What are the common warning signs of mental health problems in children?

Certain persistent behavioral and emotional changes in children can indicate the presence of mental health issues. It is important to notice these signs early, as early intervention can make a significant difference. Common signs include problems occurring in more than one setting (such as home and school), changes in appetite or sleep, social withdrawal, regression to younger behaviors such as bedwetting, signs of distress such as sadness or crying, as well as self-destructive behaviors or persistent thoughts of death [1].

When are behavioral changes concerning?

It is normal for children to go through temporary behavioral changes due to daily life stressors, such as the arrival of a new sibling or moving to a new school [1]. However, these changes become concerning if they are severe, persistent, and interfere with daily activities at home, at school, or with friends [2]. If these symptoms persist for weeks or months, the child may benefit from an evaluation by a healthcare professional [3].

Specific warning signs by age group

Warning signs of mental health problems vary by a child's age. For younger children, signs may include frequent temper tantrums or intense irritability, persistent fear or anxiety, complaining of frequent stomachaches or headaches with no known medical cause, constant movement and inability to sit quietly (except when watching videos or playing video games), excessive or very little sleep, frequent nightmares, disinterest in playing with other children or difficulty making friends, recent academic decline or lower grades, and repeating actions or checking things multiple times (such as repeatedly checking if a door is locked) for fear of something bad happening [3].

For older children and adolescents, signs may include loss of interest in activities they previously enjoyed, low energy, excessive or very little sleep, or feeling drowsy throughout the day, periods of extremely high energy and activity with a need for much less sleep than usual, spending more and more time alone and avoiding social activities with friends or family, excessive dieting or exercise, or fear of weight gain, engaging in self-harm behaviors (such as cutting or burning the skin), substance use (tobacco, alcohol, or drugs), engaging in risky or destructive behaviors alone or with friends, suicidal thoughts, or stating they believe someone is trying to control their minds or that they hear things others cannot hear [3].

The importance of early diagnosis and intervention

Early diagnosis and access to services for children and their families can make a difference in the lives of children suffering from mental health conditions [2]. Without early diagnosis and treatment, children with mental health conditions may face problems at home, at school, and in forming friendships [2]. Mental health conditions can also interfere with a child's healthy development, causing problems that may persist into adulthood [2]. If you are concerned about your child's mental health, talk to a healthcare provider for a comprehensive evaluation [2]. Treatment may include medication and talk therapy [1]. For more information about supporting children's mental health, you can visit Child Mental Health: Emotional Support and Signs of Risk (Arabic).

When to seek emergency help?

U.S. references mention the existence of free, confidential 24/7 mental health crisis support lines within the United States. Outside the U.S., check locally available crisis services and call local emergency services when there is an immediate risk to the child's safety [2]. In mental health emergencies, it is important to obtain immediate help [1]. Signs of self-destructive behavior, such as head-banging or sudden repeated injuries, or recurring thoughts of death, may be indicators of the need for emergency care [1].

Medical references

• Child Mental Health
• About Children's Mental Health
• Child and Adolescent Mental Health - National Institute of Mental Health (NIMH)