Practical tips for supporting children's mental health

The rates of mental illness in our children may not be as bad as the media would have us believe, writes psychologist Melanie Woodfield.

A silent tragedy”, “the unseen epidemic”, “a ticking time bomb”… our news feeds are often filled with gloomy headlines about children’s mental health. Add in media coverage of the Covid-19 pandemic, the state of the planet and the morals of world leaders, and it can be hard to feel optimistic about the future. But it’s not all bad news; the good news just doesn’t sell as well. There are plenty of resilient, emotionally well children riding life’s waves and doing just fine. And for those of you concerned about your child’s mental wellbeing or struggling yourself, there are more and more evidence-based strategies and programmes available to help you through.

“The children now love luxury; they have bad manners, contempt for authority; they show disrespect for elders and love chatter in place of exercise. Children are now tyrants. They contradict their parents, chatter before company, gobble up dainties at the table, cross their legs and tyrannise their teachers.” A quote describing the children at your local primary school? Funnily enough, no. Though there’s some debate about who wrote it, this description was written around 400BC. Turns out, concern for children’s emotional and behavioural wellbeing is not new.

The times they are a-changing

Our lifestyles have changed however, and the trouble is, some aspects of modern lifestyles intuitively seem like they must be bad. Too much screen time, too much sugar, too much indulgence, distracted and/or divorcing parents, too much childcare – well, surely those things must lead to poor outcomes for children?

It’s surprisingly hard to sift through quality research to find out. One of the difficulties is that a lot of the existing research studies have looked for links between these factors and children’s wellbeing, without looking to see if these things cause mental illness. And there’s a difference. Two things might be linked (or correlated), but one doesn’t necessarily cause the other. An often-used example is that ice cream sales skyrocket around the same time that rates of violent crime and murder increase internationally. Buying ice cream doesn’t cause you to kill, but the two are linked. The underlying thing they have in common is hot weather. So, while increased screen time in teenagers might be correlated with poor sleep, low mood and/or anxiety, we don’t necessarily know whether it directly causes the changes, or whether other factors (like being inside, not exercising or not connecting with others face to face) might actually be to blame.

Greater awareness

There’s also the possibility that as a society, we are getting better at identifying and categorising (or ‘labelling’) children’s needs. Thanks to high-profile public health initiatives, such as Sir John Kirwan’s television ads, it may be that depression, anxiety and other mental health conditions have moved onto  our radar and we’re more likely to spot them. Over time, there have also been big changes in how we categorise and diagnose mental health difficulties. For example, ADHD wasn’t included in an early version of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is now in its fifth edition, and diagnostic categories have been both dissolved and developed over time. So it can be hard to chart whether rates have changed over generations, and how.

Discussions are ongoing in scientific literature about whether the true rates of mental illness in children and adolescents (adjusted for all of these factors) are actually increasing. In an editorial for a prestigious academic journal, Cambridge University Professor Tamsin Ford summed things up well by using words like “probably” and “potentially” when looking at prevalence rates of mental health issues in children and adolescents. Helpfully, she also highlighted the importance of parental wellbeing in optimising children’s wellbeing.

Practical tips for supporting children’s mental health

New Zealand’s Mental Health Foundation has a ‘five ways to wellbeing’ campaign which captures the evidence-based essence of practical things that help our mental health. Here are those five  principles, along with thoughts and tips around how they apply to parents and children.

1.  CONNECT. Prioritise relationship.

Slow down, listen and talk. Don’t take it personally if it doesn’t go well at first, instead find a way to connect that’s easiest for all – perhaps while driving in the car, over a shared meal or with cuddles at bedtime. Talk about feelings, including your own (but not too much, or it could be overwhelming), and keep it basic for the little ones – happy, sad and angry is plenty.

As much as you can, surround your child with sensible people. Connection and belonging are important for wellbeing, and that looks different at different developmental stages. A child needs a village – you may need (or want) to widen the small circle of key trusted adults in your child’s world. And, as they grow into adolescents, young people are influenced by their peers. This is part of their developmental process of identity formation – figuring out who they are in relation to others. While this is sometimes out of parents’ control, plugging them in to formal (eg Scouts, Guides or sports teams) or informal (eg church or youth groups) communities can be useful as kids mature. Of course, balance this with not making them (or you) too busy.

