Children's Mental Health

Mental health problems affect about 1 in 10 children and young people. They include depression, anxiety and conduct disorder, and are often a direct response to what is happening in their lives.

70% of children and young people who experience a mental health problem have not had appropriate interventions at a sufficiently early age.

The emotional wellbeing of children is just as important as their physical health. Good mental health allows children and young people to develop the resilience to cope with whatever life throws at them and grow into well-rounded, healthy adults.

Things that can help keep children and young people mentally well include:

• being in good physical health, eating a balanced diet and getting regular exercise
• having time and the freedom to play, indoors and outdoors
• being part of a family that gets along well most of the time
• going to a school that looks after the wellbeing of all its pupils
• taking part in local activities for young people.
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Other factors are also important, including:

• feeling loved, trusted, understood, valued and safe
• being interested in life and having opportunities to enjoy themselves
• being hopeful and optimistic
• being able to learn and having opportunities to succeed
• accepting who they are and recognising what they are good at
• having a sense of belonging in their family, school and community
• feeling they have some control over their own life
• having the strength to cope when something is wrong (resilience) and the ability to solve problems

Changes often act as triggers: moving home or school or the birth of a new brother or sister, for example. Some children who start school feel excited about making new friends and doing new activities, but there may also be some who feel anxious about entering a new environment.

​Teenagers often experience emotional turmoil as their minds and bodies develop. An important part of growing up is working out and accepting who you are.

Risk factors that make some children and young people more likely to experience problems than other children:​

• having a long-term physical illness
• having a parent who has had mental health problems, problems with alcohol or has been in trouble with the law
• experiencing the death of someone close to them
• having parents who separate or divorce
• having been severely bullied or physically or sexually abused
• living in poverty or being homeless
• experiencing discrimination, perhaps because of their race, sexuality or religion
• acting as a carer for a relative, taking on adult responsibilities
• having long-standing educational difficulties.

Common mental health problems in children and young people:

• Depression affects more children and young people today than in the last few decades, but it is still more common in adults. Teenagers are more likely to experience depression than young children.
• Self-harm is a very common problem among young people. Some people find it helps them manage intense emotional pain if they harm themselves, through cutting or burning, for example. They may not wish to take their own life.
• Generalised anxiety disorder (GAD) can cause young people to become extremely worried. Very young children or children starting or moving school may have separation anxiety.
• Post-traumatic stress disorder (PTSD) can follow physical or sexual abuse, witnessing something extremely frightening of traumatising, being the victim of violence or severe bullying or surviving a disaster.
• Children who are consistently overactive ('hyperactive'), behave impulsively and have difficulty paying attention may have attention deficit hyperactivity disorder (ADHD). Many more boys than girls are affected, but the cause of ADHD aren't fully understood.
• Eating disorders usually start in the teenage years and are more common in girls than boys. The number of young people who develop an eating disorder is small, but eating disorders such as anorexia nervosa and bulimia nervosa can have serious consequences for their physical health and development.

Help available:

• Parental help:
  If they have a warm, open relationship with their parents, children will usually feel able to tell them if they are troubled. One of the most important ways parents can help is to listen to them and take their feelings seriously. They may want a hug, they may want you to help them change something or they may want practical help.
  Children and young people’s negative feelings usually pass. However, it’s a good idea to get help if your child is distressed for a long time, if their negative feelings are stopping them from getting on with their lives, if their distress is disrupting family life or if they are repeatedly behaving in ways you would not expect at their age.
• Professional help:
  If your child is having problems at school, a teacher, school nurse, school counsellor or educational psychologist may be able to help. Otherwise, go to your GP or speak to a health visitor. These professionals are able to refer a child to further help. Different professionals often work together in Child and Adolescent Mental Health Services (CAMHS).
  Most support for troubled children and young people is provided free by the NHS, your child’s school or your local council’s social services department.
• Talking it through:
  Assessments and treatments for children and young people with mental health problems put a lot of emphasis on talking and on understanding the problem in order to work out the best way to tackle it. For young children, this may be done through play.
  Most of the time, the action that professionals recommend is not complex. and it often involves the rest of the family. Your child may be referred to a specialist who is trained to help them explore their feelings and behaviour. This kind of treatment is called a talking therapy, psychological therapy or counselling.
• Medication:
  Most research into medications for mental health problems has focused on adults, rather than children. Children and young people need to be assessed by a specialist before they are prescribed any drugs. There is a lot of evidence that talking therapies can be effective for children and young people, but drugs may be also help in some cases.
• Confidentiality:
  The professionals supporting your child will keep information about them and your family confidential. Young people can seek help on their own, either by ringing a helpline or by approaching a professional directly, but your consent is usually needed for them to get medical care if they are under 16.
  Young people have a right to privacy if they do not want to talk to you about their conversations with professionals, but you should still respond sensitively if they seem to be upset.

