While dealing with a child’s problematic behaviour it is important to investigate both a learning problem and a mental health problem. This post focuses on what to look for when a child is struggling with a mental health problem. Most people do not know the difference between normal life issues or a mental health issue or are afraid to bring it up as a possibility because of the social stigma associated with it.
A large percent of parents, teachers and mental health providers still believe that mental health problems in children are very rare; problematic behaviour is often dismissed as part of normal development or as a result of unfortunate life events, such as; immaturity, bullying, parents separation, or just not getting along with the teacher/school/administration. Approximately 40 percent of adults do not know the signs and symptoms of mental health problems in children. On top of this lack of information is the uncomfortable feeling (stigma) adults have about mental health issues, so the topic is not raised and the bad behaviour is labeled as the child willfully being bad.
Life throws problems at all of us and it is natural to react to these with anxiety, sadness, difficulty concentrating, being overactive, impulsive and non compliant. Yet there is a threshold, where these behaviours are more a sign of mental health problems than just a reaction to normal life events.
Here are 3 things to look at when deciding if the behaviour is part of growing up or is in fact an indication of a mental health issue and therefore needs to be assessed:
1. The symptoms of the child’s behaviour and an impairment in functioning both need to be present. For example, children do get sad at the death of a grandparent and are able to get caught up in their school work. A child who is sad, has issues sleeping and never seems to be on top of the assignments, warrants further investigation. If there is a link between symptoms and impairment, you are looking at more than just a reaction to growing up.
2. The second important factor to investigate is how long the symptoms/dysfunction has been present. Any anxiety, depressive or defiant behaviours that last longer that 3 months is a strong indication the child needs to be assessed. Personally, I would investigate these behaviour sooner than a 3 month duration based on my intuition. I have had many parents and teachers tell me within the first month of the child attending school that, “something is just not right”, so trust your intuition. Any expression of self-harm or suicidal thinking requires immediate attention.
3. The number of symptoms and the intensity of behaviour is also an important clue. If, over time the symptoms get worse it means the child is not able to cope (with whatever) and adults should be concerned. Who ever notices this first should contact the responsible adults in the child’s environment to see if the behaviour occurs in multiple setting. (In the case of anxiety, many children can keep it together at school, but when they get home they fall apart and can become aggressive, but they tend to have issues with completing assignments. Parents will often blame the school when this happens and the teacher often blames the parents for not supporting the school; both of these are incorrect assumptions.)
Any mental health symptoms in children necessitates paying attention to the child’s behaviour. Watchful waiting, heightened surveillance and frequent check ins between home and school should be the priority to see if the behaviour deteriorates, symptoms accumulate and impairment develops. Then immediate intervention is appropriate and necessary if the child is to be helped. Waiting for the child to “grow out of it” and then deciding in grade 6 that he or she needs help only makes it worse.
Do you know a child who is struggling and are not sure what to do? Email me and I can help