Concerned about your kid’s mental health? How to talk to them

The dire warning U.S. Surgeon General Vivek H. Murthy sounded this month about young people’s mental health shed new light on a not-so-new problem. One in three high school students and half of female students were reporting persistent feelings of sadness or hopelessness in 2019, even before the pandemic hit and exacerbated the crisis.

“We also know that, too often, young people are bombarded with messages through the media and popular culture that erode their sense of self-worth — telling them they are not good-looking enough, popular enough, smart enough, or rich enough,” the surgeon general’s public health advisory states. “That comes as progress on legitimate, and distressing, issues like climate change, income inequality, racial injustice, the opioid epidemic, and gun violence feels too slow.”

Parents and caretakers may be wondering how they can talk to their kids — whether they fear their child is struggling or they just want to lay a foundation so that their children will feel comfortable bringing up difficult topics in the future.

Here are some tips from the surgeon general’s advisory, the American Psychological Assn. and the Los Angeles Unified School District, as well as David W. Bond, director of behavioral health for Blue Shield of California, and Whitney Brammer, clinical psychologist for the division of adolescent and young-adult medicine at Children’s Hospital Los Angeles.

Conversations parents can have with their kids on a regular basis

The public health advisory provides some advice related to talking with kids. Here are the highlights:

• Show them love and acceptance.
• Praise them for the things they do well.
• Listen to them and communicate openly about their feelings.
• Encourage children to ask for help.
• Connect them with other adults who can serve as mentors.
• Talk with your child about values.
• Teach children to be confident and comfortable in expressing needs and boundaries.
• Talk to children about the importance of mental health and show positive ways you deal with stress.
  

How to talk to kids about difficult topics

When bad news happens, the American Psychological Assn. advises planning a conversation with your children — even practicing it in your head in advance — so you feel prepared. It’s also important to find a quiet moment, so that your child is the sole focus of your attention.

Find out what your child already knows and start by listening. It’s OK to show your own emotions and model your ability to pull yourself together and move forward. Tell the truth in a way that’s easy for your child to understand and make sure to reassure them.

Children need to know that they are loved, that you’ll do everything you can to keep them safe and that they can always ask you any questions or continue the conversation in the future.

What to do if you’re concerned about your child

Parents may be reluctant to confront a child they suspect is struggling with mental health challenges, said Bond, but he encouraged parents to start the tough conversation.

“You are the parent,” he said. “It is not prying to ask how your child is doing and ask about their feelings.”

Brammer advises parents to be cognizant of their own emotions before they talk to their children. It can be scary for parents to think that their child is in trouble, so there can be an urge to minimize the child’s experience to push down some of that fear.

Bond suggested easing into the topic: “If you sit down and say, ‘Let’s talk about mental health,’ that might work for some families but it might not be a [comfortable] topic of conversation in some cultures.”

It’s often more effective to start by making an observation that’s nonjudgmental, said Brammer. For example, “I noticed you haven’t had much of an appetite lately” or “I’ve noticed that you’re not spending as much time with your best friend.”

Teens and young adults frequently feel alone and that there’s something wrong with them, Brammer said, so it’s important to let them know it’s OK to feel sad, nervous or uncertain about the future.

“And then a parent could choose to ask ... about what kind of support the teen might want, to help empower them and help them feel a sense of control over this,” Brammer suggested.

When trying to understand your children’s mindset, it’s best to ask open-ended questions so you’re genuinely open to what your kids are experiencing. And if they don’t want to talk about it, try again later.

“One thing is not to argue and get into a little bit of a power play,” Brammer said. “If there is resistance, go back to validation or acknowledging where [your concern] is coming from.”

However, if you’re worried your child is self-harming or contemplating suicide, it’s important to be direct.

A Los Angeles Unified School District School Mental Health handout recommends making these three inquiries:

• Tell me what happened.
• How long have you been feeling this way?
• Have you thought about suicide?

Some things parents should keep in mind

Your child’s experience may not mirror your own. Even though you were a teenager once, Bond tells parents, you are not a teenager now. The experiences your child is having likely are different from what you experienced.

Don’t minimize, diminish or dismiss your child’s stressors. “Be an active listener who validates your teen’s experiences and humanity,” Bond said.

Create a safe space. When having vulnerable conversations, Bond recommends sitting next to your child rather than sitting across the table — which is often where a disciplinarian is when reprimanding someone.

Speak to kids at their level. UNICEF has a helpful guide to talking your kids about mental health, broken down into four age groups: under 5, 6-10, 11-13 and 14-18.

Make sure your children understand there’s nothing wrong with them. These labels — like when kids feel like they are “crazy” — are very hurtful, Brammer said. “When we want to build up our compassion for them and help them increase their resilience, it’s so important to have that safe space for them to explore their emotions,” she said.

Let your children feel like you’re following their lead. Try not to come from the perspective of “you have to do this” or “you should do this, because... ” Brammer said. “It’s such an important piece of being a teenager to help them find and honor their own voice, and you don’t want to dismiss that or shut that down.”

Suggest therapy. Educate your child about different types of mental health support. Emphasize that any thoughts shared with a therapist would remain private, and normalize the option of getting professional help.