50% of all lifetime cases of mental illness begin by age 14 and 75% by age 24. 70% of youth in state and local juvenile justice systems have mental illness, with at least 20% experiencing severe symptoms. The average delay between onset of symptoms and intervention is 8-10 years. Only 50% of youth with mental illness receive treatment.
Mental health conditions in children are diagnosed and treated based on signs and symptoms and how the condition affects a child’s daily life. There are no simple tests to determine if something is wrong. To make a diagnosis, your child’s doctor might recommend that your child be evaluated by a specialist, such as a psychiatrist, psychologist, social worker, psychiatric nurse, mental health counselor or behavioral therapist. Diagnosing mental illness in children can be difficult because young children often have trouble expressing their feelings, and normal development varies from child to child. Despite these challenges, a proper diagnosis is an essential part of guiding treatment.
Children who have an emotional disturbance may exhibit characteristics and behaviors such as:
- Hyperactivity (short attention span, impulsivity)
- Aggressive behavior, frequent outbursts of anger or self-injurious behavior (acting out, fighting)
- Withdrawal (not interacting socially with others)
- Excessive fear or anxiety, persistent nightmares
- Immaturity (inappropriate crying, temper tantrums, poor coping skills)
- Learning difficulties (performing below grade level academically)
- Long-lasting negative moods, often accompanied by poor appetite and thoughts of death
Children with the most serious emotional disturbances may exhibit distorted thinking, bizarre motor acts and abnormal mood swings.
Children who do not have emotional disturbance may display some of these same behaviors at various times during their development. However, when children have an emotional disturbance, these behaviors continue over long periods of time. Their behavior signals that they are not coping with their environment or peers.
Impacts of Mental Illness in Families
Any illness can disrupt a family, and mental illness can do that without question. The whole family can reel from the situation, especially when the diagnosis is elusive, or if there is little understanding of what mental illness is, or if the signs and symptoms are emerging but are confusing. In some cases there are a variety of approaches to identification and treatment of childhood mental issues. Some of these approaches have a lot of research that underlays them. In some cases the treatment may be based more on an individual’s personal worldview. Don’t be afraid to ask any treatment provider for documentation of their academic credentials, appropriate licensing, and that the service offered is an evidence based treatment.
What Clergy/Staff Need to Know
Children who are dealing with a mental health challenge need specific support, as do their families. Before a child is diagnosed with a mental health condition, parents and children commonly experience feelings of helplessness, anger and frustration. Encourage the parents to ask the child’s mental health provider for advice on how to change the way they interact with the child, as well as how to handle difficult behavior. Encourage family members to praise the strengths and abilities of the child. Suggest new stress management techniques, which might help families understand how to calmly respond to stressful situations. Consider suggesting family counseling or attending local support groups, too. The reality is that treatments have improved a lot in the past decade and while it is true that mental health issues can be frequently diagnosed in kids, the vast majority of them are successfully managed/treated with well documented interventions.
Learn if assistance has been offered to the child and family in the school setting. There is a federal mandate that public schools offer screening and where appropriate an individual education plan for kids with special issues. It is good to persist so as to uncover the resources and services that are available.
Clergy can reduce the shame or fear the family may have by sharing what you have learned about mental illness as well as being receptive to their struggles without minimizing them. Encourage the family to explore treatment options to help the child, affirming that while it is stressful, mental illness is treatable.
Clergy can learn about recognizing signs and symptoms of mental illness by signing up for a Mental Health First Aid course. (Go to MHFA.org) Some MHFA classes are geared specifically to needs of children and adolescents. Also, you can go to CaringClergyProject.org to view several short videos on subjects such as making referrals and starting a spiritual support group.
The clergy may be crucial in approaching the spiritual dimension of the physical nature of an illness which may be a mental illness. It is a complex and sensitive issue in talking about mental health being a neurological disease that has implications for one’s faith. How does a child with a brain disorder/mental illness think/experience/talk about God? What theodicy questions might the family have in terms of “why does God allow my child to suffer?” Find some scriptural references of Jesus having compassion for children and passages that offer spiritual comfort. A clergy person can address the spiritual needs of the children and families.
How Your Congregation Can Help
- Locate and promote a parenting skills training class to help families learn how to handle difficult behavior.
- Start a spiritual support group to help parents and families connect with others who have similar problems and concerns. Groups often meet regularly to share frustrations and successes, to exchange information about recommended specialists and strategies. These groups can meet to deepen and develop their faith foundation and practice, listen to one another, and be open to the Spirit’s healing presence with each other.
- Offer comfort and support for parents who are caregivers of children with mental illnesses. Acknowledge how this care affects their own health. The stress that parents are under may lead to missed work or lost free time. It can strain relationships with people who may not understand the situation and lead to physical and mental exhaustion. When appropriate, send cards and letters of support; make visits; and even offer respite care by those who have been trained to offer such care.
