Discussing mental health issues with your child can be intimidating, but necessary, doctor says

Experts say Florida, and the United States as a whole, is in the middle of a mental health crisis. 

Child suicide rates are rising. Depression is the leading cause but often isn’t diagnosed until it is too late. 

"We know half of all mental disorders can be diagnosed prior to age 14. But for about half of those kids, they'll go up to ten years without appropriate diagnosis and treatment," said Dr. Jennifer Katzenstein, Johns Hopkins All Children's Hospital director of psychology.

She said Florida doesn't have the resources to provide a full continuum of care for children. Screening is improving but falls mainly on busy pediatricians. 

"That's difficult for a pediatrician to do everything they are supposed to be doing during that appointment," said Dr. Katzenstein.

Another problem is waiting lists. A shortage of child psychologists and therapists means families can't get the help they need. Mental health care at schools also has challenges.

"Providing a therapeutic intervention in the middle of a school day can sometimes result in a child coming back to class feeling more emotional or being more upset," said Dr. Katzenstein. 

She explained that parents have to step up. 

"It's always about remembering that they are the expert on their child and knowing what is developmentally appropriate,” she added.

Watch for important changes, Dr. Katzensteineven suggested, in children as young as four and five years old. Kids that young will show increased irritability, frustration and mood swings. 

"For older kids, maybe a change in what they want to wear or a lack of interest in doing self-care tasks," she said.

Then there is the delicate issue of discussing mental health with a child. It starts at the right time and place.  Get rid of all distractions like phones and television. 
Dr. Katzenstein said parents should know language is important. Eliminate words like “crazy” from the conversation. 

For young kids, concentrate on feelings, she said. Books, or movies, that deal with emotions can be helpful. Ask them questions like: 
What are some times when you felt happy? 
Or when you felt sad?  

For older children, ask open-ended questions:
What does your school day look like? 
Who are you hanging out with at school? 

"If you are asking those questions regularly and getting a different answer, that can be a red flag that something might be going on," said Dr. Katzenstein. 

She said parents shouldn't be afraid of silence. 

"A lot of times, if we sit through that silence after we've asked a question, our kids will respond to us,” she said.

When children do open up about an issue, don't freak out. 

"It may take all of our strength as parents to not find ourselves becoming emotional in that point, but staying calm and cool and collective," Dr. Katzenstein said. 

If mental health issues do arise, she said to let children know they're never alone. 

"As parents we keep you safe,” she explained, “but we'll also seek out the treatments for you that you need, in order to be your best self and to have the highest quality of life."