As a parent, you want to do everything possible to support your kids. But when your child has a mental illness, it’s often difficult to know how to manage their condition or where to turn for help.
Kids today are facing a variety of stressors, including the repercussions of the COVID-19 pandemic, social media overload, increasing academic demands, political unrest, climate change, and the generally unsettled state of the world.
According to the National Alliance on Mental Illness (NAMI), 1 in 6 youth ages 6 to 17 experience a mental health disorder each year, and approximately 50% of all mental illness begins by age 14.
Youth and young adults experienced a unique set of challenges during the pandemic, including isolation from their peers and family members, adapting to virtual learning, increased exposure to physical or emotional abuse at home, and changes in sleep habits and other routines. The impact of these experiences continues to affect their mental health today.
In late 2021, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association declared a national state of emergency in children’s mental health. In addition, the U.S. surgeon general issued an advisory called “Protecting Youth Mental Health,” a report highlighting the urgent need to address the nation’s youth mental health crisis.
School counselors, psychologists, social workers, and other mental health professionals are doing their best to provide solutions.
“We’ve seen an increase in child mental health problems beginning pre-pandemic through the pandemic and post-pandemic,” says Doug Tynan, Ph.D., ABPP, director of professional affairs for the Delaware Psychological Association in Wilmington. “In particular, we saw a big surge in anxiety and depression, particularly among middle school- and high school-age kids, in large part due to loss of in-person social interaction with peers, social isolation during quarantine, and academic disruption.”
While Tynan believes the situation is beginning to improve for school-age kids, he says schools continue to report increased rates of anxiety and absences, along with difficulty finishing long-term tasks or executive functions that require time management, planning and organization, developing problem-solving strategies, setting goals, and completion of assignments or projects.
“We also saw a slight increase in hyperactivity and disruptive behavior among younger kids [when] children returned to class after being virtual for a year,” says Tynan, “in addition to an uptick in emotional dysregulation—or trouble managing feelings and emotions. …When kids are in a state of distress at an age when they’re supposed to be developing self-regulation skills, that may be expressed as anxiety, worry, or depression, or result in acting out or more defiant behaviors.”
When kids are in a state of distress at an age when they’re supposed to be developing self-regulation skills, that may be expressed as anxiety, worry, or depression, or result in acting out or more definite behaviors.
—Doug Tynan, Delaware Phycological Association
For kids who struggle in the classroom, school counselors can be a good first line of defense in identifying whether a child is having challenges because of a learning disability, ADHD, autism, or another condition. Psychologists are working with schools to build training programs to help teachers and other staff create supportive classrooms.
A new program in nearby Maryland can serve as a modeling tool. The Mental Health Technology Transfer Center Network (MHTTC) and the University of Maryland’s National Center for School Mental Health (NCSMH) have developed Classroom WISE (Well-Being Information and Strategies for Educators), a free online course and resource library that draws on psychological research on social-emotional learning, behavioral regulation, mental health literacy, trauma, and more. The course teaches actionable strategies such as how to create safe and supportive classrooms, reduce the stigma of mental health, and how to model emotional self-regulation. These strategies can be used by anyone who interacts with students, from faculty and counselors to coaches and bus drivers.
“Teachers are one of our most important resources in the schools,” says Nancy Lever, Ph.D, a clinical psychologist and associate professor at the University of Maryland who serves as co-director of the NCSMH and executive director of the University of Maryland school mental health program. “They tend to be the ones who work closest with students and get to know them on a personal level. Students who are struggling often confide in their teachers, so it’s really important that they have the skills related to identification of mental health concerns and strategies for how to support their students, as well as how to make an appropriate referral when necessary.”
If students appear to struggle with problems outside the scope of what school support can provide, parents can reach out to a mental health clinic or a child psychologist.
“Schools are valuable partners in helping to identifying kids who could benefit from subsequent mental health services,” says Hannah Carpenter Lyden, Ph.D, ABPP, a licensed clinical psychologist at the Hockessin Center for Change. “Through social and emotional learning programs, schools play a very important role in helping kids recognize negative feelings they might be having and making them feel comfortable with going to an adult to share what’s going on.” It’s helpful to have a partnership with the schools, she stresses, particularly when it comes to students with ADHD, anxiety, and disruptive behaviors.
Therapists can help identify specific disorders and provide families with the necessary tools to help their children manage their mental health.
