Mental Health Caregiving: Children & Adolescents

INCITE Consulting Solutions

Mental Health Caregiving: Children & Adolescents

INCITE Consulting Solutions

By Erin Black, INCITE Consulting Solutions

Raising children is hard. It is also incredibly rewarding. And exhausting. Fun. Frustrating. Caring for children has been made even more complex through the COVID-19 pandemic. I know: I have one son diagnosed with depression and anxiety and one son diagnosed with ADHD, both of whom I home-schooled last year when they never went back after spring break. I also have two (foster) sons, both born with drugs in their system.

Amidst all of the challenges child-rearing brings, addressing mental health concerns--like physical health concerns--can be intimidating, confounding, and complicated. Understanding the facts and some of the resources available is a good starting place when you are trying to understand or determine if there is a mental health condition in a child that needs professional attention. Children’s mental and physical health are closely related, so it is very important to address both. 

There are many dimensions of children’s mental health and possible sources of a mental health disorder. In most cases, neither parents nor children have control. Just like a physical condition affects the body, mental conditions are due to physiological problems in the brain (i.e. a chemical imbalance). This is no one’s fault. At the other end of the spectrum, there are factors that can be controlled that can prevent or limit trauma in a child's life that could result in a mental illness.

Adverse Childhood Experiences (ACEs)

Adverse childhood experiences are potentially traumatic events that occur from birth (even in utero) to adulthood. ACEs can include violence, abuse, and growing up in a family with mental health or substance use conditions. Toxic stress from ACEs can change brain development and affect how the body responds to stress. ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood.1

There are three types of ACEs.2

  • Abuse
    • Physical
    • Emotional
    • Sexual
  • Neglect
    • Physical
    • Emotional
  • Household dysfunction
    • Mental illness
    • Incarcerated relative
    • Mother treated violently
    • Substance abuse
    • Divorce

We want to raise kids in the healthiest environment so that they can have the best chances at a happy and healthy life, so it’s important to understand what ACEs are and the effects they have. Preventing ACEs could reduce the number of adults with depression by 44 percent; that’s up to 21 million cases of depression. It could also reduce up to 1.9 million cases of heart disease and 2.5 million cases of obesity.3

Here are some of the negative effects of ACEs.4

  • Behavior
    • Lack of physical activity
    • Smoking
    • Alcoholism
    • Drug use
    • Missed work
  • Physical and mental health
    • Obesity
    • Diabetes
    • Depression
    • Suicide attempts
    • STDs
    • Heart disease
    • Cancer
    • Stroke
    • COPD
    • Broken bones

To learn more about ACEs visit the Centers for Disease Control and Prevention (CDC) or take this ACEs quiz from NPR. Most of all, if you think a child is suffering, seek professional help. 

Statistics on Children and Mental Health

The CDC reports5 that mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions which can cause distress and problems getting through the day. Among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety, and behavior disorders.

Here are a few statistics on children's mental health6:

  • ADHD, behavior problems, anxiety, and depression are the most commonly diagnosed mental disorders in children, affecting a total of approximately 17 million children.
  • Some of these conditions commonly occur together. For example, having another disorder is most common in children with depression (74 percent).
  • Treatment rates differ among mental disorders ranging from 78 percent to 54 percent.
  • Diagnosed mental, behavioral, and developmental disorders begin in early childhood. Seventeen percent of children are between two and eight years of age. 
  • Rates of mental disorders change with age. Depression and anxiety are more common with increased age while behavior problems are more common among children aged six to 11 years.

Children’s Mental Health During COVID-19 

There is a plethora of information on COVID-19 and the mental health of children and sufficient data worldwide that indicates an increase in mental health concerns. One study with over 51,000 participants found that duration rather than intensity of loneliness was more strongly associated with mental health symptoms. These researchers also suggest that loneliness for youth during the disease containment measures may affect their future mental health and recommend early intervention.7 

Children’s Mental Health Resources for Parents and Caregivers

There are several warning signs to look out for that may be indicative of a mental health condition in a child including: Problems in more than one setting (home and school); returning to behaviors more common to younger children like bedwetting; signs of self-destructive behavior like cutting, social withdrawal, having intense worries or fears that cause problems in relationships; getting in fights; and feeling very sad/signs of being upset (tearfulness) for more than two weeks.8,9 

Here are some guidelines on how to get the support you need to help the child you care for as well as some actions you can take to look after your own mental and emotional needs.

1. Get educated. Remember that old ad campaign, “The More You Know”? Well, it’s true. The more you know, the better prepared you are. The Substance Abuse and Mental Health Services Administration (SAMHSA) has put out a very good guide to talking with children specifically as it relates to caregivers, parents, and teachers during an infectious outbreak. SAMHSA has a number of other good resources for parents and caregivers on their website. The National Alliance on Mental Illness (NAMI) also has information on learning to help your child and your family. 

2. Get connected. It’s important to remember that you are not alone. There are millions of other families out there supporting children who have a mental health condition. NAMI is a great place to start getting connected and asking questions, and they have a lot of wonderful resources and chapters throughout the U.S. Find your local NAMI chapter here. Call a friend and connect to people who are important to you. If you’re a person of faith, connect to your place of worship and consider joining a local support group that can help address your specific care situation. 

3. Get moving. As busy parents, we know we’ve got to take care of ourselves but most days it seems impossible. You will be most effective at sticking to personal care if you break them into small but meaningful rituals. So while you may not have time for a spa day (though I know you deserve one), do try to spend a little time outside. Harvard Medical School recently published research on ecotherapy that found a strong connection between time spent in nature and reduced stress, anxiety, and depression. Dr. Nate Sowa, MD, PhD recommends you go for a walk outside if at all possible. Spend a few minutes reading a book (preferably outside!). Eat well and drink plenty of water when you can; it’s important to keep your own energy levels up.

4. Get comfortable talking about mental health. If you are a child’s primary caregiver or you know someone who is, approach conversations about mental health as you would those about physical health. There is nothing to be ashamed of. It’s not your fault, and it’s not the child’s either. Understanding the stigma will go a long way to reducing it. If you love a caregiver, invite them out like you would any other family member or friend. Ask them how their child is doing and listen to them. Learn about the mental health condition and ask if you can help in any way. Drop off a meal or some flowers. Mow the lawn. Offer to go shopping for or with them.

5. Get help and learn from experts. In addition to NAMI, Mental Health America has a wealth of resources on children’s mental health. You can also connect with their local affiliate. Don’t feel like you have to do it all yourself. Know what to look for and don’t be afraid to ask for help. Mentalhealth.gov’s website has information on what mental health behaviors to look for in children and how to support them. If you or your child need immediate help, call 911. If someone is experiencing emotional distress, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or chat live online. You can also reach out to the SAMHSA Treatment Referral Helpline at 1-877-726-4727 to get general information on mental health and locate treatment services in your area.  

References

1. Vital Signs: Adverse Childhood Experiences (ACEs), Centers for Disease Control and Prevention (2019)

2. Take The ACE Quiz — And Learn What It Does And Doesn't Mean, NPR (2015)

3. Vital Signs: Adverse Childhood Experiences (ACEs), Centers for Disease Control and Prevention (2019)

4. Take The ACE Quiz — And Learn What It Does And Doesn't Mean, NPR (2015)

5. Data and Statistics on Children's Mental Health, Centers for Disease Control and Prevention (2019)

6. Ibid.

7. New Findings About Children’s Mental Health During COVID-19, Psychiatric Times (2020)

8. Child Mental Health, MedlinePlus (2018)

9. For Parents and Caregivers, MentalHealth.gov (2019)

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