Children’s Mental Health week 2023 is February 6–12.
After 7 years of trying to balance being a Dad and a Psychologist I have come to the conclusion that parenting would be so much easier if we were still cavemen. Firstly, our brains would be unevolved, removing our ability to ruminate, worry, and stress about the overwhelming responsibility and pressures of fatherhood. Secondly, protecting and nurturing children would be solely based on hunting, gathering, and fending off sabre-tooth tigers, and not trying to help them navigate social pressures, society’s norms, expectations, self –image and the impact on their emotional wellbeing and mental health.
This caveman approach highlights that, as fully evolved Dads, we constantly have to manage our own mental state at the same time as worrying about our child’s wellbeing. This is not easy and looking for support can be overwhelming. But for many Dads this is anxiety provoking in itself. I thought, as a psychologist, that I was well placed to manage these overwhelming feelings on my own. But it turns out it doesn’t matter how much mental health training you have, you are human first.
The following guide is based on my experiences as a human, as a Dad, and as a Clinical Psychologist working with children and families. Whilst I truly believe that every child is different, I have also learnt that this is one of the most unhelpful things you can say to a parent who is looking for advice and support. This guide provides suggestions and recommendations to help with future mental health challenges, and an age based breakdown of what to look for if you are worried about your children’s emotional well-being.
Table of Contents 1Under 5’sWhat to look out forThe “dad” check inHow can you help?Where to go to for support2Primary School AgeWhat to look forThe “dad” check inHow can you help?Where to go to for support3Secondary School Age / AdolescenceWhat to look out forThe “dad” check inHow can you help?Where to go to for support4Useful links
For most families the life of a toddler is pretty much sleep, eat, repeat, mixed in with the fun and innocence of exploring the world for the first time. People are often surprised that emotional difficulties can be an area of concern at such an early age. The thing to remember is that you are still dealing with a little human, and they will have an emotional response to the world around them, and sometimes certain events or experiences can have a negative impact. If you can accept that this is a possibility, and prepare for it, then you are already a head of the game.
What to look out for
My usual advice to parents is to not waste so much energy on constantly comparing themselves and their children to other families. Everyone does things differently. However, if you are worried about your toddler’s behaviour & emotional wellbeing, this is the one exception, as your children’s mental health trumps all other reservations.
The reason for this is that disruptive behaviour and highly expressed emotions are common placed for children under 5. So what we need to be looking for are behaviours which seem to be more frequent, last longer, or appear more severe than in other children. Here are some examples:
- Is your child persistently sad/unhappy/withdrawn?
- Are they significantly worried/anxious about things?
- Do they show little interest in playing with others?
- Are they struggling with routines and development (sleep, toilet training, feeding etc.)?
- Do they experience severe temper tantrums and/or aggressive behaviour?
The “dad” check in
As a Dad, I have personally navigated the 0-5 year old stage twice now, and it has been amazing in so many ways. But it has also been the most sleep depriving, draining, challenging, and emotionally overwhelming chapter of my life. It has affected my marriage, my job performance, and my overall mental state.
Acknowledging that this is a challenging chapter in your life does not make you any less of a Dad. It allows you to have clarity about what is going on in your world. This clarity, in essence, is a parent managing their own emotional distress, before addressing what their child is going through. When working with parents I use the airline oxygen mask analogy. We are always instructed to put our own mask on before helping our children, because how can we expect to keep them alive if we are struggling to breathe?
How can you help?
This is always a challenging stage of development to navigate when trying to help and support our children. Your child is in the early stages of language development, with limited capacity to process what is going on for them, both physically and emotionally. This often means we have to become parenting versions of Sherlock Holmes, using are powers of deduction.
The most important thing you can offer your child is love, affection and consistency during this time. As ‘airy fairy’ as that may sound you need to remember that your child doesn’t have the capacity to understand what they are experiencing, and that can be frightening and frustrating. In that moment they need to know they are safe, and at this age this best way to communicate that is love and affection.
Where to go to for support
If you have on-going concerns about your child’s mental health make sure you book an appointment with your GP. Persistent emotional difficulties in children under 5 can often be related to physical health. This age group can struggle to identify and articulate physical symptoms; which can lead to persistent irritability and frustration.
A visit to the GP will help to assess whether you child is experiencing physical or mental health difficulties and they will make the appropriate referral if further support is needed.
Primary School Age
Parents can have different reactions to the start of their child’s educational journey. At certain moments it can represent the freedom to return to prolonged periods of adult life, and an opportunity to reconnect with the parts of our lives that have been sitting on the side lines. However, more often than not, there is also a great deal of anxiety. This worry stems from the uncertainty of letting go. Part of this uncertainty is about what challenges our children will face and how they will manage this on their own.
There are obviously going to be a lot of developmental differences between the ages of 5 and 11 years old. But there is a shared experience throughout primary school of facing many social, emotional and academic challenges for the first time.
Children’s Mental Health: What to look for
During this stage your children are now active across multiple settings (home, school, clubs, friend’s house etc.). If you are worried about them it is really important to talk to teachers, coaches, family and other parents. It is helpful to get a complete picture before reaching a conclusion or making any decision about how to help. Here are some of the things to look out for:
- Major change in eating and/or sleeping patterns.
- Night time bedwetting, having previously been dry at night.
- Difficulty initiating and/or maintaining social relationships.
- Extreme sensitivity to rejection or failure.
- Frequent sadness, tearfulness or crying.
- Anxiety leading to school refusal.
- Low self-esteem (often communicated through comparison with others).
The “dad” check in
A child’s language development is often a fascinating and funny journey, and it is genuinely exciting to be able to communicate more with our children. But words are powerful. Often what our kids have to say to us can trigger fear, guilt and feelings of inadequacy. “Nobody likes me”, “I’m useless at everything”, “I don’t have any friends”.
