Family Help Guide Menu

Mental Health Conditions and Treatment

Family Help Guide Menu

Mental Health Conditions and Treatment

How to find the right care for your child

You are the expert on your child, and you can be his or her best advocate. The more you know about your child’s mental health condition, the better able you will be to help your child and improve life for your family. Learn as much as you can about your child’s diagnosis, treatment options, and educational services and other supports.

If your child is struggling, it does not mean you are a bad parent. Childhood mental disorders result from many causes, including biological and psychological risk factors, as well as stresses such as bullying or trauma. The good news is that mental health disorders are very treatable.

Childhood and teen mental health disorders and treatment

“For years, my husband and I were puzzled and overwhelmed by our daughter’s impulsive, sometimes out-of-control behavior. It was a relief to finally get a diagnosis, because that led to answers and treatment.”

— Maria

Children and teens can develop the same mental health conditions as adults. Studies show that one in four children has a diagnosable mental illness, but only 20 percent of those in need receive treatment. More than half of all lifetime mental health conditions emerge by age 14.

Mental health stigma is the greatest barrier to care, according to the U.S. Surgeon General. Don’t allow stigma get in the way of treatment that can ease suffering and help your child to thrive in school and in life.

There are many effective treatments that can reduce or eliminate symptoms and improve long-term mental and emotional health for children and teens. Treatment can help struggling youths learn to manage their illness, succeed in school, improve relationships, and build resilience. Without treatment, symptoms can last longer and may worsen.

Mental health conditions that can affect children include:

Anxiety

Anxiety is the fearful anticipation of danger or problems, accompanied by an intensely uncomfortable feeling. Anxiety can lead to school refusal or avoidance. Anxiety disorders include Generalized Anxiety Disorder, Panic Disorder, Phobias, and Obsessive-Compulsive Disorder. Anxiety often accompanies other mental health disorders. 

Attention Deficit Hyperactivity Disorder (ADHD)

Attention Deficit Hyperactivity Disorder (ADHD) is marked by impulsive or hyperactive behavior and difficulty paying attention or concentrating. This may impair the ability to listen, organize work, or follow directions, and cause problems in relationships with peers, teachers, and parents.

Bipolar Disorder

Bipolar Disorder is a mood disorder marked by impairing extremes of energy, elation, irritability, and/or agitation characterized as mania, and deep despair, which also may include irritability. These extreme states may occur periodically, with healthy periods in between, or may rapidly cycle, occurring multiple times in the same day. Some individuals with bipolar disorder also experience delusions and hallucinations.

Depression

Depression is a mood disorder that includes a cluster of symptoms present for at least 2 weeks. Symptoms may include feelings of hopelessness, guilt, and self-blame; recurring thoughts of death and suicide; loss of energy; inability to concentrate; change in appetite; too much or too little sleep; and loss of interest in activities formerly enjoyed.

Eating Disorders

Eating Disorders include Anorexia Nervosa and Bulimia, conditions that can cause serious and sometimes life-threatening medical problems.

Anorexia is diagnosed when an individual severely limits food consumption and weighs less than 85% of expected weight. Those with anorexia often have an intense fear of gaining weight and a distorted body image. They may exercise to excess.

Bulimia is diagnosed when an individual binges on large quantities of food and then purges to prevent weight gain. Purging can take the form of self-induced vomiting, use of laxatives, diuretics, enemas, or by excessive exercise. Often, the individual feels unable to control his or her eating.

Schizophrenia

Schizophrenia is a psychotic disorder characterized by strange ideas or delusions, and/or auditory, visual or sensory hallucinations such as seeing or hearing things that are not there. Schizoaffective Disorder is a psychotic disorder with symptoms of Schizophrenia and Bipolar Disorder.

Substance Use Disorder

Substance Use Disorder occurs when an individual has a dependence on alcohol or drugs that is accompanied by intense and sometimes uncontrollable cravings and behaviors to obtain the substance.

Trauma

Trauma is the experience of an event that is extremely emotionally painful or frightening and which often results in lasting mental and physical effects. Traumatic events may include a car accident, community violence, physical or sexual abuse, or a natural disaster.

