Here’s when to seek professional help for your child’s mental health
By Dr. Robin Alter, The Psychology Foundation of Canada
Photo © Andriy Popov/123RF
Sep 21, 2018
Yes, parenting is the hardest job in the world. A major ingredient in the development process of a child’s brain, which provides the foundation for all future learning, is the interaction between children and their parents and other significant adults in a child’s life. Wow, what pressure. And the importance of your role as a parent can feel even more overwhelming when you think you might not be able to help your child. It’s not always easy to know when your child needs professional help, but hopefully these guidelines will help.
Don’t just look at severity of symptom
First of all, it’s not the severity of symptoms that determines how serious the problem is. A child can have very severe symptoms, such as tantrums or meltdowns before going away to camp, or before a big exam or performance event. He or she might have many sleepless nights, but in the end they go to camp and have a great time, or manage the exam or concert with ease. Children naturally express more emotion than adults do.
They are still learning the skills of emotional regulation and many children communicate their feelings through behaviour rather than words, so give them a chance to handle the situation and come out on top of it. In the DSM V, the bible of psychological disorders, symptoms are not considered “disorders” until they’ve been around for months and have had a significant negative impact on one’s home life and/or school life. So hang in there for a while. Childhood is all about challenges and learning. This could be one of them.
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Determine if it’s age-appropriate behaviour
One thing to consider is whether this issue or problem is common among children of a particular age group. It is normal for a young child to have separation anxiety and not so normal for a teenager. It is normal for a child to have meltdowns, especially when they are in a situation where they are in overload — being asked to deal with more things and more severe things without adequate coping skills.
Children have fewer strategies to deal with stress than adults, because they have been coping with life’s challenges for far less time. They don’t have the experience to draw upon or the ability to self-reflect about what’s going on. So they have meltdowns. That’s when adults step in and explain to them what’s going on, offering solutions and strategies to deal with the stress, guiding them to effective solutions for everyday problems. If the situation persists, if they are not using the strategies and not getting better after a few months, then seek out a professional.
Ask yourself: Is your child in danger?
If your child is engaging in self-harm behaviour or putting themself at risk for harm, then it is imperative that you find a way to communicate to your child that this is unacceptable and won’t be tolerated. The first time it happens, sit down with them and try to find out the cause. Many children I see in my office say something like, “I said it, but I didn’t mean it” or “I was just being dramatic.” In this case we have to teach our children how to communicate their needs and the intensity of their needs in another way.
This kind of talk may be their way of shouting from the rooftop so that they get attended to. But they could learn to say, “I’m in the red zone” or “I’m at 100 on the scale” or whatever you decide between the two of you that sounds the alarm. This way, with whatever problems exist, you might be able to find solutions together.
If they do say it repeatedly, then it is necessary to seek professional help, even a trip to the emergency room. Children learn more from what we do than what we say. A mental health professional might not be available for weeks or months. But your action of taking them to the hospital communicates loud and clear that this is an emergency. You might not get long-term help, and might even have to wait hours to see someone, but the time spent waiting says to your child that you cherish their life and take threats to it very seriously. This might be a one-time intervention that changes that behaviour to solve that problem for good.
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Look at their progress
Another thing to consider is whether your child is making progress. If they are still having sleep difficulties, but are leaving the bed a little less than before, getting a bit more sleep than before, and letting you sleep more than before, then you are making progress and are on the right track. Even a professional is not going to perform a miracle and make the problem go away instantly. So hang in there. Be encouraged by small steps and be reassured that your child is making an effort in the right direction. If, however, if in spite of continued efforts on both your parts over several months there isn't progress, call a professional so that you become part of a team to find solutions and have someone to support you when the going gets tough.
Take stock of your support network
Children can have a host of problems: a lack of interest in school or extra-curricular activities; sleep problems; withdrawn behaviour; extreme acting out and aggressive behaviour; persistent tantrums and meltdowns; adjustment to divorce and blended families; and the list goes on. Many children have these periods in their life and hopefully they have parents or caregivers to help them.
That’s what we're here for. These become teachable moments and opportunities for growth and learning. If you’re in a two-parent family, the parents have each other to consult. Many people also have extended family and friends with children who can act as a sounding board and give advice. If you’re a parent who is more on their own with the difficult job of parenting, someone recently divorced or an immigrant in a new country, then this may be a good reason to seek professional help.
Dr. Salvador Minuchin, a psychiatrist and pioneer in the field of family therapy was in England for a while with his wife, Dr. Patricia Pittluck, a psychologist. While there Patricia spent several years collecting data, asking the question: “What’s the difference between families who seek help from a children’s mental health centre and those that don’t?” The answer was surprising. The problems each faced were exactly the same. Those that sought professional help were more isolated — new immigrants and newly divorced, for example. Those who didn’t seek professional help had extended networks of family and friends to get advice from. So, if you are feeling alone in what many consider to be the toughest job in the world, then by all means reach out if help is available.
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Remember kids have stress too
The Psychology Foundation of Canada has a program Kids Have Stress Too! which can be found on its website. It is a great resource to learn about the signs of stress and how to help kids manage stress. One of the strategies is to take a good look at your child every day. Look for changes, notice how they look and feel to you. If you notice something, then ask them how they’re doing. Do a bit of probing. Kids actually like it when we ask them how their life is going. If you notice big changes in your child’s behaviour — sudden and unusual bouts of irritability, sleep habits, tone of voice, eating, expressions of hopeless, self-derogatory statements — then see if you can open up the discussion about what’s at the root of it. If, for whatever reason, your child won’t allow you to help, then seek out professional help.
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