A child’s mental health affects nearly every aspect of their overall health. Their physical health and their ability to become successful, contributing members of society depends on the state of mind they bring to every situation. Children’s mental health issues are real, common and treatable. An estimated 15 million of our nation’s young people can currently be diagnosed with a mental health disorder. Many more are at risk of developing a disorder due to genetic and environmental risk factors. However, it is estimated that only about 7 percent of youth who need services receive appropriate help from mental health professionals (Department of Health and Human Services, 2001 — Report of the Surgeon General’s Conference on Children’s Mental Health: A National Action Agenda).

1) What should I do if I am concerned about mental, behavioral, or emotional symptoms in my child? Keep in mind that every child is different. Even normal development, such as when children develop language, motor, and social skills, varies from child to child. If you are concerned about changes in behavior or other symptoms, talk to your child’s doctor or health care provider. If your child is in school ask the teacher about observed changes in behavior and see if the school system can provide an evaluation. Share this with your provider as well. Be prepared to seek further evaluation by a specialist with experience in child mental health issues. Specialists may include psychiatrists, psychologists, social workers, psychiatric nurses, and behavioral therapists.

2) How do I know if my child’s problems are serious? Many everyday stressors can cause changes in a child’s behavior, however, not every problem is serious. For example, the birth of a sibling may cause a child to temporarily act much younger than he or she is. Behavior patterns that may indicate a more serious issue include:

• Problems across a variety of settings, such as at school, at home, or with peers
• Changes in appetite or sleep
• Social withdrawal, or fearful behavior toward things your child normally is not afraid of
• Returning to behaviors more common in younger children, such as bed-wetting, for a long time
• Signs of being upset, such as sadness or tearfulness
• Signs of self-destructive behavior, such as head-banging, or a tendency to get hurt often
• Repeated thoughts of death.

3) How are mental illnesses diagnosed in young children? Just like adults, children with mental illness are diagnosed after a doctor or mental health specialist carefully observes signs and symptoms. Some primary care physicians can diagnose a child themselves, but many will refer to a specialist for diagnosis and treatment.

• Before diagnosing a mental illness, the doctor or specialist tries to rule out other possible causes for a child’s behavior. The doctor will:
• Review the child’s medical history
• Discuss the issues you have observed
• Review the child’s developmental level
• Ask about any family history of mental health disorders
• Ask if the child has experienced physical or psychological traumas, such as a natural disaster, or situations that may cause stress, such as a death in the family
• Consider reports caretakers and/or teachers

Children are constantly changing and growing and diagnosis and treatment must be viewed with this in mind. While some problems are short-lived and don’t need treatment, others are ongoing and may be very serious. In either case, it is important to see more information so you can understand treatment options and make informed decisions.

3) What are the treatment options for children? The specialist will recommend specific treatment based on the diagnosis. Treatment options may include psychotherapy and/or medication. Talk about the options with the specialist and ask questions. Some treatment choices are a part of standard health care practice while others may be in the experimental stage.

4) Will my child get better with time? Some children get better with time and others children may need ongoing professional help, it all depends on the diagnosis. That is why it is important to consult with a health care providers as soon as possible because treatment may produce better results if started early.

5) How can families of children with mental illness get support? Like other serious illnesses, taking care of a child with mental illness is hard on the parents, family, and other caregivers. Support groups are available for many different types of issues and age groups. By sharing experiences in a safe and confidential setting encourages empathy and a sense of community.

Help is available. For additional information, visit MagellanHealth.com/MYMH

Sources: American Psychological Association, National Institute of Mental Health

If you’re raising children today, it can be easy to focus on the negative, especially with the constant media stream coming from all directions. Helping children see the positive in the world today is more important than ever. Research shows that optimists, who believe they can achieve success, are in fact more able to do so. They are less likely to get depressed, get fewer illnesses, have longer relationships, and live longer.

Here are 12 tips to help your children develop a positive outlook on life.

1. Quit complaining. Focusing on negative thoughts and frustrations is classic pessimism. The more you moan about troubles at work, money problems, etc. the more likely it is that your children will learn to do the same thing. Instead, try talking about things that go right.
2. Have high expectations. Kids won’t develop an optimistic, “can-do” attitude unless they have the opportunity to prove their worth.
3. Encourage reasonable risk-taking. Discouraging your children from doing activities because they might not be as skilled as other children can undermine their confidence.
4. Wait before reacting. Let your children try to solve things without your help. This will boost their sense of accomplishment and also make them more optimistic about what they can do in the future.
5. Be realistic and honest, even in difficult situations. For example, if your child is having a difficult time making friends at a new school, empathize with him/her, but explain that making friends takes time and he/she needs to take active steps to meet other kids and make friends.
6. Show your children you love them. Make time for them every day and use words and affection to show you care.
7. Be a positive role model. Your children will mimic your behaviors, so make sure you show them constructive ways of dealing with life’s challenges and misfortunes.
8. Allow your child to experience success. For example, give them age-appropriate tasks around the house and praise them for their efforts.
9. Teach practical skills with patience and humor. Help your child to keep up with peers – for example, tying shoelaces, using cutlery and managing the toilet.
10. Listen to their problems. Take concerns seriously and be supportive as they learn how to cope with life’s hurts and disappointments.
11. Point out the ‘silver lining’ in every cloud. Get your child into the habit of looking for the positives, even times where it may only seem like the chance to learn from a mistake.
12. Make happy events a regular part of your family life.

