Mental health experts give parents tips for tackling tough conversations with kids

Last month, a national survey from the children’s mental health initiative On Our Sleeves found that 93 percent of parents with children under the age of 18 know it’s important to have discussions about mental health. Unfortunately, the same survey found that 59 percent of them felt they needed some help to get the conversation flowing.

Part of the problem, experts say, is that mental health has too often been stigmatized. While awareness has grown in recent years, many parents still don’t know how to approach the subject.

“When it comes to our mental and emotional health, as a society we place [it in] some sort of ‘other’ category that is more stigmatizing, more difficult to talk about,” said Angelina Brown Hudson, executive director of NAMI Greater Houston which offers support and education on mental health. “We don’t know where to go.”

These types of conversations have become even more important in the wake of the COVID-19 pandemic, which has exacerbated issues that already existed. A U.S. Centers for Disease Control and Prevention survey found that one in three high school students experienced poor mental health during the pandemic, and nearly half felt persistently sad and hopeless. Other surveys have found that depression, self-harm and suicide have risen among adolescents.

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The teenage years have always been one of the hardest periods of childhood, as kids are experiencing high school, puberty and relationships for the first time. The pandemic has been even tougher because it’s disrupted their usual routines, like going to school and playing sports, said Angela Koreth, a licensed professional counselor-supervisor at the Menninger Clinic.

Koreth runs a parents’ group at the Menninger Clinic, and often hears parents say they don’t know how to begin a conversation about mental health. They care about their kids and don’t want to trigger a feeling or emotion that could make things worse, she said.

All teens are different, so there’s no ideal roadmap for a conversation. But experts offer some guidelines to help you get started.

Knowing when it’s time to talk

It’s difficult to determine if a child is struggling by their mood alone. Teens who are depressed could seem withdrawn, or they may lash out at others, Hudson said.

Instead, look out any notable changes in their behavior, especially if they persist, experts said. Everyone has a bad day, but a string of them could be cause for concern.

“If we find that our teens are having them for long periods of time, or quite often, that might indicate something’s off,” Koreth said.

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If they are not eating, don’t want to get out of bed, don’t want to go to school or have stopped hanging out with their friends, it’s time to talk. Smoking, drinking, using drugs or self-harming are also red flags that need to be addressed immediately, experts said.

If your child is having suicidal thoughts, you should take them to an emergency room to ensure they get the help they need, Hudson said.

How to get started

If you’re planning to talk about a sensitive issue like mental health, you don’t need to go in cold. Take some time to think about the concerns you want to express and the questions you want to ask, said Beth Garland, a clinical psychologist at Texas Children’s Hospital who specializes in treating adolescents with eating disorders.

“You can be thoughtful ahead of time [about] where you want the conversation to go,” Garland said.

It’s best to have the conversation in a private spot where distractions will be limited, and to make sure you have enough time for a full discussion. Car rides could be an ideal time to have those one-on-one talks.

Starting the conversation could be tricky, but there are some approaches you could take. Tell your teen that you’ve noticed something different, and ask them if anything has changed.

You also bring up something about mental health that you saw on TV or read online, and ask your teen if they have any thoughts about it. Or you could ask them if it’s something they ever discuss with their friends, Garland said.

Some things to avoid

There’s no perfect approach to a conversation about mental health, but there are some things you should avoid.

Although the conversation may be emotional, try your best to avoid becoming angry or upset, Koreth said. A teen may be reluctant to talk at all because they feel like they’re disappointing their parent, so it’s best to avoid giving them that impression.

“Don’t let your emotions rule how you might have that conversation, start that conversation or respond to that conversation,” Koreth said.

Avoid using any negative terms, especially ones like “crazy” or “insane,” Garland said. You also shouldn’t minimize the way they’re feeling by telling them it doesn’t sound like a big deal, because that could make them feel invalidated.

As tough as it might be, you should also resist the urge to try to “fix” your teen during the conversation, experts said. You might have a good idea, but it’s better to make sure your teen feels like you’re truly listening as they open up to you.

Keep the discussion flowing

Listening is also the best approach to keep a conversation flowing, experts said. But that can be trickier than sounds. Often during conversations, people let their minds wander as they think about what they plan to say next.

“Truly listening is being there, present in the moment, to be able to summarize back what that person is saying,” Garland said.

When it is your time to talk, you could clarify certain things they’ve told you and ask if you’re hearing them correctly, she said.

Tell your child that you love them, and that you’re proud of them for sharing what they’ve told you. And you should be empathetic by telling them that what they’re going through sounds difficult.

If you do have any advice to offer, you could ask your teen if you can share it. Koreth also suggests asking your teen if they’ve given any thought to the matter, in case they have an idea for next steps.

It’s also important to keep in mind that you’re not going to solve a problem in a single conversation. If your child is struggling, you’ll likely be having ongoing discussions.

What if they don’t want to talk?

If your child isn’t willing to talk to you right away, you shouldn’t press the issue, experts said. Instead, ask them if they’d be willing to sit and listen to what you have to say, or ask if there’s another time you could have the discussion.

The exception to leaving the conversation for a later time is when there’s a safety issue, Garland said. If your child is using drugs or you’re fearful of the potential for self-harm, you should make sure they get the help they need as soon as possible.

In some instances, teens may be willing to have a discussion through text messages instead of face-to-face. You could ask them if they feel more comfortable doing that, Hudson said.

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Also consider whether they’d be prefer to speak with another trusted adult, such as a relative, a counselor or a clergy member. Some teens may feel more comfortable opening up to someone who isn’t their parent.

“It’s more important to save the child than you be the hero,” Hudson said. “[But] you are the hero when you’re taking the time out to make sure they’re connected to the person they can open up to.”

Where can you turn for help?

If you determine your child would benefit from some additional help, there are plenty of resources you can turn to in the Greater Houston area.

The Houston Chronicle spent more than a year investigating how Texas treats people who are mentally ill as part of its In Crisis series.

High school guidance counselors and your child’s primary care doctor can often provide recommendations for where to go to find counseling or treatment. Organizations such as NAMI Greater Houston offer educational courses, support groups and other services.

Texas Health and Human Services also has a guide for families looking for community mental health services for their children.

Parents and guardians often want to seem like they have all the answers to help their children. But everyone needs help from time to time, Hudson said.

“We believe it’s our job and our job alone to fix whatever the problem is,” Hudson said. “But the truth of the matter is, when it comes to a child’s emotional and mental health and wellbeing, you kind of need a team.”

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