Ep 79 – Child mental health

The number of young people struggling with anxiety and depression seems to be on the rise and resources to help these young people are increasingly stretched. In this episode, Dr Kate Chesterman and Dr Dave Ledward (GP with an interest in mental health) discuss the growing problem of managing the mental health of children. They focus on the vital role that parents and caregivers play in supporting young people through emotional turmoil and discuss the educational sessions that Dave has run for the families of young people with mental health issues. Dave discusses some of the pitfalls and traps that caregivers can fall into when trying to support their young people and shares his top tips for parents and professionals to help manage an emotional crisis.

Key references

1. Children & Young People’s Health Services – Just One Norfolk. Supporting children’s mental health. Accessed 17 September 2023. Includes a video by Dr Ledward.
2. This May Help: Advice for supporting your child’s mental health. Accessed 17 September 2023. Developed by NHS professionals and parents who have supported their children through their own mental health journey. Easy to follow advice to help families.
3. MIND. Accessed 17 September 2023. Advice and support for patients and their families.
4. Chathealth. Accessed 27 September 2023. Local area texting service for parents and teens.
5. Your online mental wellbeing community. Accessed 17 September 2023. Online counselling support from peers with moderation by trained professionals.

Key take-home points

• It is important for parents and caregivers to understand that there is no such thing as a “wrong” emotion, even though an emotion may arise from an incorrect interpretation of an event or induce an inappropriate behaviour. Use of metaphors to help with understanding of this vital concept may be helpful.
• Parents can help children to accept their emotions as necessary feelings that are expressed in a given moment, rather than as “problems” to be solved.
• Strategies that are generally unhelpful include: questioning emotions (for people who are depressed this can re-enforce a belief that something is wrong); attempts to rationalise a person’s feelings, or to offer solutions; anger; avoidance of a person’s feelings (this can be extremely hurtful); and overprotection (e.g., “I’ll do that for you because it makes you anxious”).
• Advise parents to focus on listening and letting their child be present with their emotions. Phases such as “I’m here to listen”, “is there anything I can do to help?” and “you have the right to feel this way” can be helpful to demonstrate a willingness to be in their presence and to re-enforce that it is ok and safe to have such feelings.
• Healthcare professionals should look to empower parents as well as looking elsewhere for solutions.
• As a first step, listen, encourage and acknowledge parents as the best people to help their child. This initial approach can help to create a “window of tolerance”, whereby the rational brain is engaged and parents are more likely to accept suggestions.
• Remind parents of the links between emotions and thoughts or behaviours, for example that feeling certain emotions can result in changes in thinking patterns (strong emotions can lead to primitive thinking).
• When young people are struggling with their mental health, inactivity and avoidance can fuel emotions. Therefore, suggest that parents encourage positive changes in behaviours that foster a sense of enjoyment and achievement, which can in turn impact emotions.