.

How can parents ensure the conversation is ‘safe and comfortable’?

Do some research: As the parent and adult, it’s important you have some understanding of what you’re talking about, so read up on mental health and mental health issues.

Try to stay calm: As much as possible, try not to show too much emotion. And listen. Choose a time where there isn’t chaos or conflict.

Encourage questions: You might open a conversation by saying, “You seem sad and worried sometimes, and you know, that happens to everybody, including parents. I think it’s good we talk about it and you can ask me questions so we can find ways to help.”

What are some signs a young person might have a mental health issue?

Small children: You might notice more interrupted sleep, increased anxiety and they don’t want to be away from you. If a child doesn’t usually have tantrums but starts having them, that can indicate they’re stressed.

Small children also often express emotions physically, such as feeling sick in the tummy, having headaches and not wanting to go to school because they feel unwell. These signs could indicate a physical health problem, too. If any of these issues happen more frequently, then mental health could be a concern.

Teenagers: As children become more adult-like they’re going to present more like us. During a time of instability, you might notice they’re more overtly worried, stressed, angry or sad. Other signs to look for include big changes in sleep and appetite. It’s especially concerning if any of these signs persist for longer than a week. Teenagers are likely to withdraw socially, as well as with family and at school, and might talk about feeling down.

When do signs of anxiety, sadness and withdrawing socially become a concern?

Generally, if any signs of mental health issues persist longer than a couple of weeks that would be concerning.

Watch for changes in functioning, such as not being able to go to school regularly, loss of focus on academic work, or not wanting to spend time with friends or family. Sometimes with teenagers it’s hard to tell, though a big sign is when they spend more time in their room and possibly on social media or playing online games more often, rather than socialising.

It helps to monitor those signs and if there any concerns, arrange to see someone to assess the situation and provide advice. Some good starting points are school counsellors and your family doctor.

Early intervention is important to help minimise the risks. Young people tend to have fewer resources to cope, so they need help managing the symptoms. It’s also useful to help them understand there’s hope they’ll get better the sooner their mental health issues are treated. We want to minimise the duration of any mental health issues as much as possible, because left untreated they can impact developmental stages, including socially and at school.

Early intervention can include psychological therapy and family counselling, which can help the family understand what’s going on and how to support the young person.

Medication, when appropriate, can be used to help the symptoms of some mental health issues, usually when an issue goes on longer or if there are specific challenges such as severe depression or anxiety that really impact on the person’s functioning. Medication should be very carefully monitored and supported by counselling.

When a young person is struggling with mental health, how can families support them at home?

Communicate about how you can help: The most important thing is to have open communication about mental health. Your doctor can help here, too, by explaining the steps for treatment, and, that while it takes time to recover, it’s completely normal for young people to go through these issues and recover.

Try to reduce stress at home: Create a safe place at home by keeping conversations calm as possible and being more gentle – including with each other as parents.

Liaise with your school: With the teenager’s permission, organise support while at school, including having a quiet, safe place to go if they become anxious, and a plan for going home if needed. When you’re planning to talk to someone else on a teenager’s behalf, discuss what you’ll say with them beforehand and check they’re comfortable with it. Adolescents are very sensitive to how they’re perceived, so respect their wishes about what they don’t want to be said.

Develop a support plan: At any age, a support plan will give you structure, including counselling and any other interventions. It’s useful to have some structure around how they spend their time, such as sleep, exercise, meals and socialising with friends and family. Especially when they don’t feel like doing some of those things, like seeing friends, encourage them to take steps to look after themselves.

Do young people ‘grow out of’ mental health issues?

Generally, people don’t just grow out of a mental health issue. Mental health issues often occur in episodes, so people at any age might be vulnerable to having another one at some point.

Sometimes it can be difficult telling the difference between what’s normal in adolescence versus ongoing symptoms and illness. If you have any questions, seek professional advice:

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