- Sponsor a local mental health program at your church, such as the 12 session NAMI Family to Family series. Contact your local NAMI affiliate about the 12-week free course on mental illness for family members of those who have a mental illness.
- Bring a casserole (or other food) to a family in crisis around a child’s mental illness. Of course, be sure to ask first if this is something that would be appreciated.
- Identify a Children’s Mental Health guide, contact person, or advocate in the congregation. A lay person who has personal experience or professional knowledge can help plan a program of education about children, youth and family mental health. This person can also assist the pastor, other staff and pastoral caregivers to provide appropriate resources and referral possibilities to families.
- Provide comfort and support for parents and family through a “companion,” who offers hospitality, shares the journey, listens and encourages the building of an appropriate group for care and support.
- Create connections to local mental health allies who work with children and families. Invite them to speak at a forum; set up an informal conversation with children’s mental health provider; recognize and publicize local children’s mental health resources during Mental Illness Awareness Week in October and Mental Health Month in May.
- Your Child’s Mental Health: 12 Questions Every Parent Should Ask. This is a list of 12 questions parents can ask regarding their child. Behaviors indicated on this list that last for more 2 weeks may indicate a need for professional help
- Facts about Young Children with Challenging Behaviors. This one-page sheet indicates the importance of early intervention, preschool and before the end of 3rd grade, which may lead to positive outcomes.
- Suicide Prevention Hotline: If you are concerned about a child’s thoughts or talk about dying by suicide, call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to be connected to a trained counselor at a suicide crisis center nearest to where you live.
- NAMI Basics. This basic free educational program deals with the fundamentals of caring for yourself, your family, and your child or adolescent with mental illness. There is a toolkit of information and even info to use until a person joins a class. Contact your local NAMI to find out when it is offered in your area.
- A Guide for Starting a Spiritual Support Group for Mental Health and Wellness. This is a 4-page guide to starting and leading a spiritual support group in your faith community.
- Kids in the House –resources for parents on mental health. See this extensive variety of videos by experts in mental health.
- ADNet, a resource on autism from the Anabaptist Disabilities Network. This newsletter tells a poignant story of a congregation’s response to a child in their midst who lives with autism. There are 7 suggested steps for a congregation to take and along with helpful resources at the end of the article. Autism in the Congregation: Offering Jesus’ Welcome to All Children
- National Federation of Families for Children’s Mental Health. This is a national-run organization focused on the issues of children and youth with emotional, behavioral, or mental health needs and their families. They offer resources, fact sheets and advocacy information.
- Challenging Kids. This website offers a list of 10 mental health concerns including Asperger’s syndrome, sensory dysregulation, and tourette’s syndrome and gives extensive resources, websites, videos, and books for educators, families, children and teens.
- Child Mind Institute. Information on 48 different diagnoses are listed along with many personal stories. They believe that the rule of thumb in all medicine—diagnosis drives treatment—is just as critical in psychiatric care.
- About Our Kids/NYU Child Study Center is run by New York University and seeks to improve the treatment of child psychiatric disorders and to eliminate stigma being or having a child with a psychiatric disorder. You can seek for a doctor nationally.
- Worry Wise Kids. Anxiety is the #1 mental health problem facing children and adolescents today and is the most treatable. This website gives causes, treatments, anxiety types, and more.
- Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD). For members, there are webinars and online toolkits to help you understand ADHD, including the symptoms, causes, and treatments. This is a clearinghouse for evidence based information on ADHD, serves as a local face-to-face support group, and is an advocate on public policy.
- International OCD Foundation “OCD in Kids” website. There are lists of signs and symptoms of obsessive compulsive disorder including treatment and how to talk with the school. You’ll find personal stories and online support groups.
- The Child Anxiety Network. This is a thorough, user-friendly site about child anxiety. It also provides direction for those who are not sure where to turn when they think their child may need professional help to cope with anxiety.
- American Academy of Child and Adolescent Psychiatry. Find information on oppositional-defiant disorder, bullying, depression, substance use and more. The offer short videos on a wide variety of topics that respond to specific questions. This website has more than 100 links that are very specific and helpful.
- Anxiety and Depression Association of America (ADAA) This website offers facts and information on finding help, living and thriving, and taking action. There are online, anonymous screening tools to help a person decide to talk with a mental health professional. It includes one on eating disorders, which has the highest mortality rates of any mental illness.
- National Eating Disorders (NEDA) NEDA supports individuals and families affected by eating disorders, and serves as a catalyst for prevention, cures and access to quality care. There is conversation about the causes of eating disorders, which are complex, and there are preventions. There is Proud2BMe, an interactive website for young people. The help line is: 1-800-931–2237.
- National Institute on Mental Health. There is research on 15 mental illnesses and information on 24 psychiatric disorders.
- Victim Advocacy: Guide to Supporting Survivors of Domestic Violence.