Warning signs of mental health conditions

It can be difficult to tell signs of a serious problem from normal and sometimes challenging childhood or teenage behavior. If you are worried about your child’s mental health, trust your instincts and seek expert advice. Be alert for symptoms that cause distress, interfere with ordinary functioning, or exist across settings— at home, school, and/or with peers. Consult a doctor or a mental health provider if your child has drastic mood, personality, or behavior changes, thoughts of death, frequent complaints of stomach pain or headaches, or repeated use of drugs or alcohol.

Seek an evaluation if your child or teen:

  • Feels intense worry or fears that get in the way of daily activities
  • Feels very sad, hopeless, or withdrawn for at least two weeks
  • Feels sudden, overwhelming fear for no reason, sometimes with a racing heart or fast breathing
  • Has a drop in grades or refuses to go to school
  • Sleeps too little or too much, has frequent nightmares or sleep-walks
  • Is extremely angry or volatile, is involved in multiple fights, and/or wants to hurt people or animals
  • Has self-destructive behavior, such as head-banging, cutting, or burning
  • Severely limits eating, causes himself/herself to vomit, exercises excessively, or uses laxatives or diuretics to lose weight
  • Has reckless or out-of-control behavior that could injure himself/herself or someone else
  • Has strange thoughts or beliefs, or does very odd or unusual things
  • Hears, sees, or feels things that are not there
  • Reverts to behaviors common to younger children, such as bed-wetting

Seek an evaluation if your child or teen:

  • Feels intense worry or fears that get in the way of daily activities
  • Feels very sad, hopeless, or withdrawn for at least two weeks
  • Feels sudden, overwhelming fear for no reason, sometimes with a racing heart or fast breathing
  • Has a drop in grades or refuses to go to school
  • Sleeps too little or too much, has frequent nightmares or sleep-walks
  • Is extremely angry or volatile, is involved in multiple fights, and/or wants to hurt people or animals
  • Has self-destructive behavior, such as head-banging, cutting, or burning
  • Severely limits eating, causes himself/herself to vomit, exercises excessively, or uses laxatives or diuretics to lose weight
  • Has reckless or out-of-control behavior that could injure himself/herself or someone else
  • Has strange thoughts or beliefs, or does very odd or unusual things
  • Hears, sees, or feels things that are not there
  • Reverts to behaviors common to younger children, such as bed-wetting

Talk with your child’s health care provider about the symptoms or behaviors you have observed. Contact your child’s teacher to ask if your child has shown unusual or worrisome behaviors at school. Share this information with your child’s health care provider. Ask if your child needs further evaluation by a specialist, such as a psychiatrist, psychologist, social worker, or counselor.

Diagnosis

There are no blood tests to diagnose mental disorders. Diagnosis is made based on observed symptoms and how the condition impacts a child’s daily life, using criteria in the Diagnostic and Statistical Manual of Mental Disorders V (DSM-5). The DSM-5 is a diagnostic guide published by the American Psychiatric Association and used by mental health professionals nationwide.

The first step in diagnosis is typically a physical exam to identify or rule out potential physical causes for mood or behavior issues, and to take a history of symptoms and the child’s development. The physician also will ask about any upsetting changes, stresses, or traumas the child may have experienced. Based on this information, the physician may recommend evaluation by a child and adolescent psychiatrist or other mental health professional.

The mental health provider will evaluate symptoms, including behavior and impaired functioning, feelings that the child expresses, and the observations of parents, teachers, and others. Any family history of mental health conditions is also considered, since disorders can be inherited.

Diagnosing mental health conditions in children is challenging because children are growing, development varies with each child, and young children may not be able to express what they are thinking and feeling. Adolescence and young adulthood is a time when mental health conditions can emerge or become more pronounced. As a result, diagnoses for children and teens often change over time. It is important to persevere, because a proper diagnosis is essential to getting the right treatment.

Treatment

Treatment is based on the diagnosis, severity of symptoms, age of the child, and the training and expertise of the practitioner. Psychotherapy, also called “talk therapy,” can be very effective for many conditions. Often, a combination of medication and psychotherapy is recommended. Behavioral interventions include skills training for children and youths with severe and disruptive behaviors, and behavior management coaching for parents or caregivers.

Substance Abuse and Treatment

If you are concerned that your child or teen may be abusing alcohol, street drugs, or prescribed medications, it is important to seek professional evaluation. Substance abuse counseling and treatment is available through many community mental health centers and private clinicians, as well as outpatient, in-patient and residential treatment programs.

