How to Talk to Children and Teens About Mental Illness
Do’s and don'ts for helpful conversations with young people about mental health.
Posted February 19, 2021 | Reviewed by Devon Frye
Key Points: It takes a significant amount of courage for a child to share their mental health concerns with a parent or other trusted adult. Responding with empathy and a willingness to listen is the best way to honor the child's bravery and help them get the help they need.
So many parents have reached out to me recently to ask what to do if their child or teen tells them they are worried they might have a mental illness, I felt compelled to write about it, and share some of my experiences on this matter.
I’m not going to be talking here about what to do if you suspect your child might have a mental illness, but more when it’s the other way around: your child or a child you know discloses to you directly or indirectly that they are concerned about their mental health. They may even tell you about a specific mental illness they are worried they might have, particularly if they are old enough to Google their experience and do research before they speak to you.
It’s important to remember that if a child does try to talk to you about this, it’s probably taken them a lot to work up the courage to speak to you. They are likely feeling vulnerable, and extremely aware of how you respond in this moment. Below is a list of some things to avoid saying, as well as some responses that may be more helpful.
Don’t say: "We all do/feel that sometimes."
It can be very tempting to try and soothe your child that what they are experiencing is normal and there’s nothing to worry about—case closed! Any parent who does respond like this is likely doing it from a good place—these are in fact the words my own (very caring) mother said when I tried to talk to her about stuff that was going on for me (which I didn’t know at the time was OCD).
The problem is, however, that responding in this way can feel really dismissive to anyone—especially a child. And when it comes to mental illness, no, "we don't 'all' do this a bit"; some action may well need to be taken to work through the problem.
This approach also shuts down important conversations about what is actually going on for the child before they can get started.
Don’t say: "You’ll grow out of it."
Again, this is often said to reassure. The problem is that for many mental illnesses, this is not the case—and the passage of time without intervention may only make symptoms more entrenched. And even if it is the case that a child would stop feeling the way they do when they get older (which can happen, particularly if what a child is describing is more related to specific events they feel sad about, such as exams or friendships), it is still an invalidating thing to hear as a response to sharing something that is currently a big problem.
Remember, phrases like “when you’re older” or “in the future” probably don't offer much consolation or mean much to a child who is locked in with their present concerns.
Don’t say: "You have nothing to be sad about!"
Parents and carers may seek to help the child feel better by reminding them that "others have it worse"—the intention being to "focus on the positives!"
The problem is that all suffering is suffering, even though yes, someone else always probably has it worse. If you had a splitting headache, it probably wouldn’t help you if someone came and told you that there was someone else in the hospital down the road who was in *more* pain! In fact, I’ll bet it would just make you even more upset!
Hearing “you have nothing to be sad about” may also play into the guilt the child is potentially already experiencing around why they are struggling—it’s very possible they’ve already tried (unsuccessfully) to talk themselves of it using the same logic.
Don’t say: "That's not normal."
While saying "we all do that sometimes" can be dismissive, "that’s not normal" strikes at the other end of the spectrum—sending the child into panic mode. The child or teen speaking to you is likely already concerned, or they wouldn’t be speaking to you in the first place. Hearing that you think they are abnormal may make them more likely to try harder to hide things and not bridge the topic again—to try really, really hard to just "act more normal." Take it from me—this usually amounts to a whole lot of internalisation of pain, at a high cost.
Don’t say: "Don't tell anyone else about this."
It can also be tempting for parents or carers to advise their child not to talk to others about this. This can come from a place of shame, and concerns about what it will say about the family if other people "find out" their child has a mental illness. It can also come out of a place of misguided concern for the child—the fear that if they tell, they will be ostracised and bullied.
But even if the concern comes from a good place, making mental illness a taboo or unspeakable topic usually makes children feel even more unacceptable or broken. I was advised by my parents to keep my OCD diagnosis a secret—for years even my sister didn’t know, and doctors' appointments and medication were all concealed from other family members and friends. It was a stressful secret, and looking back, we all wish we’d done it differently.
In most cases, I really believe parents say these things because they want to help their child feel better—there is no manual for how to talk about this stuff, and it’s instinctive to want to reassure those we love that everything is fine and there is nothing wrong. I don’t wish to make any parent or carer feel bad if they have said any of these things—most are, after all, just doing their best and it can be very hard to know what to do in these circumstances.
But it is possible to have a productive, supportive conversation, and preparing beforehand can help parents feel ready when the conversation arises. Below are some things that may be more helpful for a concerned child or teen to hear:
- “That sounds really difficult.”
- “Can you tell me a bit more about what’s going on?”
- “When did this start?”
- "How does the stuff we've just spoken about make you feel?"
- “I’m glad you felt able to talk to me about this.”
- “Do you have any ideas about what you’d like us to do next? (It’s ok if you don’t.)”
- “I am here for you. Let’s make a plan for next steps.” (This may involve you both committing to doing some research, speaking to a doctor, or just setting a time in the near future to have another conversation about it.)
Above all, my best advice is this: don’t shut down the conversation—listen carefully. Make it clear that you want to support however you can, and that it is a good thing that this conversation is happening.
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