Know the Warning Signs: National Children’s Mental Health Awareness Day

by Ryan Kline, Extension Educator, Ross County, 4-H and Family & Consumer Sciences

As school bells ring, summer camps begin, and warmer days are here again, children across the nation head home to enjoy the summer. However, with the change in schedule, parents, camp counselors, and community leaders may see more warning signs or symptoms of mental health issues or challenges in children. Research published in the Journal of Developmental and Behavioral Pediatrics found that diagnoses of anxiety and depression have increased in children ages 6 to 17. As adults prepare to support youth with mental and emotional health issues, awareness is key to helping people feel comfortable in these challenging situations.a group of children

In honor of the youth struggling and managing mental health challenges, we celebrate National Children’s Mental Health Awareness Day. I will be honoring the day by promoting that my fellow educators, teachers, and volunteers know the warning signs of mental health issues in children.

Youth Mental Health by the Numbers:

  • 20% of teens aged 13 to 18 live with a mental health condition.
  • 18.8% of high school students had contemplated attempting suicide.
  • 7 in 100,000 children aged 10 to 19 died by suicide in 2018.
  • A 10-year gap is common between symptoms and taking action to improve mental health.

Youth across the country struggle with mental health challenges. Mental health affects children of all ages, from toddlers to teens, and different types of mental health challenges can become more prevalent throughout the developmental process, especially as young people approach their teen years. According to the Center for Disease Control and Prevention, children ages 12 to 17 are more commonly diagnosed with anxiety and depression, while 6- to 11-year-olds are more commonly diagnosed with behavior disorders. Many times, the challenge for parents is knowing whether the behaviors are symptoms of mental health issues versus the normative challenges experienced in adolescent development.

Identifying the Warning Signs in Youth

Change is not always a bad thing. As youth develop, personalities may adapt and behaviors may shift slightly; however, when these changes are sudden and drastic, there may be an underlying mental health issue.

  •  Withdrawing from Friends, Family, or Activities

Social interaction is healthy for youth. When children suddenly start isolating themselves from friends and family and losing interest in activities, that can be a clear sign that something may be happening with their mental, social, or emotional health. Isolation can be detrimental to the development of youth and can be a sign of a mental health challenge.

  • Mood Swings/Out of Character Behavior

Noticing a change in behavior is an important first step to taking action to better a child’s mental health. Whether it is an action that is extreme or a slight change in behavior, checking in about feelings after an outburst can help youth better identify and manage emotions.

  • New, Overwhelming Fear

Commonly seen in a distinct change of behavior from fearless to fearful, children can develop fear or fear-driven behavior after trauma. When the fear is something that the child used to do like attending school or walking to the park, it can be a sign that something bigger is going on in the child’s life.

Despite their prevalence, mental health disorders are under treated, a situation exacerbated by the increased demand created during the coronavirus pandemic and a shortage of mental health providers. Analysis from the Youth Risk Behavior Survey found that 25% of youth aged 12 to 17 had received some sort of mental health treatment within the past year. As parents, educators, and society learn more about the impact of mental health on youth across the country, treatment rates may continue to grow.

What Can You Do as an Adult?picture of hands

Ask Direct Questions

May times it can be difficult to ask questions about mental health. However, one of the best ways to check on our youth is to create open spaces for them to share and communicate about how they feel. Also, if a child is exhibiting behaviors associated with suicide, ask them directly about their feelings and intentions. A conversation can save a life.

 Share Emergency Numbers

Encourage teens to save several emergency numbers to their cell phones so if the need arises they are prepared to assist someone in crisis.

 Connect with a Professional

Whether it is a pediatrician, mental health specialist, or counselor, involving a professional is the best way to ensure that the child is receiving assistance. Teachers, volunteers, or community members can only do so much – there is a time and place for intervention.

National Children’s Mental Health Awareness Day shines a national spotlight on the importance of caring for every child’s mental health and reinforces that positive mental health is essential to a child’s healthy development. Understanding the impact of mental health on children is a crucial part of creating a bigger change. By identifying some of the symptoms or behaviors associated with mental health challenges, educators and community volunteers can better serve and develop healthier youth. Creating clear actions for better mental health can help to shape the future of children’s mental health.

