All children are sad, anxious, irritable, or aggressive at times, and many find it occasionally challenging to sit still, pay attention, or interact with others. In most cases, these are just typical developmental phases. However, such behaviors may also indicate a more serious problem in some children.
When might children benefit from an evaluation?
Younger children
- Have frequent tantrums or are irritable much of the time
- Often seem fearful or worried
- Complain about frequent stomachaches or headaches with no known medical cause
- Are in constant motion and cannot sit quietly (except when they are engaged in an activity they enjoy, such as watching videos or playing video games)
- Sleep too much or too little, have frequent nightmares, or seem sleepy during the day
- Are not interested in playing with other children or have difficulty making friends
- Struggle academically or have experienced a recent decline in grades
- Repeat actions or check things many times (for example, repeatedly checking to make sure a door is locked) out of fear that something bad may happen
Older children
- Have lost interest in things that they used to enjoy
- Have low energy
- Sleep too much or too little or seem sleepy throughout the day
- Have periods of highly elevated energy and activity and require much less sleep than usual
- Spend more and more time alone and avoid social activities with friends or family
- Diet or exercise excessively or fear gaining weight
- Engage in self-harm behaviors (such as cutting or burning their skin)
- Smoke, drink, or use drugs
- Engage in risky or destructive behavior alone or with friends
- Have thoughts of suicide
- Say that they think someone is trying to control their mind or that they hear things that other people cannot hear
Get immediate help
If you, your child, or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988 or chat at 988lifeline.org. In life-threatening situations, call 911.
Where should I start if I'm concerned about my child's mental health?
Being proactive and aware of your child's mental health is an important first step.
If you have concerns about your child's mental health, start by talking with others who frequently interact with your child. For example, ask their teacher about your child's behavior in school, at daycare, or on the playground.
You can talk with your child's pediatrician or health care provider and describe your child's behavior and what you have observed and learned from talking with others. You can also ask the health care provider for a referral to a mental health professional with experience and expertise in evaluating and treating children. Get information about finding a health care provider or accessing treatment at www.nimh.nih.gov/findhelp.
You can also speak with school administrators and staff about your concerns or refer to the next section "How to Access Mental Health and Wellness Services" to find options for onsite and community based mental health services for your student.
How is children's mental health assessed?
An evaluation by a mental health professional can help understand and clarify your child's emotions, behavior, and current situation. Based on this information, the mental health professional can decide if your child would benefit from an intervention and what intervention might work best.
A comprehensive evaluation of a child's mental health usually involves:
- A parent interview to discuss the child's developmental history, temperament, relationships with friends and family, medical history, interests, abilities, and any prior treatment
- Information gathering from the child's school, such as standardized test scores and reports on behavior, capabilities, and difficulties
- If needed, an interview with the child for testing and behavioral observations
Asking questions and providing information to your child's health care provider can improve your child's care. Talking with the health care provider builds trust and leads to better results, quality, safety, and satisfaction with care.
Here are some questions you can ask when meeting with prospective treatment providers.
- Do you use treatment approaches that are supported by research?
- Do you involve parents in the treatment? If so, how are parents involved?
- Will there be "homework" between sessions?
- How will progress be evaluated?
- How soon can we expect to see progress?
- How long should treatment last?
For more ideas on how to start a conversation with your child's health care provider, visit www.nimh.nih.gov/talkingtips.