When your child is evaluated for substance issues, be sure to ask for a mental health evaluation too. Substance abuse treatment should be offered in combination with mental health treatment, since youths with mental health needs often self-medicate, and are at high risk for substance abuse and addiction.

Substance Use Disorder is a psychiatric diagnosis measured on a continuum from mild to severe. Treatment consists of behavioral therapy, and may include medication to treat withdrawal, depression, or other co-occurring mental health disorders. Therapy helps individuals change their attitudes about substance use and provides skills to manage stressful situations.

Research shows that parent and family involvement is the most important factor in successful intervention, treatment, and recovery for youths. A youth who has recently started using can benefit from early intervention services, including education, life skills, social skills, and individual or group counseling. Those with more severe substance abuse or addiction may need higher levels of care, such as intensive outpatient or in-patient treatment. Families also may be asked to participate in family therapy, support groups, or educational meetings.

Not all substance abusers become addicted, but those who do face a higher rate of relapse. The National Institute on Drug Abuse (NIDA) describes addiction as a treatable chronic disease. Relapse is likely for many, but does not mean failure. Relapse indicates that treatment should resume, or another method of treatment should be tried.-

Choosing mental health providers

It is important to find a clinician who is a good fit for your child, and who will treat parents as allies. No one knows a child better than his or her parents, and a clinician who ignores parent input or does not return calls can’t provide the best care. If the relationship is not working, it’s reasonable to make a change.

FRED maintains directories of recommended psychiatrists, psychologists, and therapists. These lists are available upon request to FRED members only. Clinicians must be recommended by a FRED member in order to be included on the lists.

When meeting with a psychiatrist, therapist, or social worker, ask lots of questions about your child or youth’s diagnosis and proposed treatment, as well as the provider’s experience and expertise. Mental health conditions can be tricky to diagnose, especially for children and teens, and treatment must be tailored to the individual. Don’t hesitate to seek a second opinion.

Seek the most skilled mental health professionals available. Talk to other parents, physicians, therapists, school social workers, guidance counselors, and clergy, to learn which local clinicians have the most experience and expertise in treating your child’s condition. Be sure to ask what license the mental health or substance abuse provider holds. Children and youths may benefit from treatment by a psychiatrist, a psychologist, social worker, therapist, or substance abuse counselor.

Community mental health centers are good resources for counseling and psychiatric treatment, accepting payment on a sliding scale or through private insurance or Medicaid. Thrive Counseling Center is the local community mental health center for Oak Park and River Forest. Thrive is located 120 S. Marion St. Oak Park, Il, 24-hour phone 708-383-7500.

Health insurance companies also offer information about mental health professionals in their coverage network, and hospitals frequently maintain referral directories. Mental health organizations, such as county or township mental health boards or committees, or a local chapter of the National Alliance on Mental Illness (NAMI) also may have information about local public and private mental health providers.

National Alliance on Mental Health (NAMI)

The Substance Abuse and Mental Health Services Administration (SAMHSA) also offers a Behavioral Health Treatment Services list.

SAMHSA Treatment Services List

Parenting a Child With Mental Health Needs

“Your standards change. My son left the house during a family dinner and sat under a tree. He has learned ways to calm himself when he is having an episode, so he is not hurting himself or destroying the house. I thought he did exactly the right thing. I was proud of him.”

— Cheryl

Parenting a child with mental health needs requires deep reserves of love, patience, flexibility, and compassion. Your child may be struggling now, but he or she can get better. It’s important to differentiate your child’s personality, strengths, and talents from his or her diagnosis. Recognize your child’s efforts and successes, and hang onto positive expectations for the future.

Learn about local mental health services to help your child and improve family life. These can include training to manage or improve a child’s behaviors, or respite services that offer caregivers a much-needed break. Contact the local park district or special recreation district to find out about recreational and social skills programs that may benefit the child.

Build a Mental Health Team

It helps to build a mental health team to assist and support your efforts. The team can include your child’s physician, psychiatrist, therapist, and/or case manager; school special education staff; and other adults who help, such as tutors, coaches, or extra-curricular instructors.

The support of another parent who has successfully navigated the children’s mental health system also can be invaluable. Many community mental health centers employ Certified Family Partnership Professionals (CFPPs), who are trained to incorporate their life experience gained through parenting a child with mental health needs to help other families. Inquire about CFPP services in your community.