Organisations that can help (UK):

• ​ChildLine
• YoungMinds
• Contact a Family
• Family Lives
• Bernardo's
• Penumbra (Scotland)
• CALM (Campaign Against Living Miserably)
• PAPYRUS (Prevention of Young Suicide)
• Children and Young People's Mental Health Coalition (CYPMHC)

Information from mentalhealth.org.uk

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Loneliness in Young People

Loneliness is a significant problem that can predispose young children to immediate and long-term negative consequences. Early childhood experiences that contribute to loneliness may predict loneliness during adulthood.

Many young children understand the concept of loneliness and report feeling lonely. For example, kindergarten and first-grade children responded appropriately to a series of questions regarding what loneliness is ("being sad and alone"), where it comes from ("nobody to play with"), and what one might do to overcome feelings of loneliness ("find a friend") (Cassidy & Asher, 1992). In a more recent study (Ladd, Kochenderfer, & Coleman, 1996), kindergarten children's loneliness in school was reliably measured with a series of questions such as, "Are you lonely in school?"; "Is school a lonely place for you?"; and "Are you sad and alone in school?" These studies suggest that young children's concepts of loneliness have meaning to them and are similar to those shared by older children and adults.

Consequences of Loneliness:

• Poor peer relationships and therefore expressing more loneliness than peers with friends
• Feeling excluded, which can damage self-esteem
• Feelings of sadness, malaise, boredom, and alienation
• Missing out on many opportunities to interact with peers and to learn important lifelong skills. Lonely children value peer relationships as much as other children

Contributing Factors of Loneliness:

• Conflict within the home
• Moving to a new school or place
• Losing a friend
• Losing an object, possession or pet
• Experiencing the divorce of parents
• Experiencing the death of a pet or someone significant
• Being rejected by peers (including not fitting in, being picked on, taunted, excluded, and physically or verballed attacked; bullied and victimised)
• Lacking social skills and knowledge of how to make friends
• Possessing personal characteristics (e.g., shyness, anxiety, and low self-esteem)

Recognising Loneliness:

• The child being timid, anxious, unsure of themself, or sad
• Showing a lack of interest in the surroundings
• Being rejected by peers
• Avoiding peers by choice
• Lacking the social skills to initiate or maintain conversations, or, having the social skills but is reluctant to use them
• Being victimised by peers
• Is the loneliness a pattern, or something recent?
• Some children appear to have friends, but still report being lonely

These observations are best assessed to the truths by talking to the child individually and asking them how they feel, ​and also documenting their behaviors and responses to determine whether they are lonely or are happily and productively self-engaged.

Strategies
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Although research in support of specific practices assisting lonely children in the classroom is weak, teachers might consider several approaches that may be adapted to individual children. Children who are aggressive report the greatest degrees of loneliness and social dissatisfaction (Asher, Parkhurst, Hymel, & Williams, 1990). Children are rejected for many reasons, and teachers will need to assess the circumstances that seem to lead to the rejection. Is the child acting aggressively toward others? Does the child have difficulty entering ongoing play and adapting to the situation? Does the child have difficulty communicating needs and desires? Once the problem is identified, teachers can assist the child in changing the situation. The teacher can point out the effects of the child?s behavior on others, show the child how to adapt to the ongoing play, or help the child to clearly communicate feelings and desires. Children who are supported, nurtured, and cherished are less likely to be rejected and more likely to interact positively with peers (Honig & Wittmer, 1996).

Children who are neglected or withdrawn also report feelings of loneliness, although to a lesser extent than do aggressive-rejected children. Because these children often lack social skills, they have difficulty interacting with their peers. These children may also be extremely shy, inhibited, and anxious, and they may lack self-confidence (Rubin, LeMare, & Lollis, 1990). If children lack certain skills, the teacher can focus on giving feedback, suggestions, and ideas that the child can implement. Children who possess adequate social skills but are reluctant to use them can be given opportunities for doing so by being paired with younger children. This experience gives the older child an opportunity to practice skills and boost self-confidence.

Children who are victimized by others believe that school is an unsafe and threatening place and often express a dislike for school. Furthermore, these children report lingering feelings of loneliness and a desire to avoid school even when victimization ceases (Kochenderfer & Ladd, 1996). These findings point to the importance of implementing immediate intervention strategies to reduce victimization. Teachers can provide firm but supportive suggestions to the aggressor. For example, teachers might guide and assist children in developing the life skills they need, such as respecting others and self, engaging in problem solving, working together on skills and tasks that require cooperation, and expressing feelings and emotions in appropriate ways (Gartrell, 1997).

Teachers can think about how the curricula might be helpful to a child who is feeling lonely. Some children may benefit by being given opportunities to express their feelings of sadness or loneliness through manipulation, drawing, movement, music, or creative activities (Edwards, Gandini, & Forman, 1993). Arranging the dramatic play area with props may help some children act out or express their feelings and feel a sense of control. Use of crisis-oriented books with children, referred to as bibliotherapy, may assist a child in coping with a personal crisis. Sharing carefully selected literature with children may assist in facilitating emotional health. Children who are able to express and articulate their concerns may want to talk about their unhappiness.

Information from mentalhelp.net