Mental health is as important to a child's safety and well-being as their physical health. It can impact on all aspects of their life, including their educational attainment, relationships and physical well-being. Mental health can also change over time, to varying degrees of seriousness, and for different reasons.
NSPCC
Any child or young person can develop mental health issues. But research has shown there are some factors that are associated with children and young people's long-term mental health.
The traumatic impact of abuse and neglect increases the likelihood of children developing a range of mental health issues – both during childhood and in later life. These include anxiety, depression, eating disorders and post-traumatic stress disorder (PTSD) (Norman et al, 2012; Spatz Widom, 1999).
Specific types of abuse may be connected to certain mental health issues. Children who have experienced emotional abuse may be more likely to develop anxiety and depression compared with children who have experienced other types of abuse (Cecil et al, 2017; Gavin 2011). One study found that almost three quarters (74%) of young people who had experienced sexual assault developed PTSD (Lewis et al, 2019).
Abuse and neglect can also make children more vulnerable to developing more than one mental health condition at one time (known as composite mental health issues) (Chandan et al, 2019).
Providing effective mental health support for children who have experienced abuse and neglect can help them recover from its effects (NSPCC, 2019b).
d/Deaf and disabled children and young people with complex or additional needs may face a range of challenges including:
reduced mobility
prejudice, discrimination and bullying.
These challenges may lead to lower self-confidence, difficulty forming peer networks and social exclusion, putting them at higher risk of developing mental health issues (Falcounbrige, Hunt and Laffan, 2019).
Adults may confuse the signs of learning disabilities with the symptoms of mental health issues. This can mean concerns aren't recognised and responded to quickly or appropriately.
Children from black and minority ethnic groups may experience:
racism, discrimination and prejudice – this can be direct, indirect or institutional
an increased stigma around mental health issues in the community.
This can lead to inequalities and issues in accessing appropriate care and support for mental health needs (Bignall et al, 2020).
LGBTQ+ children and young people may experience:
prejudice, discrimination and bullying
a fear of or an actual rejection from family and/or friends
feeling excluded or like an outsider.
They may also experience gender dysphoria: the unease felt when someone's sex registered at birth does not match their identity.
These factors and experiences mean they are more likely than their heterosexual and cisgender peers to experience a range of mental health problems (Chakraborty et al, 2011; Becerra-Culqui, et al 2018).
Children in care are more likely than their peers to have a mental health difficulty (NSPCC, 2019c). This can be due to isolation and loneliness. Children in care may also have experienced abuse or neglect, which increases the likelihood of developing mental health issues (National Youth Advocacy Service, 2019).
Young carers are more likely to experience mental health problems than peers who don’t have caring responsibilities (Sharpe, 2021).
Young carers may:
feel worry or stress about the health and wellbeing of the person/s they care for
feel that they must manage or hide their emotions due to fear or guilt of upsetting the person/s they care for
feel that they don’t have time for themselves and are missing out on opportunities or activities.
Excessive or inappropriate caring roles and a lack of support from services can be risk factors in a young carer experiencing poor mental health. (Carers Trust, 2023; 2016; 2023; Sharpe, 2021).
Stressful or traumatic situations and experiences, such as bereavement or sudden changes in environment, can trigger mental health issues.
Anyone can experience loneliness, but risk factors include:
having a long-term health condition or disability
having caring responsibilities
living in care
being from an ethnic minority community
being LGBTQ+
(Mental Health Foundation, 2022).
Studies show that there is a strong association between social isolation and anxiety and depression in children and young people (Almeida et al, 2021).
You need to be able to recognise the signs that a child may be struggling. However, it's important to remember that some mental health issues may not have visible signs. There are also factors that might make it more difficult for a child or young person to ask for help.
Some children and young people may try to hide how they are feeling or what they are doing (Theodosiou L. et al, 2020). This might be because they:
worry they won't be taken seriously
believe others won't understand
have had a negative experience talking about their thoughts and feelings in the past
feel that no one can help them
fear being dismissed or labelled an attention seeker or 'crazy'
(Mental Health Foundation and Camelot Foundation, 2006).
Children and young people may not always have the language or ability to communicate how they feel. They may be unsure who to talk to and how to talk about their problems.
