Children’s mental health is in crisis (2023)

As the United States approaches 2 full years of the COVID-19 pandemic, mental illness and the demand for psychological services are at all-time highs—­especially among children. While some children benefited from changes like remote learning, others are facing a mental health crisis. Prior to COVID-19, Centers for Disease Control and Prevention (CDC) data found 1 in 5 children had a mental disorder, but only about 20% of those children received care from a mental health provider. Whether kids are facing trauma because of child abuse or loss of a family member or everyday anxiety about the virus and unpredictable routines, they need even more support now—all amid a more significant shortage of children’s mental health resources.

In a 2020 survey of 1,000 parents around the country facilitated by the Ann & Robert H. Lurie Children’s Hospital of Chicago, 71% of parents said the pandemic had taken a toll on their child’s mental health, and 69% said the pandemic was the worst thing to happen to their child. A national survey of 3,300 high schoolers conducted in spring 2020 found close to a third of students felt unhappy and depressed much more than usual.

Mental health crises are also on the rise. From March 2020 to October 2020, mental health–related emergency department visits increased 24% for children ages 5 to 11 and 31% for those ages 12 to 17 compared with 2019 emergency department visits, according to CDC data (Leeb, R. T., et al., Morbidity and Mortality Weekly Report, Vol. 69, No. 45, 2020).

(Video) Special Report: After lockdown - a children's mental health crisis

Emergency visits could be mitigated with more widespread outpatient care, but even before the pandemic, kids often had to wait months for appointments (Cama, S., et al., International Journal of Health Services, Vol. 47, No. 4, 2017). Only 4,000 out of more than 100,000 U.S. clinical psychologists are child and adolescent clinicians, according to APA data. School psychologists are also in short supply, leaving kids without enough support at school. The National Association of School Psychologists (NASP) recommends a ratio of 1 school psychologist per 500 students; current NASP data estimate a ratio of 1 per 1,211 students.

The pandemic has also exacerbated existing disparities in mental health services. A 2020 technical report from the University of Massachusetts Boston and University of Massachusetts Amherst found that students who needed access to school-based services the most, particularly those with lower socioeconomic backgrounds, had lower rates of counselors and school psychologists in their districts.

While federal funding has provided schools with money to support students’ well-being, psychologists have been seeking additional long-term solutions to address the mental health problems revealed and exacerbated by the pandemic, from building mental health into school curricula to training teachers in prevention strategies to support students based on psychological science.

Here are some of the most notable ways psychologists have worked to address students’ mental health and what’s ahead.

Bringing mental health into the classroom. The American Rescue Plan Act, passed in March 2021, included $170 billion for school funding, and many schools used the funding to hire mental health workers, including psychologists. Other federal and state funding is being allocated toward training more psychologists. For example, in Nevada, which has historically ranked last in U.S. mental health, the University of Nevada, Las Vegas, received a grant to train school clinicians in urban diversity and social justice, and Nevada State College received funding to create a new program to train school mental health clinicians, including psychologists.

(Video) COVID-19 crisis threatens children’s mental health

While the field of psychology recognizes a shortage of mental health services for kids, addressing those needs may not be a realistic solution until the workforce grows. Relying on temporary funding to hire permanent staff isn’t financially sustainable for lower-income districts, said Kenneth Polishchuk, APA’s senior director for congressional and federal relations. As a result, Polishchuk said, many schools are hiring mental health providers on a short-term basis, as well as taking a preventative approach focused on training teachers in psychological principles.

Psychologists in some districts are training teachers in basic social and emotional skills to help students cope with stress and anxiety in real time, said Kathryn H. Howell, PhD, an associate professor of child and family psychology at the University of Memphis and chair-elect of APA’s Committee on Children, Youth and Families. Howell said equipping kids with coping skills in the classroom can prevent strain on school psychologists while also improving students’ ability to learn.

“As psychologists, we don’t just want to bring in interventions that only we as experts can deliver,” Howell said. “We need to make it sustainable by teaching those on the front lines how to equip kids with the skills they need to thrive.”