Coordinate and communicate clearly with your team. Some team members will need to work closely with each other. For example, it can be helpful to link the child’s psychiatrist with the therapist, or a teacher with an after-school tutor.

Lean on your mental health team. Use the expertise of each team member to help navigate challenges and gain new skills. Learn the situations that are difficult for your child and, enlist the team to work on strategies to cope with stressful situations.

Plan ahead for situations that can anticipated:

  • Transitions are often very stressful. Children and teens often do best with a daily routine, including a daily schedule that he or she can review. Help your child prepare for new situations, and talk through possible coping strategies.
  • A new school year can provoke overwhelming anxiety. It can help to arrange a visit to the new classroom or to meet the teacher before classes begin.
  • Children and teens fear losing control in front of peers. Arrange a go-to adult at school or other setting who will provide a quiet, supervised space if your child becomes anxious or agitated. Create a subtle signal that your child can use to let a teacher or other adult know that he or she needs to exit.
  • Be realistic about your child’s capacity to manage demanding situations. If your child is consistently stressed in a particular setting, offer an alternative.
  • Self-advocacy is an essential life skill. Allow your child opportunities to come up with solutions and to self-advocate in an appropriate way. Help your child think through a range of options and possible outcomes.
  • Choose your battles. You may decide some battles are not worth fighting, especially if your child is very symptomatic or there is a compromise option.

Plan ahead for situations that can anticipated:

  • Transitions are often very stressful. Children and teens often do best with a daily routine, including a daily schedule that he or she can review. Help your child prepare for new situations, and talk through possible coping strategies.
  • A new school year can provoke overwhelming anxiety. It can help to arrange a visit to the new classroom or to meet the teacher before classes begin.
  • Children and teens fear losing control in front of peers. Arrange a go-to adult at school or other setting who will provide a quiet, supervised space if your child becomes anxious or agitated. Create a subtle signal that your child can use to let a teacher or other adult know that he or she needs to exit.
  • Be realistic about your child’s capacity to manage demanding situations. If your child is consistently stressed in a particular setting, offer an alternative.
  • Self-advocacy is an essential life skill. Allow your child opportunities to come up with solutions and to self-advocate in an appropriate way. Help your child think through a range of options and possible outcomes.
  • Choose your battles. You may decide some battles are not worth fighting, especially if your child is very symptomatic or there is a compromise option.

Tools and Strategies

Parents and children can gain skills to address problems early. Several tools can help to identify growing problems, recognize what works or doesn’t work, and help clinicians better understand each child’s unique needs.

These resources include:

Mood Charts

Mood charts provide a visual image or narrative of how important components such as mood, medications, and life events fit together. This record can help to evaluate the effectiveness of treatments, illuminate patterns or cycles, and indentify signs that predict a crisis. Charts are especially helpful for parents of children with bipolar disorder, depression, anxiety, or other mood problems. Chart with a calendar, a notebook, or on a computer.

The Depression and Bipolar Support Alliance (DBSA) offers a free Wellness Tracker which allows tracking of mood, medications, nutrition, and exercise.

Healthline.com offers mood charts, including APPS for phone or tablet use.

Charts can consist of colors or a few words that describe the child’s behavior and mood at regular intervals. Time of day can be a key component. Many children and youths struggle to sleep at night and wake in the morning, or they melt down at home after school. Note anything that may have affected the child’s mood, such as an exam, an argument, or encountering a limit—often, the word “No.” Keep track if the child has a cold, did not sleep well, or binged on sugary treats. Record medicine changes as well as anything that helps the child to cope, such as a quiet space, journaling, or listening to music.

Share the charts with your child’s clinicians and with your child. Mood charts can help your child recognize patterns and effective coping strategies, fostering self-control, competence, and resilience.

Columbia Impairment Scale (Parent Version)

This assessment tool is a single page questionnaire that can help parents rate how well a child or teen functions in relationships with family and friends, at school, in sports or activities, as well as the child’s behavior and feelings. This record can help the child’s clinician to identify areas in which the child needs help, as well as his or her progress over time.