Check out Ohio 4-H Mental Health Month resources and our grab-and-go resources.

*The Lifeline and 988: 988 has been designated as the new three-digit dialing code that will route callers to the National Suicide Prevention Lifeline. While some areas may be currently able to connect to the Lifeline by dialing 988, this dialing code will be available to everyone across the United States starting on July 16, 2022.

References

America’s Health Rankings. (2022). Mental health providers. https://www.americashealthrankings.org/explore/annual/measure/MHP

Bitsko, R. H., Holbrook, J. R., Ghandour, R. M., Blumberg, S. J., Visser, S. N., Perou, R., & Walkup, J. T. (2018). Epidemiology and impact of health care provider-diagnosed anxiety and depression among US children. Journal of Developmental and Behavioral Pediatrics, 39(5), 395‒403. https://doi.org/10.1097/DBP.0000000000000571

Bitsko, R. H., Claussen, A. H., Lichstein, J., Black. L. I., Jones, S. E., Danielson, M. L., Hoenig, J. M., Davis Jack, S. P., Brody, D. J., Gyawali, S., Maenner, M. J., Warner, M., Holland, K. M., Perou, R. M., Crosby, A. E., Blumberg, S. J., Avenevoli, S., Kaminski. J. W., & Ghandour. R. M. (2022). Mental health surveillance among children — United States, 2013–2019. Morbidity and Mortality Weekly Report, 71(Suppl-2),1–42. https://doi.org/10.15585/mmwr.su7102a1

Centers for Disease Control and Prevention. (2022, March 4). Data and statistics on children’s mental health. https://www.cdc.gov/childrensmentalhealth/data.html

Ivey-Stephenson, A. Z., Demissie, Z., Crosby, A. E., Stone, D. M., Gaylor, E., Wilkins, N., Lowry, R., & Brown, M. (2020). Suicidal ideation and behaviors among high school students – Youth Risk Behavior Survey, United States, 2019. Morbidity and Mortality Weekly Report, 69(Suppl-1), 47‒55. https://doi.org/10.15585/mmwr.su6901a6

National Alliance on Mental Illness. (n.d.). Mental health facts: Children and teens. https://www.nami.org/nami/media/nami-media/infographics/children-mh-facts-nami.pdf

National Institute of Mental Health. (2021). Child and adolescent mental health. https://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health

Pombo, E. (2021, May 7). Warning signs of mental illness in children. National  Alliance on Mental Illness. https://www.nami.org/Blogs/NAMI-Blog/May-2021/Warning-Signs-of-Mental-Illness-in-Children

U.S. Department of Education. (2021). Supporting child and student social, emotional, behavioral, and mental health needs. https://www2.ed.gov/documents/students/supporting-child-student-social-emotional-behavioral-mental-health.pdf

U.S. Surgeon General. (2021). Protecting youth mental health: The U.S. Surgeon General’s advisory. https://www.hhs.gov/surgeongeneral/reports-and-publications/youth-mental-health/index.html

Zolopa, C., Burack, J. A., O’Connor, R. M., Corran, C., Lai, J., Bomfim, E., DeGrae, S. Dumont, J., Larney, S., & Wendt, D. C. (2022). Changes in youth mental health, psychological wellbeing, and substance use during the COVID-19 pandemic: A rapid review. Adolescent Research Review, 7, 161‒177. https://doi.org/10.1007/s40894-022-00185-6

Connect the Dots for Mental Health

Ohio 4-H decided to focus on mental health during the month of January 2021. Mental health has always been important, but the need to focus on mental health was never more apparent than in 2020.

Throughout the month, members of the 4-H Healthy Living Design Team wrote about different dimensions of wellness. Even though our focus was on mental health, we touched on many other aspects of health– physical, emotional, social, intellectual, environmental, financial, and creative. We presented some background information, suggested strategies to address each area, and shared our own experiences.

