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Children's mental health is just as important as their physical health. While most children cope well with life's ups and downs, sometimes parents may notice their child's behaviour is unusual or different from other children the same age. A child may often be distressed or behave differently from how they have in the past. Changes may be gradual or may happen quite suddenly - either way it is a sign that your child needs help and support.
Children and young people are usually developing well when they enjoy:
- being with others in the family
- being with friends and other children of their own age
- play and leisure activities.
Everyone feels sad, angry, afraid or upset at times, especially when things go wrong for them. Not everyone will respond to the same event in the same way. Some children cope better than others with stress or things that upset or frighten them. Some may want to talk a lot about something that distresses them. Others may keep their feelings more to themselves. The support and understanding they receive from people around them is extremely important in helping children cope with problems.
Most children show their feelings in the way they act.
Their behaviour will tell you how they feel so it's important to try and understand what the behaviour means.
If you notice your child being sad or angry much of the time, or there are significant changes in how they behave, it is important to get help.
Children can have problems with feelings and behaviour at different times in their lives. These problems happen more often than most people might think. Children are most at risk of serious problems between the age of 12 and 16 years, although concerns can show up earlier. Problems can become worse over time if the child or young person does not get any help.
Some signs a child is having difficulties can be:
Behaviour problems are usually easy to see. They can include ongoing:
- aggression or bullying
- refusal to cooperate or do what they are asked
- cruelty to animals when children are old enough to understand not to do this
- hyperactivity, difficulty paying attention or keeping an interest in what they are doing
- being inhibited, withdrawn
- being easily upset or fearful.
Problems with feelings are not as easy to see as problems with behaviour. They can include ongoing:
- sadness, worry (anxiety) or depression
- fear of particular things such as spiders or burglars (phobias)
- excessive worry about body shape, weight, how they look, or food
- feelings of worthlessness, shame, guilt or self-hate
- poor control of emotions.
Younger children may be overwhelmed by strong feelings when upset, angry or frustrated and they may struggle to control their feelings. While 'tantrums' are normal for younger children it may be of concern if they happen often or for extended periods.
Problems with thinking are much less common and affect only about one person in a hundred. While they don't usually happen until late adolescence, signs can show up earlier. Some signs a child may be having thinking problems include:
- low self-worth
- always worrying and being negative about things
- thinking in strange ways, eg thinking that when something happens it is caused by something completely unrelated
- thinking that people are 'out to get them'.
Some children have problems making friends or playing with other children. They may also have trouble relating to parents or other adults. Some signs a child is struggling with relationships include:
- being aggressive and arguing
- having trouble communicating
- being extremely shy
- being over-talkative.
There are many things that can be involved when children have problems with behaviour, feelings, thinking or relationships. They can be related to the child or the whole family and can include:
- family history of mental health problems (genes)
- serious illness, disability or injury
- problems with friends, social isolation or not fitting in
- bullying or discrimination
- problems with school work or learning
- thinking patterns such as perfectionism or 'black and white' thinking
- lack of trusting relationships with parents or other significant adults
- separation from parents, family break-up or divorce
- death or loss of someone close
- lack of engagement in activities, school or employment
- emotional, physical or sexual abuse, chronic neglect or violence
- changing homes, schools, towns or country (migration)
- big stressors for the family, eg homelessness or financial problems.
The more stress some children have to deal with, the more likely they are to develop problems.
While we can't always prevent 'bad' things from happening in a child's life, it is important to try to minimise stress and help children develop ways of coping.
It is important to take note of any significant changes in children's usual pattern of behaviour. Children and young people can display signs of problems internally (eg withdrawal) or externally (eg aggression). Notice how severe the problem is, how often it happens and how it affects children at home, school or other places.
Signs in young babies
- Being unusually quiet
- Not liking to look at you
- Not being comforted by you when crying.
There are many reasons why these things may be happening for your baby. Talk with your doctor or Child and Family Health Service (CaFHS) nurse. They can help you work out what's happening and get any support you need.
Signs in preschool children and toddlers
- Not seeming to be attached to parents.
- Not playing.
- Not enjoying interactive games with parents.
- Not beginning to talk, or stopping talking once they have learned.
- Cannot be comforted when upset.
- Frequent, unexplained temper tantrums.
- Harming themselves or others, eg ongoing biting, hitting, or aggressive play.
- Going backwards in their learning, eg toilet training.
- Cannot put 2 words together by age 2.
- Changes in weight, ie not growing and putting on weight, or weight loss.
- Being over-friendly with everyone - treating strangers the same as family.
- Not relating to others - acting as if people were not there.
- Repeating the same play or activity time and time again.
Signs in primary school-age children
- Withdrawing from people or usual activities.
- Constant crying and clinginess.