Records File

Keep all records of your child’s testing, medication trials, and evaluation reports together in a file or safe place where you can find them quickly. Insist on receiving copies of all evaluations and consultation and testing reports. These records can inform clinicians of what has or hasn’t worked, and help you to advocate for your child’s educational needs. This information also can prevent duplication of past treatments.

Emergency File

An emergency file includes everything you might need in a mental health emergency: contact phone numbers for your child’s treating physician or psychiatrist, including cell phone numbers or after-hours contact information, current and past medications, insurance information, and hospital preferences. Include phone numbers for a friend or relative who can support you or shelter your other children in a crisis.

All-In-One Binder

A single binder with divided sections for emergency information, mental health history and treatment, school and special education information, and medical health information, will help you to be prepared for any appointment, meeting, or emergency.

Talking with your child about mental health

It’s important to talk with your child about his or her mental health condition. Your child may feel frightened, confused, angry, or ashamed. He or she may have encountered stigma or false information from peers or online.

Learn about mental health conditions and treatments, so you can provide accurate information, and offer support and guidance. Sharing information and inviting questions also can encourage your child to return with concerns in the future.

The best way to talk about mental health conditions depends on your child’s age and developmental level. Don’t overload your child with more information than he or she wants or can handle. Younger children need less information because of their limited ability to understand. School-age children may want more details, and it is important to address their questions directly and honestly, and to offer reassurance. Teenagers typically are able to take in more information, and may ask tougher questions.

Parents also can explain that is normal to sometimes feel sad, angry, anxious or irritable, but when these feelings are very intense, last for a long time, or interfere with school and relationships, it could signal a problem that requires treatment. Whatever the child’s age and maturity, make sure the conversation happens when the child feels safe and comfortable, and be alert to his or her reaction. Offer reassurance if your child or teen becomes upset or confused.

Treatment decisions

“After our son started seeing a counselor, his mother and I saw a big improvement in only a month. We still have good days and bad days, but the good days are starting to be more and more.”

— Michael

Parents need treatment guidance from trusted health care professionals when making decisions about medication or therapy for a child or teen.

Medications are often prescribed for children and teens diagnosed with mental health conditions. These medications include anti-psychotics, mood stabilizers, anti-anxiety agents and/or anti-depressants. Closely monitor your child whenever medication treatment begins or the dosage changes. Be alert for worsening depression, sleeplessness, agitation, or social withdrawal. Report these symptoms promptly to your child’s psychiatrist or other prescriber

Questions to ask about medications:

  • Why is medication recommended?
  • What are the expected benefits?
  • What are potential side effects?
  • When should symptoms start to improve?
  • How will progress be measured?
  • How will the prescriber decide if a change in medication or dosage is needed?

Questions to ask about medications:

  • Why is medication recommended?
  • What are the expected benefits?
  • What are potential side effects?
  • When should symptoms start to improve?
  • How will progress be measured?
  • How will the prescriber decide if a change in medication or dosage is needed?

Every individual is different, and finding the right medication often involves a period of trial and error. Some medications have difficult side effects, such as sleepiness or weight gain, that must be weighed against benefits. Medications may take 4 to 6 weeks or longer to take effect. If your child’s symptoms are not getting better, ask the psychiatrist or physician to explain his or her plan to watch and wait, adjust the dosage, stop the medication trial, or try a different medication. Encourage your child or teen to ask questions too.

Parents and guardians have a right to be informed about and to approve any mental health treatment, including medication. Children should be included to the extent possible, based on age, maturity, and their ability to understand. Treatment works best when there is a partnership between the child or youth, clinicians, and parents or caregivers.

More information on medications is available in the American Academy of Child and Adolescent Psychiatry’s Parent’s Medication Guide.

Parent's Medication Guide

Psychotherapy, like medication, should be tailored to the child or youth and the family. Effective therapy can ease symptoms, increase hopefulness, and improve functioning and quality of life. Some children or teens prefer to meet with a therapist when a parent is in the room. Others talk more openly when they are alone with the clinician.

Therapy should be geared to the disorder, its severity, and the child’s level of function. It should help the child and family to define and manage problems. Some improvements, such as better management of difficult emotions, should be noted in 3 to 6 months.

Questions to ask about psychotherapy:

  • What type of therapy is recommended?
  • How will this treatment benefit my child?
  • What are the treatment goals?
  • What skills or coping strategies can my child gain?
  • How often should therapy take place, and how long should therapy continue?
  • Should therapy include parents or other family members?