If you look back over the month, I think you can see how all the different dimensions of wellness are related to each other. For example, one way to make mindfulness part of our day is to listen when someone is talking to us. In turn, this will lead to better social connections, which will enhance our social health. Social connection creates a positive feedback loop of social, emotional, and physical well-being. In fact, research suggest that the quality of our social ties might be the single biggest predictor of our well-being. We can reach out to friends when we’re feeling stressed; in turn, we can check in with our family and friends to be the person that they turn to when they need support.

Of course, physical activity helps keep our body healthy. But that’s not all it does. Engaging in physical activity is recommended as a way to manage stress, which addresses our mental health. And even better when we can take that activity outdoors. Then we can practice mindfulness when we take in the sights, sounds, and smells when we’re walking outdoors.

Self-care strategies keep us healthy in many ways: in addition to physical activity, getting enough sleep; eating healthful foods; and making time for fun, learning, and creative activities are things we can do. Some of these strategies may require us to establish better habits to make them a regular part of our lifestyle.

The coronavirus pandemic has been challenging for everyone. It’s easy to think of what we didn’t get to do. However, I think you can probably think of some good things that happened last year. Among my family and friends there were high school and college graduations, weddings, new babies, new homes, new jobs, and other milestones. They may have looked different, but life kept on going. It’s important to pause and recognize the good things that happen every day, no matter how small.  Another way to see the connections is in the COPE with COVID suggestions put forth by Dr. Bern Melnyk, Chief Wellness Officer at The Ohio State University and Dean of the College of Nursing. You can see how these suggestions incorporate aspects of physical, mental, emotional, and social health, as well as gratitude and mindfulness.

Today’s Take-Away: Look for ways to pledge your health to better living. The resources developed for Ohio 4-H Mental Health Month are posted on our webpage. But even though the month is over, we will continue to share information, ideas, and inspiration about healthy living topics throughout the year.

Yours in Health,

Signature

Theresa Ferrari, Extension Specialist, 4-H Youth Development

Resilience

I think we all can agree that we have COVID-19 fatigue, and what we thought would go away in 2020 is still with us. As we are winding down Ohio 4-H Mental Health Month, I am hopeful you have found a few tips or tricks that you can add to your mental health tool kit and pull out whenever you need a little boost.

Today’s “Thoughtful Thursday” post really hit home for me. Helen Keller has always been an inspiring individual, and I have read so much about her and all the things she was able to accomplish. If you do not know much about her, now is a great time to research her and reflect on today’s quote.

One of the groups I work closely with in Fairfield County are the Junior Leaders. This group of teens, ages 13 and up, work with peers from all over the county to promote 4-H, develop leadership skills, and conduct community service projects. In 2019, this group of teens decided to use another Helen Keller quotation on their club shirts. “Alone we can do so little. Together we can do so much.” I think this quotation holds as much power today as the one in our social media post!

During this time of COVID, I know I feel like I am spinning my wheels and not accomplishing nearly as much as I should be. But I do not think that is what I should be focusing on. Instead, I need to shift my thinking and focus on the good things happening around me and getting back to how I felt before ‘the world shut down.’ Resilience is just that, the ability to recover from any difficulties and to come back stronger than before. Another definition of resilience that I love is ‘toughness,’ which I think we all have developed from experiencing and surviving the pandemic thus far.

For some of us, we need that support and connection from others to do great things, and it is important that we realize that trait in ourselves. My challenge for you today is to take time to reflect on what makes you resilient and what you may need to come back stronger than before. When things return to ‘normal’-ish, I hope you are able to share those skills and activities you have discovered during this difficult time with your 4-H club members, family, or friends. Let us all work together so that we can accomplish all the things we want to do and more to make our world a better place.

Wish you all the best,

Aubry Fowler, Fairfield County 4-H Educator

 

Dealing with Feelings

Surprise, frustration, excitement, disappointment, calmness, fear: Feelings, or emotions, are a normal part of our everyday lives. Everyone experiences them. We should resist labeling our emotions as “good” or “bad”—it’s how we react and respond to the emotion that’s important.

Identifying your emotions, understanding how they influence your behavior, and being able to manage them are considered a foundation of social emotional learning. When thoughts and emotions work together, it’s easier to make more effective decisions, solve problems, and achieve goals.