2.  GIVE. Your time, your words, your presence.

You don’t have to be a superhero here. Small children’s play is just not as interesting to adults as it is to kids. Thankfully, just short bursts of five minutes at a time of drawing alongside your child and following their lead in their play can be hugely beneficial.

Aim to take the pressure down – for you and your kids. Communicate to your children that good enough is good enough. Perfectionists worry that if they don’t expect the highest standards of themselves, their performance will drop. Ironically, often the opposite happens: when we take the pressure off, we perform much better.

And remember to put on your own oxygen mask first. If you’re struggling yourself, it’s harder to meet your children’s needs.

3.  TAKE NOTICE. Savour the moment.

Children are naturally good at taking notice of the little things in life – a slug, a butterfly, a leaf shaped like a hand. We can nurture this natural mindful noticing of their world by drawing close and reflecting their interest, even for short moments. Just pick up a key word or phrase and echo it back to them. 

When it comes to taking notice, however, we do need to be careful not to compare. Other children might seem to be sleeping through the night, leaping emotional hurdles with abandon, making oodles of friends or calmly tolerating frustration, but you’re only seeing a snapshot of their wellbeing. If you’re going to compare, look for good news. When you have a child, you pay more attention to children and young people generally, and especially to the bad things that can happen. It may be that as parents, we are tuned in to young people we know of where there have been real struggles, and we pay less attention to the good news stories around us.

4.  KEEP LEARNING. Embrace new experiences, see opportunities, surprise yourself.

Children are naturally creative and imaginative. Encourage music, storytelling, crafts, acting and play. Children gain a sense of achievement and mastery from learning new skills. We can pass on the skills we might have (baking, sports or finger knitting) and also model the enjoyment of new learning.

You can support your child to learn about their own emotional landscape from a young age. Children can learn that emotions range and change, and that’s normal. That their feelings have a name and a purpose. If children learn what anger feels like, and have a name for that experience from a young age, they’re more likely to communicate their feelings verbally later on – rather than hitting or kicking.

We can also build up our kids’ coping skills, helping them learn how to deal with frustration and disappointment. Believe it or not, you’re doing your young child a favour when you don’t make everything immediately right again. The toy running out of batteries, the pop-up dog not popping up anymore, the tower falling down – we’re wired to relieve our children’s distress, and we feel compelled to make it right straightaway. But in contrast, supporting your child to tolerate frustration or disappointment for brief age-appropriate periods can do wonders for their emotional wellbeing.

Adults know only too well that sometimes life involves unfair, unjust or disappointing things. Things that can’t be made right, things we just have to accept. You can help your child manage these brief periods by validating their feelings – “Oh it fell down, that’s disappointing! You’d been working so carefully to make it strong.” Pause. No need to add, “It’s okay, you can build another one” or “I’ll build it back to how it was.” Just pause.

5.  BE ACTIVE. Do what you can, enjoy what you do.

Remember the basics: our minds and bodies are so very closely linked. Things like getting enough sleep, eating a reasonably balanced diet and getting regular exercise can do wonders for wellbeing. Not to mention our strength, fitness, balance and focus. But if your child refuses to eat anything but chicken nuggets and won’t budge off the couch … just do your best with baby steps towards a greater goal.

AND REALLY IMPORTANTLY...

Don’t panic. Chances are it’s not a disorder. Sometimes a season of challenging behaviour after a house move or daycare change is actually a sign of healthy development. Likewise a season of shyness every so often. But if the concerns stick around and/or things worsen once the stressor has faded, have a chat with your family doctor.

While it’s pretty bleak to say so, tough stuff happens to good people. Accept that many things are outside of your control, and that all you can do is be ‘good enough’ as often as possible.  Remember also, mental health is not simply the absence of illness. It’s wellbeing, strength, connectedness, contributing, fulfilment... 

So, despite the potential challenges ahead, there’s room for optimism for the future. Yes, some children will experience a mental health condition in childhood, adolescence or in adulthood. On the bright side, for most children, recovery is not only possible, it’s likely. There are sensible things we can do to enhance children’s wellbeing (like the practical tips above), and – more good news – they’re often free and reasonably easy to do.

Dr Melanie Woodfield is an Auckland-based child and adolescent clinical psychologist, researcher and mum to rapidly growing boys. She tends to channel the great wisdom of both Pollyanna and Annie (“The sun will come out, tomorrow”) when thinking about the future for today’s children.