Questions to ask about psychotherapy:

  • What type of therapy is recommended?
  • How will this treatment benefit my child?
  • What are the treatment goals?
  • What skills or coping strategies can my child gain?
  • How often should therapy take place, and how long should therapy continue?
  • Should therapy include parents or other family members?

Family therapy may be recommended, typically including at least one parent, and possibly siblings or other family members. Goals of family therapy are to improve communication, reduce conflict, teach problem-solving skills, and to increase positive interactions. Parents also can learn behavior management skills to help a child handle difficult emotions, to more effectively respond to disruptive behaviors, or to de-escalate a crisis.

Therapists, and psychiatrists, and other health care professionals working with your child should be in regular contact with each other, to coordinate treatment and confer on strategies, observations, goals, and therapeutic progress. They may require written consent from you and/or your child in order to consult.

Confidentiality

Confidentiality is an essential component of a trusting therapeutic relationship but confidentiality has limits, especially concerning a child under age 18. It’s important for the clinician to talk with the child and parents in advance about what issues will be kept confidential, and when confidentiality will be broken.

Safety is not negotiable. A physician or therapist should tell parents (and possibly police or other emergency responders) if a child could be in danger, or could be a danger to others. This is called “duty to warn.” However, a teen may be dealing with sexuality or other difficult issues that he or she may not want to share with parents. Sharing these concerns confidentially with a physician or therapist can benefit the child or youth. If parents strongly disagree, this should be made clear to the clinician and the child or youth at the beginning of treatment.

Mental health privacy requirements are outlined in the federal Health Insurance Portability and Accountability Act (HIPAA) and the Illinois Mental Health and Developmental Disabilities Confidentiality Act. Illinois privacy law is stricter than HIPAA requirements, and therefore Illinois law supersedes HIPAA.

Medical privacy laws are often misunderstood. HIPAA and Illinois law DO NOT prohibit mental health providers from receiving information from parents, nor do privacy laws prevent your child’s provider from talking to you or responding to your phone calls or emails. Parents should be partners in care.

Some clinicians require written consent before discussing mental health issues with parents or guardians. However, confidentiality can be waived without written consent. HIPAA and Illinois law allow providers to share information with parents or other individuals when the person receiving care is present, aware, and simply DOES NOT OBJECT to the sharing of information.

Under Illinois privacy laws:

  • Parents can receive, inspect, or copy mental health records if a child is under 12 years old.
  • Parents can receive, inspect, or copy mental health records for a child 12 to 17 years old, if the child “is informed and does not object” or the “therapist finds no compelling reason to withhold” the records.
  • Parents can receive limited information about mental condition even if a child 12 to 17 does not consent. This information includes current physical and mental condition; diagnosis; treatment needs; services provided; and services needed.
  • Parents can receive information about a medical condition for a child 12 to 17 years old without consent. For example, if a parent asks a provider if a child is pregnant, the provider must provide information about this medical condition. Parents must ask about a specific medical condition.

NOTE: These provisions are outlined in Illinois statute 740 ILCS 110/4 and 740 ILCS 110/4(a)(3)

Under Illinois privacy laws:

  • Parents can receive, inspect, or copy mental health records if a child is under 12 years old.
  • Parents can receive, inspect, or copy mental health records for a child 12 to 17 years old, if the child “is informed and does not object” or the “therapist finds no compelling reason to withhold” the records.
  • Parents can receive limited information about mental condition even if a child 12 to 17 does not consent. This information includes current physical and mental condition; diagnosis; treatment needs; services provided; and services needed.
  • Parents can receive information about a medical condition for a child 12 to 17 years old without consent. For example, if a parent asks a provider if a child is pregnant, the provider must provide information about this medical condition. Parents must ask about a specific medical condition.

NOTE: These provisions are outlined in Illinois statute 740 ILCS 110/4 and 740 ILCS 110/4(a)(3)

Individuals 18 years or older, verbal or written consent is required to receive mental health or medical information unless the person seeking information is the legal guardian or holds power of attorney for the adult being treated.

Maintaining a good relationship and open communication with a child, teen, or young adult can be the best way to ensure cooperation, consent, and access to information from mental health and medical providers.

You can find more information at:

HIPAA Guide for Families
U.S. Health and Human Services Privacy Guide