Hearing this or watching your child cry uncontrollably is always painful, and it can make us feel completely helpless when we can’t immediately help our children’s mental health. Wanting to protect our children is a primal instinct, and it can have a massive emotional impact if we believe that we are failing at this. This is why managing our child’s distress can feel unbearable. How do we protect our children from all this? The answer is simple, we can’t. As harsh as that may sound, I have seen that when parents accept this, it creates clarity and a slight reduction in the guilt and inadequacy that we all carry as parents, especially in these early years.
How can you help?
Despite the emotional roller-coaster, it does feel much easier to intervene with talking children! So share with your child what you’ve noticed and that you are worried about them. Try and remember that they are still developing and may not have the ability to rationalise what they are feeling, or clearly articulate it. This can be very frustrating when your ‘I just want to make it better’ button has been pushed. Encourage them to talk about it however it comes out, and that it doesn’t have to make sense. This is all about validating their experience; acknowledging that they are going through something, even if you don’t fully understand.
Despite all my psychology and therapy training, my personality still lives up to the male stereotype of trying to problem solve, and it is often hard with children to just let them talk about what they’re struggling with, but it does make a difference. It shows that you listen, you care and you not going to judge them, and therefore they feel safe to come to you in the future.
Obviously once your child has shared, you can begin to problem solve together. At this point it can often be helpful to talk about trying different experiments and seeing what works. This just stops the child feeling hopeless if things don’t work straight away.
Let your child know that there are many adults out there that care about them and that you are going to let their teacher, coach etc. know what is going on, so that they can ask for help if they need to. This also allows you to ask those trusted adults to keep an eye an out for your children.
Where to go to for support
If your child continues to struggle over a prolonged period of time speak to school. They may have internal or external support services that they can refer you to. If not, make an appointment with the GP and they can refer to the appropriate team or service.
I know suggesting the GP seems very basic, and when you are really worried about your child you want to hear something much more helpful! The problem is that the provision of mental health services, and how to access them, is very localised. What you need to do is find out what is available in your area, and the GP is often the best starting place. You can also go online and search for what is available near you.
Secondary School Age / Adolescence
Whatever your belief about God and creation, I find it hard not to think that something went wrong in the design of adolescence. At the beginning of this developmental stage children start to process information through multiple emotions (often at the extreme end!), but they don’t fully develop the ability to rationalise these feelings until their early twenties. What this basically means is that our children are predominantly processing information through the emotional part of their brain, why the rational and empathic part remains ‘under development’.
What to look out for
This stage poses a challenge for parents. How do we tell the difference between general adolescent, or ‘normal teenager’ behaviour and someone really struggling with their mental health? The most effective way to tackle this challenge is to remain curious and engaged. Don’t assume the behaviour is normal or just a phase, but equally don’t jump to the conclusion they are struggling and need professional help. Every teenager is different and another full blown Sherlock Holmes investigation is often required. Here are some of the things to look out for:
- Being ‘grumpy’, irritable or angry all the time.
- Eating more or less than usual.
- Talking about feeling hopeless, worthless or guilty.
- Persistent sadness, or low mood that doesn’t seem to go away.
- Lacking interest in activities or hobbies that they once enjoyed.
- Withdrawing from friends and family.
- Poor concentration and attention.
- A decline in school performance.
- Exclusion form school repeatedly or repeated truanting.
- Substance misuse.
The “dad” check in
I will freely admit that I am yet to directly experience the challenge of parenting teenagers. But after working with hundreds of families, I am certainly braised for impact! These children are in limbo between childhood and adulthood, they are biologically charged for impulsive thrill seeking, and they are trying to manage highly expressed emotions mixed in with the physical roller-coaster of puberty.
Even without additional mental health concerns, this is always draining for parents. So you need to take care of yourself. This means being open about how you are coping, don’t bottle up your feelings. You need to model the benefits of sharing what you are going through. Again, this allows you to reflect on what buttons your teenager’s behaviour is pushing in you. Knowing this can help you manage your emotions, when they’re kicking off.
Finally, don’t forget that oxygen mask. Carve out some time, or work out what you need to recharge and be there for the children.
How can you help?
Focus on listening, with as little lecturing as possible. Remember that all teenagers are emotionally sensitive, that is a baseline before we even consider any mental health concerns. So try to avoid criticism or passing judgment once your child begins to talk. The important thing is that your child is communicating; we can’t do much if they storm off and close the door. But don’t give up if they do close the door! Give them space, but continue with gentle persistence. Teenagers will find it hard to talk, but knowing that you are there is therapeutic in itself.
With this age group it is even more important to validate what they are going through and acknowledge what they are feeling. So move away from “it’s not that bad” or “just don’t worry about it”, to “I’m here, talk to me”, or “I can’t imagine what that feels like, but I can see it’s really impacting you”. In other words don’t problem solve. Simply acknowledging what they are experiencing can go a long way in making them feel understood and supported.
You can do things indirectly too. Plan family activities, or simply invite them to try new things (sports, dance, walking, outings etc.), but always try and match their interests. This will help because our physical and mental health are inextricably linked. This means that you can also help your child through exercise, providing a healthy diet, and encouraging them to manage their sleep and screen time.
Where to go to for support
After 10 years of working in child and adolescent services I think this is often the most difficult age for parents to manage their child’s mental health on their own. Adolescence is a time when teenagers are trying to assert their independence and regularly reject their parent’s offers of support. If your attempts to intervene are being rejected or you’re not seeing any improvements, please ask for support. You can do this by contacting school or asking to see the GP. They can refer on to pastoral support, and child and adolescent mental health services.
Remember accepting your child’s difficulties, validating their experiences, and seeking help, takes real strength. You’ve got this.
Here are some useful websites for further support: