Kid’s Mental Health Resources

Stats of Kid's Mental Health in US

This area focuses on the complexities of treating children’s mental health and pediatric considerations. Many treatments are not FDA-approved for kids and but it’s a population that shouldn’t be ignored. The key to success lies in building trust with both the child and the family, as trust is the foundation for effective care and outcomes. Three quick points to consider with this group:

  1. Focus on what’s stable and instill HOPE: Understand the vulnerability of children and their families. Parents or the family already feel distress due to being in this circumstance in the first place and may feel apprehensive about taking more risks. Therefore, instill hope by expressing some thoughts, being transparent, reassuring the family about how treatment and improvements are a part of the process. Don’t make empty promises.  
  2. Be aware of your own limitations and communicate boundaries: Note the age-range/availability that you are comfortable with as a provider vs. conducting therapy services…for example, if I’m not available as often or more than 1x/month, I wouldn’t see patients <16 due to not being able to give consistent care, whereas for prescribing medication, this wasn’t a major issue. Keep focusing on the stability despite the obstacles, so networking or referring patients may be more ideal. Overall, respect the family decisions even if they disagree with treatment, etc. but document everything -including what they have refused or declined and continue to discuss options/alternatives.
  3. Treat the whole family: Understand how the family dynamics affect the child’s mental health, and be patient with building trust even if it takes multiple visits before you start the treatment (depending on the acuity of the circumstances)… Also, note the mental health or social factors in the family that will affect the kid, such as poor housing, transportation issues, low-income, substance abuse, etc. that may also affect the plan of care.

Assessing children during intake can be challenging, but there are strategies that can help. Start with simple questions, such as asking where the child (or the adult/family member) has been treated before. This approach not only makes the family feel more comfortable to discuss past mental health treatment but also quickly provides key information.

If the child has been treated elsewhere, follow up by asking what they were treated for, past diagnoses, whether medications were prescribed, and what worked or didn’t. This helps gather a significant part of the assessment, including details on hospitalizations or other facilities involved.

If it’s a child’s first time receiving mental health services, ask basic questions about home life and emotions. However, for younger children, you may have to rely more the family or other sources for information. The goal is to make everyone feel comfortable and gather the necessary details in a way that builds trust to start treatment.

A Quick Assessment Guide 

This summary outlines a general approach for assessing children, with a focus on mental health, development, and social factors:

1. Developmental History and Health:

  • Children: inquire about pregnancy and delivery details (vaginal birth, c-section), any issues during pregnancy or birth, vision or hearing concerns, and developmental milestones. Even if a child seems healthy, don’t assume; check for subtle issues, such as delays vs. normal development.
  • Adults: ask about childhood development and whether they graduated high school or earned a GED -this also assesses possible learning issues if someone didn’t complete formal education. -but in general teachings should be straightforward, consistent with simple, basic terms.

2. Daily Functioning and Well-Being:

  • Assess: sleep patterns, appetite, energy, hygiene, and daily activities. Sleep, in particular, affects behavior, learning, and mood in all ages. Ask about bedtime routines, how well the child wakes up, and focus during the day. Emphasize the child’s functioning at school and home. Questions about performance, quality of life, and how the child processes information can help parents understand why treatment or medication may be necessary.

3. Psychological and Social Emergencies:

  • Screen for psych emergencies like suicidal ideation (SI), violence, psychosis, or substance abuse (ETOH/drug use).
  • Social emergencies: include issues like sexual or physical abuse, threats, domestic violence, or inadequate family resources that endanger health or safety.

4. Environmental Stressors and Family Dynamics:

  • Assess family living situations for safety and environmental concerns, such as transportation issues, housing instability, or socio-economic challenges.
  • Understanding family dynamics is crucial in evaluating a child’s success and resilience.

5. Substance Abuse:

  • Screen for substance use among children and teens. Be mindful of alcohol and drug access, especially noting how parents may be the source of the access. Advise families about securing potentially dangerous items (e.g., guns, alcohol, drugs, sharp objects, etc.).

6. Chronic vs. Acute Issues:

  • Distinguish between new and chronic problems by asking how the patient has felt in the past two weeks. Avoid leading questions, especially with children, to get a more accurate self-report of their feelings and always consider rating scales to help people describe the feelings.

7. Non-Psych Concerns:

  • Always review medical history, including allergies, height/weight, and vitals. Discuss necessary lab tests and monitoring with the family to ensure a comprehensive approach to the child’s health.

This approach provides a holistic view of the child’s physical, emotional, and environmental context, ensuring thorough care and support.

Pediatric Mental Health and Additional Topics

Common Disorders: a quick DSM-5 review of psych diagnoses that are frequently seen in children, and the following are simple guides and topics about personal experiences for treating these main disorders:

Clinical Pearls with Medications & Symptom Management: 

Common Kid Issues

Additional References & Resources

This intake assessment was roughly based on Pediatric Psychopharmacology for Primary Care. Another helpful book is DSM 5 Pocket Guide for Child & Adolescent Mental Health. 

Posts about Kids:

Pages About Kids:

CDC recommends that healthcare providers:

  • Use the WHO growth charts to monitor growth for infants and children ages 0 to 2 years of age in the U.S.
  • Use the CDC growth charts to monitor growth for children aged 2 years and older in the U.S.
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