- Fears, worries or excessive anxiety about being left alone.
- Ongoing sleep problems, eg persistent nightmares.
- Hyperactivity - constant movement beyond regular playing.
- Difficulties focusing or concentrating.
- Marked fall in school performance.
- Unexplained laughing or crying.
- Feelings of hopelessness.
- Soiling or wetting pants.
- Ongoing disobedience or aggression towards people or pets.
- Being too afraid to undertake usual activities.
- Daydreaming so much that it interferes with usual activities.
- Frequent temper tantrums.
- Damaging property or lighting fires.
Signs in older primary school-age children and teenagers
- Withdrawing from family, friends and social activities.
- Marked change in school performance or school attendance.
- Abuse of alcohol and/or drugs.
- Changes in sleeping and/or eating habits.
- Anti-social behaviour such as stealing or vandalism.
- Great concern about weight or physical appearance.
- Constant worrying.
- Hearing or seeing things that are not there.
- Sadness, worry, depression and being irritable.
- Thoughts about death - comments about not wanting to live or being better off dead.
- Frequent outbursts of anger.
- Signs of self-harming such as cutting.
While there are things that can increase the risk of children developing problems, there are also things that can provide a 'buffer' and help protect children. The most important thing parents can do is make sure children feel loved, safe and secure.
Having a stable family life and consistent routines can help.
Parents can also help children build their coping skills and self-confidence, and make sure they have trusted people to talk to. Over time children build their resilience to deal with the ups and downs of life.
'Tuning in' to your child
- Notice any changes in your child's behaviour.
- Spend one-on-one time with them each day - know what's going on in their life.
- Be interested in what they enjoy and what they are doing at school.
Feelings and skills
- Talk about feelings - let children know you understand how they feel. Help younger children name their feelings.
- Be patient as children learn to manage their emotions. Stay with children who are overwhelmed with big feelings. Help them calm down. You are showing them that strong feelings can be managed and are nothing to be afraid of. Make sure you are not expecting too much for your child's age or development.
- Let children know that everyone feels sad, upset, frustrated or angry at times. It is OK to cry and express strong feelings such as anger, as long as no one is hurt.
- Help children understand that change, loss and grief are a normal part of life.
Talking and listening
- Talk with children as often as you can, eg at mealtimes or when driving in the car. Try to be open and relaxed. Really listen to what they say.
- Talking together helps children learn to express their feelings. If they are used to talking with you, especially about sensitive things, they will be more likely to come to you if they feel upset.
- Talk about things that might stress children, eg what they see on TV or other media. Reassure them that they are safe, even if what they see is scary.
- Talk openly with older children about world events, or sensitive topics such as the use of drugs and alcohol.
- Help children have a network of trusted family and friends to talk to. Make sure people agree to be on your child's network and that children know how to contact them.
- Protect children from knowing too much about adult problems - it can cause them stress.
Showing your love
- Let children know you love them in as many ways as you can. It builds their sense of security and belonging.
- Give lots of hugs, cuddles and gentle touch.
- Do things together as a family - both fun things and chores. Celebrate special occasions together.
Children cope best when they feel loved, safe and secure.
- Notice the things children are good at and tell them.
- Encourage children to be optimistic and positive. Model a positive outlook yourself.
- Encourage children to be involved in a range of activities so they have the chance to build skills and confidence.
- Help children learn how to get along with others - it will help them have friends.
- Support children's learning at school. Talk with their teacher about getting more support if they need it.
Help children have a network of trusted family and friends they can talk to.
If you are concerned about your child it is important to get advice from professionals who work with children and young people.
- A first step could be to talk with your child's teacher or school counsellor. They spend a lot of time with your child and can tell you about their behaviour at school. They can work with you to support your child and get any extra help they need.
- Talk with your doctor.
- Contact the Child and Adolescent Mental Health Service (CAMHS) for free therapy services for children and families. Anyone can contact the duty officer in the following locations:
- Elizabeth: Phone 8252 0133
- Paradise: Phone 7321 4500
- Port Adelaide: Phone 8341 1222
- Oaklands Park: Phone 7425 8600
- Morphett Vale: Phone 8326 1234
- Northern country regions: Phone 1800 819 089
- Mount Gambier: Phone 8724 7055
Alternatively call the Women's and Children's Hospital on 8161 7000.
Going to a mental health professional for an assessment might help you understand what's happening for your child and get any help they need. It does not always mean they will be diagnosed with a disorder. Keeping a diary of what your child is doing before you go to the appointment can be useful. You may be asked about their development and how they behave.
It is important to look after your own feelings, health and wellbeing too - you will be better able to care for your child. Make time to do things you enjoy. If you feel low or stressed much of the time talk with your doctor or counsellor, or see other helpful Parent Easy Guides.