Some signs of mental health issues may also look like normal child behaviour. For example, tantrums in younger children or teenagers keeping feelings to themselves.
Children who have experienced abuse or neglect
Children who have experienced abuse may be reluctant to talk about how they are feeling, particularly if they haven't yet told anyone about the abuse. They may feel that something is wrong with them or that things may get worse if they talk about it.
Identifying and responding to mental health concerns may be one way of helping children who are experiencing abuse to get the support and protection that they need.
There are ways you can identify if a child needs support with their mental health.
By being attentive to a child or young person's mood and behaviour, you can recognise patterns that suggest they need support.
Common warning signs of mental health issues include:
sudden mood and behaviour changes
self-harming
unexplained physical changes, such as weight loss or gain
sudden poor academic behaviour or performance
sleeping problems
changes in social habits, such as withdrawal or avoidance of friends and family.
These signs suggest that a child may be struggling, but there could be a number of different explanations for them.
Don't attempt to diagnose mental health issues yourself or make assumptions about what’s happening in a child's life.
Recognising that a child or young person may be struggling with their mental health is the first step in helping them. The next step is to respond appropriately.
At least 1 in 4 people in the UK will have a mental health problem at some point in their lives, so in the average group of 30 this means at least 7 will be likely to experience a mental health problem in their lifetime.
Research published by Digital NHS UK (Feb 2023) suggests that:
around five children and young adults (aged 6-19 years) in every class of 30 pupils have a probable mental disorder;
13% of 11–16-year-olds have possible eating problems;
problems with sleep affect over a quarter (28.7%) of 6- to 10-year-olds and over a third (38.4%) of 11 to 16 year olds.
Move Mood (13+) - an app designed to help young people manage the things they might find difficult when experiencing low mood. Move Mood supports users to define goals and set activity schedules. The app motivates users by providing a 'companion' to help them accomplish tasks they commit to and earn 'awards' for completing them.
Calm Halm( 13+) - provides techniques to help break the cycle of self-harm. Users can learn to ‘surf the wave’ by doing five-minute or fifteen-minute activities in these categories:
Distract: helps to combat the urge by learning self-control
Comfort: helps to care rather than harm
Express Yourself: gets those feelings out in a different way
Release: provides safe alternatives to self-injury
Random: selects a random activity from the categories above
Clear Fear (11-19) - Clear Fear uses a Cognitive Behavioural framework to help change anxious thoughts and emotions, alter anxious behaviours and calm fear responses. It also has descriptions of the different ways in which anxiety can manifest, and information and resources to help manage this.
Tellmi (11+) - Tellmi is a peer-support app, where users can post questions or concerns and receive replies from a community of people their own age, whether they are struggling with stress, anxiety or depression, or having problems with relationships. All posts are checked by a trained worker before being published.
Feeling Good Teens (10-15) is designed to help build self-esteem and motivation. It features 11 tracks of varying length, from 3 minutes to 11 minutes, that guide mindful relaxation, muscle relaxation, calming the mind, building self-confidence, coping with exam stress, and sleeping well. It can help you with:
Feeling calmer and more relaxed
Feeling less stressed
Having better concentration
Having more confidence
Kooth is an online counselling and emotional well-being platform for children and young people, accessible through mobile, tablet and desktop and free at the point of use. You can chat to one of their counsellors, read articles written by young people, write in a daily journal and get support from the Kooth community.
SHUSH - Listening tips from the samaritans.
NHS - Children's mental health
Action for Children has lots of tips to help you spot signs of mental health issues in children and advice on the action you can take to help.
Three charities from The Coram Group have joined forces to produce a toolkit to help primary schools support children’s mental health and well-being.
Childline– information about mental health and a free helpline 0800 1111
NHS Moodzone– lots of practical advice, interactive tools, videos and audio guides to help you feel mentally and emotionally better.
MIND A-Z Mental Health– a list of mental health topics to help you understand.
Young Minds – the UK’s leading charity fighting for children and young people’s mental health.
The Mix – support for under 25s on mental health and other life topics.
BBC – My Mind and Me – lots of information, advice and videos around stress, anxiety and mental health.
NSPCC– advice and support around mental health.
Samaritans– offer support and advice to anyone experiencing feelings of distress, despair or considering suicide and their free helpline is available 24 hours a day. Call 116 123 from any phone.
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