 Emotion regulation, also called self-regulation, is a term generally used to describe a person’s ability to effectively manage their thoughts and feelings, with the goal of taking actions that are necessary for success in school, relationships, and the workplace. Whether you realize it or not, you are using emotion regulation strategies many times throughout each day.

For example, self-regulation includes being able to

  • resist highly emotional reactions to things others say and do,
  • calm yourself down when you get upset,
  • adjust when something doesn’t go the way you expect it to and you need to change plans, and
  • handle frustration without an outburst. It is a set of skills that that develops over time.

Think about babies – what do they do when they are upset? They cry. This is their way to get attention, to communicate that they are tired, hungry, or frustrated. They haven’t developed many other ways to handle their emotions yet. As they get older, when they are able to talk, they can use words to express how they feel. At first, adults have to help children learn how to do this. Over time, they learn more strategies and to take charge of using them.

Now fast forward in time: How do you react to situations at home, school, and/or work that you find frustrating or overwhelming? Do you ever find yourself in a situation where your emotions get the better of you and you say or do something that doesn’t get the desired result?

When thoughts and emotions work together, it supports you in making more effective decisions, solving problems, and achieving goals. However, in teenagers, the parts of the brain that process emotions are more developed than the parts of the brain responsible for good decision-making and future planning. This means that for a while the two parts of the brain are “out of balance.” Those first reactions may come from the “emotional brain” before the “thinking brain” kicks in and regulates your response. Has someone ever said to you, “What were you thinking?” when they don’t understand your reaction to a situation?  If you can’t explain what you were thinking, it may be that you weren’t thinking as much as you were feeling and reacting to those feelings.

While you’re waiting for your brain to sync up, it doesn’t mean that you have to give up – you can learn to manage your emotions more effectively. The first step is tuning in to your feelings. Notice your body’s reactions and take a pause before you respond to a situation. You may notice that your heart pounds, your face may turn red, you clench your teeth, your hands might sweat, your breathing may become faster or slower, or your facial expression could change.

Emotion regulation strategies can help you manage your body’s response and how you follow through on your feelings. Here are some strategies you can you to deal with your feelings in a healthy way.

Examples of Healthy Emotion Regulation Strategies

  • Talking with friends
  • Exercising
  • Writing in a journal
  • Meditation
  • Getting adequate sleep
  • Paying attention to negative thoughts that occur before or after strong emotions
  • Noticing when you need a break – and taking it
  • Seeking professional help

If you’ve been reading these posts, you may be noticing some common threads in these strategies. Mindfulness and self-care strategies figure prominently in these suggestions.

The strategies we choose to deal with our feelings are not always healthy ones. They may make you feel better in the short term, but they may work against you in the long run. They can have a negative impact on your physical and mental health. Their effect on your relationships with others, a component of your social health, may be undesirable as well.

Examples of Unhealthy Emotion Regulation Strategies

  • Avoiding or withdrawing from difficult situations
  • Physical or verbal aggression
  • Overusing social media, to the neglect of other responsibilities
  • Abusing alcohol or other substances
  • Self-injury

Today’s Take-Away: Emotions are a normal part of our everyday lives. Emotion regulation is not aimed at eliminating emotions from our lives, but rather understanding them and controlling their influence when this influence is undesired. You can download the Dealing with Feelings activity sheet to help you think through a situation, how you respond, and what you could do instead.

See the Ohio 4-H Mental Health Month resources and come back here for more information and ideas.

Yours in Health,

Signature

Theresa Ferrari, Extension Specialist, 4-H Youth Development

Adapted from:

Murray, D. W., & Rosanbalm, K. (2017). Promoting Self-Regulation in Adolescents and Young Adults: A Practice Brief. (OPRE Report #2015-82). Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

Rolston, A., & Lloyd-Richardson, E., (n.d.). What is emotion regulation and how do we do it? Cornell Research Program on Self-Injury and Recovery. http://www.selfinjury.bctr.cornell.edu/perch/resources/what-is-emotion-regulationsinfo-brief.pdf