“Psychological testing is a good investment if you have a student who isn’t doing well academically or behaviorally,” Tynan says. “Sometimes you uncover an attention deficit or memory problem, or a specific learning disability that may have been missed by school-based testing. If there are issues with a child that nobody can put their finger on, a thorough psychoeducational evaluation, where you’re testing for cognitive, memory, and academic skills, and getting input on the behavior, [might] be in order.”
Lyden says most of the young children she sees are experiencing emotional management challenges—tantrums, outbursts, meltdowns, or rages, in addition to disruptive behavior and aggression in school or at home. Among kids and teens, the most common reasons for treatment are anxiety and depression.
“A psychologist is uniquely positioned to test for conditions where symptoms can overlap,” she explains. “If a child is having more serious symptoms that suggest they might not be in touch with reality or are having unusual perceptional experiences, testing can be helpful in identifying whether those symptoms are a result of a mood or anxiety disorder, or a psychotic disorder.”
When it comes to treatment plans, each child is unique and requires support and feedback from therapists and caregivers. Treatment can be as simple as parents working on coping strategies with their kids, or therapy sessions with a qualified practitioner.
“As parents, we expect our kids to know how to behave and deal with their emotions and control their behaviors, but we don’t really show them how to do that,” points out Mary Vaughn, Psy.D., a private practice psychologist at Atlantic Psych Associates in Lewes. “It’s really important for parents to model how to label their emotions. For example, when a child [is] feeling anxious, tell them what you do to manage that feeling, such as taking a walk, writing in a journal, or taking a shower. That way, you’re showing your children how to notice what’s happening to them, how they’re feeling, how to talk about it, and how to deal with it.”
The key to success is finding a provider your child feels comfortable with, as well as working with a therapist that takes a team approach to working with the child, the parent, and any other concerned parties, such as a pediatrician or school counselors.
“It’s important to integrate parents into the treatment process,” Lyden says. “I value having parents and guardians involved in the sessions for many of the types of issues that I deal with, even if the target of the treatment is the child’s own growth and coping skills.”
For common conditions like anxiety and depression, one of the most prevalent evidence-based approaches is cognitive behavioral therapy, which focuses on self-help strategies to change unhealthy ways of thinking, feeling, or behaving. This often involves setting limits and sticking to routines, and teaching patients effective coping strategies that they can then practice in simulated and/or real-life situations.
Another form of therapy called Parent Management Training, or PMT, involves teaching parents how to manage their children’s behaviors more effectively. A therapist works with parents to practice these skills with their child, either during sessions or at home. Teachers can also use this technique in the school environment.
“One important thing to note is that treatment does not have to be long term,” Tynan says. “It’s important to check in with your child’s therapist and assess where they are at each phase of their therapy and see where improvement is being made. …Many psychologists also work in coordination with pediatricians if medication is part of the treatment plan, as well as school counselors and social workers to ensure we’re not replicating services. The goal is to provide a supportive, compassionate environment that will ultimately help the child succeed.”
Help Is Here
Delaware offers numerous resources where parents can find a mental health provider for their child, what type of questions to ask a provider, what type of evidence-based therapies are available, what testing involves, and more. Here are a few good places to start.
- The Society of Clinical Child and Adolescent Psychology, a division of the American Psychological Association, provides support for parents, caregivers, and families with information on evidence-based mental health treatment for children and adolescents. effectivechildtherapy.org
- Looking for a therapist? The Delaware Psychological Association shows you where to find one. depsych.org
- This Positive Parenting Program offers parents simple and practical strategies to help manage their children’s behavior and prevent problems from developing. triplep.net
- The Incredible Years offers evidence-based early intervention programs for parents and those who work with children 12 and younger. incredibleyears.com
- The National Center for School Mental Health provides information on resources used by schools to support students’ mental health. schoolmentalhealth.org
- The website Good Inside by Becky Kennedy, Ph.D., helps parents manage the stress of caregiving while raising emotionally resilient children. goodinside.com
- “Raising Kids with Big, Baffling Behaviors” by Robyn Gobbel (robyngobbel.com) and “The Whole-Brain Child” by Daniel Siegel, M.D., (drdansiegel.com) are good resources for learning more about how child development affects emotions and behaviors.
Related: A Look Into ADHD Diagnoses and Treatments in Delaware
