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Pier Bryden is a psychiatrist, clinical teacher at The Hospital for Sick Children and associate professor at the University of Toronto Faculty of Medicine.

Peter Szatmari is chief of the Child and Youth Mental Health Collaborative between the Centre for Addiction and Mental Health, The Hospital for Sick Children and the University of Toronto.

They are the authors of Start Here: A Parent’s Guide to Helping Children and Teens Through Mental Health Challenges.

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“What can I do to help my child?”

As child and youth psychiatrists, this is a question we often hear from parents sitting across from us in our offices. Whether their child is struggling with anxiety, depression, an eating disorder, substance abuse or another mental illness, their concern is the same, and often accompanied by self-blame, confusion and worry. That they missed the signs. That their child inherited a family mental illness. That the choices they’ve made – a demanding job or a big move – or inevitable life events, such as divorce or loss, are the cause of their child’s distress.

We know that being a parent is a transformative experience, one that brings multiple red-letter days of unprecedented joy. We also know that it brings a life of worry about your child – about his or her health, friends, behaviour and grades – and, of course, about your own parenting skills. We’ve been there, too. We have five children between us, and, yes, even child psychiatrists question their parenting techniques.

While physical ailments such as broken bones and fevers can be frightening in the short term, it’s usually quite clear what to do. In contrast, how to handle your child’s mental health is often much less clear. If a child is skipping school, not eating or not sleeping well, or isolating themselves from friends and family, is their behaviour just a phase? Or a sign of something more serious?

The truth is that child and adolescent mental illnesses are common: Between 10 per cent and 20 per cent of children and teenagers globally suffer from a mental-health disorder and 70 per cent of adult mental illnesses begin in childhood or adolescence. In recent years, rates of emergency-room visits and hospital admissions for self-harm and suicide attempts have climbed exponentially in Canada. Although we don’t have recent national suicide data yet available, we are concerned that our youth suicide rates may also be rising, as they currently are in the United States.

While the causes behind these troubling statistics are complex, we do know that environmental causes such as bullying; verbal, physical and sexual abuse; poverty; family violence; parental illness; and more recently, excessive exposure to social media, can all contribute to poorer mental-health outcomes in children. Despite the efforts to address these trends and the progress we’ve made as a society to destigmatize mental illness, many children and teens continue to hide their distress from their families and peers because they feel either ashamed or that they can sort it out themselves.

For any parent wondering how they can help their child, this is our answer: Don’t look away. It can be tempting to tell yourself that all children have their ups and downs and that all adolescents are moody and irritable, but if your instinct is telling you that something isn’t right, that your child is struggling, trust yourself. While individual symptoms of mental illness differ, one of the most important warning signs is a drastic change in your child’s behaviour or ability to function successfully at school and with family and friends. Don’t write this off as a phase; talk to your child and try to find out what is going on. Deep down, your child wants and needs your help, and is counting on you.

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The best thing you can do to support your child’s physical and mental health is to learn about other risk factors, especially family history and childhood experiences that may put your child at increased risk of mental illness (and make sure your information is from a reliable source). While there are no guarantees, providing your child with a structure that promotes healthy sleep, good nutrition, physical activity, appropriate screen-time use and positive, caring relationships from an early age may prevent (and will certainly mitigate) these factors from causing harm.

Early intervention is always the best prevention, but we know that navigating the mental health-care system and accessing the appropriate resources can be difficult and overwhelming. There is a shortage of child and adolescent psychiatrists, resources are limited and there isn’t a single pathway from schools to community mental-health services to emergency rooms and hospitals. But the therapy and treatments are there. If you’re concerned about your child, the best place to start is with your family doctor, a community health centre, or a teacher or school counsellor. They will know what the next step will be. Your job as a parent is to ask for help; our job as mental-health professionals is to provide you with that help.

We emphasize the word “help” – not “fix,” not “cure,” not “solve – as mental health is a continuum. Wellness doesn’t happen overnight. Be patient, open and understanding with your child. And remember to take care of yourself, too. As impossible as that might seem at a time when your child is ill, your child also depends on your physical and mental health.

And if, someday, we do see you sitting across from us in our offices, we will tell you that you are not alone, that we are in this together. We have the information, resources and supports. You have the love, courage, persistence and honesty to help your family find a way forward to a better place.

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