Help is available. For additional information, visit MagellanHealth.com/MYMH

Sources: Parents.com, Better Health Channel

Traumatic events, such as a sudden death, natural disaster, motor vehicle accident, or terrorist attack can leave children and teens feeling stressed, frightened, and helpless. Whether they personally witness the event or are exposed to it on the news or social media, children may experience intense emotions and a heightened sense of insecurity. Children’s reactions to a traumatic event depend on their age and personality, the severity of the event, the availability of support, and previous experience of trauma

Tips for all ages

Traumatic events can disrupt children’s sense of safety and result in fears and worries, nightmares, and physical reactions such as headaches, stomachaches, problems sleeping, and loss of appetite. Here are suggestions to help children through the emotional and physical challenges they may face after trauma:

• Be aware of your own reactions to the event and manage your own stress. Stay calm and offer hugs and reassurance to help restore your child’s sense of safety and security.
• Share information about the event and answer your child’s questions honestly. Listen to your child’s fears and let him/her know it is okay to share his/her feelings at any time.
• Limit or prevent exposure to disturbing news and social media coverage of the event. Children who see graphic images or hear distressing news stories may become re-traumatized.
• Maintain stable routines as much as possible, including regular mealtimes, bedtimes, and exercise.
• Engage in fun activities to help children relax and feel that life is returning to normal.
• Watch for signs of trauma, even after weeks have passed. Children cope with trauma in different ways, and some may show signs of sadness, anxiety, and troubling behavior weeks or months after the event.

Tips by age group

Preschool age

After a traumatic event, children who are age five and under may display behavior from an earlier stage of their lives, such as bedwetting, thumb-sucking, clinginess to parents, and fearfulness of strangers. They may have tantrums or cry more than usual, or become withdrawn from others. Parents and other adults can help children by providing comfort and reassurance, maintaining routines as much as possible, encouraging them to express their feelings, and giving simple explanations to children’s questions about the event. Children look to their parents for cues as to how to feel and react, and will pick up on a parent’s distress or anxiety. It is best not to expose young children to the news on TV or the radio about the traumatic event. Involving toddlers and preschoolers in fun activities and playtime with others will provide a healthy distraction.

Early childhood

Children ages 6 to 11 may show some of the same reactions that younger children have, such as reverting to more childish behaviors. They may have nightmares or trouble sleeping, find it difficult to concentrate in school, become irritable, anxious or disruptive, or lose interest in family, friends, and fun activities. Parents should reassure children that they are safe and will be taken care of no matter what. Encourage family discussion about the event and answer questions, but be careful about exposing children to news and TV footage. Keep bedtime and meal routines as normal as possible, and involve children in activities that keep them busy. Identify the positives such as community recovery activities and the ways people help each other get through difficult times.

Adolescence

Older children ages 12 – 17 may have stress reactions such as nightmares and flashbacks of the event, lose interest in school, hobbies, and friends, feel angry, guilty, or depressed, withdraw from others, have physical symptoms such as headaches, or abuse alcohol or other drugs. As with younger children, parents can help teens rebuild a sense of trust and safety by listening to their concerns without judgment and providing them with peer support opportunities. Age-appropriate volunteer activities can help teens feel useful and productive.

When to get help

Be aware of signs that a child may need extra help coping with the trauma. If six weeks or more have passed since the traumatic event and your child is not feeling better, has trouble functioning at school or at home, is withdrawn from friends and family, or continues to have physical complaints such as headaches, stomach pains, and problems sleeping or eating, contact a mental health professional.

Today, children and adolescents with behavioral health challenges are generally prescribed, and use, an alarming number of psychotropic medications. This excessive usage has raised concerns among families, practitioners and advocates amid questions about the appropriateness of the diagnoses that justify the drugs’ use – as well as the uncertainty surrounding the long-term effects of these drugs on a child’s neurological development.

Thinking ahead about the challenge

Magellan Health has had its eye on this issue for years, publishing a popular monograph, “Appropriate Use of Psychotropic Drugs in Children and Adolescents,” on the topic in 2013, which addressed the anxiety and confusion around the issue. Now – leveraging new data and research – we have released an updated monograph.

We know that appropriate use of psychotropic medications can play a role in helping children and youth with behavioral health conditions successfully live at home, achieve in school and experience positive engagement within their communities. But first parents, caregivers and practitioners need to fully understand the risks and monitor their use. When they’re used in the wrong way, these drugs can lead to a host of medical conditions and social problems that prevent youth and their families from achieving their goals.

10 questions to ask before starting treatment

To tackle this issue in the most practical way, we’ve developed a list of top 10 questions for caregivers, practitioners and the child/youth to discuss before beginning this type of treatment:

The treatment options

1. Are these medications needed?
2. Will the child benefit from therapy?
3. Did the child get a full evaluation from a behavioral health practitioner?

The medication

4. Has the medication been tested and approved for children? What are the risks, benefits and side effects?

The treatment plan

5. How will we know the child is making progress?
6. How often will the child be checked after starting the medications? What happens if we don’t see progress?
7. What warning signs should we look for and when should the doctor be called?
8. Will the treatment be noted in the child’s health care records?
9. Will the practitioner talk to the child’s other health care providers?
10. Does the practitioner know of other medications the child is taking and are there risks in combining them?

Implications

We know practitioners strive to do the right thing for the individuals they serve. With our monograph, we aim to support them in their decision-making process. Our approach is to help primary and behavioral health practitioners – as well as parents, youth and advocacy organizations – make informed decisions that most effectively meet each child’s needs. When the right medications are prescribed and monitored, they can have positive results in a child’s life.