Some teachers are incorporating formal mental health lessons into their curriculum with help from psychologists. New York state requires basic mental health education in health classes, and Peter Faustino, PsyD, a school psychologist in Scarsdale, New York, said he’s been receiving requests from teachers for help incorporating pandemic-relevant topics like anxiety, trauma, and warning signs of suicide into their classes. Other schools, he said, are investing in social and emotional health training programs for staff, such as Yale University’s RULER program, which teaches school leaders and teachers how to equip students with emotional intelligence skills.

Training teachers to address trauma. Along with more minor mental and behavioral health concerns, teachers are facing an unprecedented number of students with trauma, said Laurie McGarry Klose, PhD, president of NASP and director of the School Psychology Program at Trinity University in San Antonio, Texas. And many teachers don’t feel equipped to handle their students’ struggles: A 2020 survey by the New York Life Foundation and American Federation of Teachers found that only 15% of educators said they felt comfortable addressing grief or trauma tied to the pandemic.

(Video) How to help children going through a mental health crisis

As a result, psychologists are finding new ways to share their expertise with school personnel. For example, Samuel Song, PhD, a professor of school psychology at the University of Nevada, Las Vegas, and president of APA’s Div. 16 (School Psychology), is working on a grant with colleagues to deliver a four-part web-based curriculum on trauma-informed practices. Such programs can help teachers identify signs of trauma in students and also cope with their own trauma, which Klose says are equally important. Teachers are more likely to dismiss trauma-driven behaviors as belligerence when they’re under strain, so with proper resources and training, they can better identify kids who are struggling and route them to appropriate support services within the school system.

Mental Health Primers, developed by the Coalition for Psychology in Schools and Education, also provide information for teachers to identify behaviors in the classroom that are symptomatic of mental health and other psychological issues, with the goal of directing teachers to appropriate resources for their students.

“We know one-on-one therapy won’t be possible for every kid who’s struggling, so we need a multipronged approach to help build the capacity of teachers and staff to support kids in the classroom setting,” said Melissa Pearrow, PhD, a professor of counseling and school psychology at the University of Massachusetts Boston.

Resilience is built outside the classroom, too. Howell said psychologists and graduate students from her department at the University of Memphis are also working with local community centers to train leaders in emotional health principles. “We want to help provide mentors that can be present in kids’ lives beyond their parents, who are already dealing with a lot,” she said. “We have the expertise and scientific background, and they have expertise in working directly with families and systems, so how can we pair our expertise and learn from each other?”

Ensuring long-term resilience. While short-term crisis funding has helped many communities and schools hire mental health professionals and develop related programs, psychologists and policymakers continue to advocate for more permanent solutions. In a September 2021 address to the House Energy and Commerce Subcommittee on Oversight and Investigations, APA CEO Arthur C. Evans Jr., PhD, encouraged Congress to consider long-term investments in states’ and school systems’ mental health workforces and infrastructures. In October 2021, the Biden administration and U.S. Department of Education released new guidance for schools to better help students’ mental health needs.

(Video) By the Numbers: Children’s mental health crisis during pandemic

Several bills could help protect kids’ mental health in the long term. President Biden proposed an additional billion dollars to procure health care professionals—including mental health professionals—in schools. As of November 2021, the bill has passed in the House and will soon go before the Senate.

Also as of November 2021, bipartisan lawmakers are working to pass the Student Mental Health Helpline Act, which would create a grant program to support existing and promote new statewide student mental health and safety helplines. The Comprehensive Mental Health in Schools Pilot Program Act, a bill referred to the House Committee on Education and Labor in May 2021, would provide resources for low-income schools to integrate social and emotional learning and evidence-based, trauma-informed practices into all aspects of the school environment. Also in May 2021, the House passed the bipartisan Mental Health Services for Students Act, which would build partnerships between schools and community-based organizations to provide school-based mental health care for students. It now awaits consideration by the Senate.

Until new laws go into effect, psychologists are committed to finding new ways to address children’s mental health, not only for their own well-being but for the common good. “It’s not only the right thing to do to make sure people can have as full a life as they possibly can,” said Alan Leshner, PhD, the former director of the National Institute on Drug Abuse and former deputy and acting director of the National Institute of Mental Health, who has recently turned his attention to student mental health as a member of the National Academies of Sciences, Engineering, and Medicine Committee on Mental Health, Substance Use, and Wellbeing in STEMM Undergraduate and Graduate Education. “Young people are critical to the future of society, so it’s in society’s interest to make sure we don’t lose the talent youth could contribute to a set of problems that can be alleviated.”


What is a mental health crisis in children? ›

A mental health crisis is when your child is at risk of harming themselves or others, or if their emotions and behavior seem extreme and out of control.

What is the mental health crisis? ›

A mental health crisis is any situation in which. a person's behavior puts them at risk of hurting. themselves or others and/or prevents them from. being able to care for themselves or function. effectively in the community.

What are the main causes of mental health issues in children? ›

Causes of mental health issues in children Information and advice on the causes of mental health issues in children
  • having a long-term illness.
  • moving home and/or changing school.
  • being bullied.
  • witnessing domestic violence.
  • being abused.
  • parents separating or divorcing.
  • someone close to them dying.

What are the 3 most common mental disorders in childhood? ›

Facts about mental disorders in U.S. children. ADHD, anxiety problems, behavior problems, and depression are the most commonly diagnosed mental disorders in children.

How do you know if your child is in crisis? ›

How do I know if my child is having a crisis or a mental health emergency?
  1. Rapid mood swings.
  2. Extreme energy or lack of it, sleeping all the time, or being unable to sleep.
  3. Severe agitation, pacing,
  4. Talking very rapidly or non-stop.
  5. Confused thinking or irrational thoughts.

How do I help my child in crisis? ›

In a difficult moment like this, here are some ways you can help your child:
  1. Be direct. ...
  2. Be willing to listen. ...
  3. Don't judge or argue with them. ...
  4. Let your child control their space. ...
  5. Don't act shocked. ...
  6. Seek support during and after a crisis.
  7. Stay positive. ...
  8. Offer hope that things can get better.

What are the three types of crisis in mental health? ›

Crises can be categorized as maturational, situational, adventitious, or sociocultural.

How do you know if someone is in a crisis? ›

What are the Signs of Crisis?
  1. Appearing sad or depressed most of the time.
  2. Clinical depression: deep sadness, loss of interest, trouble sleeping and eating—that doesn't go away or continues to get worse.
  3. Feeling anxious, agitated, or unable to sleep.
  4. Neglecting personal welfare, deteriorating physical appearance.

How do you respond to a mental health crisis? ›

First aid can also be a lifesaver for someone with mental illness.
How do you respond to a mental health crisis?
  1. Assess for risk of suicide or harm.
  2. Listen nonjudgmentally.
  3. Give reassurance and information.
  4. Encourage appropriate professional help.
  5. Encourage self-help and other support strategies.
15 Mar 2018

How are children affected by mental health issues? ›

Mental health disorders in children are generally defined as delays or disruptions in developing age-appropriate thinking, behaviors, social skills or regulation of emotions. These problems are distressing to children and disrupt their ability to function well at home, in school or in other social situations.

How many kids suffer from mental health issues? ›

Study: 1 in 7 children and teens have at least one treatable mental health disorder; treatment and prevalence rates vary considerably by state.

At what age do mental health issues start? ›

50% of mental illness begins by age 14, and 3/4 begin by age 24.

What are the 5 signs of mental illness? ›

Examples of signs and symptoms include:
  • Feeling sad or down.
  • Confused thinking or reduced ability to concentrate.
  • Excessive fears or worries, or extreme feelings of guilt.
  • Extreme mood changes of highs and lows.
  • Withdrawal from friends and activities.
  • Significant tiredness, low energy or problems sleeping.
8 Jun 2019

What causes a child to be psychotic? ›

What Causes Psychosis in Children? Specific causes for most psychotic disorders are not known. However, the combination of inherited, biological, environmental, and psychological factors is thought to be involved.

How do you respond to a child in crisis? ›

Tell them often that you care about them. Being caring and telling your child that you love them will reassure them and help to make them feel more confident. Finding opportunities to praise children during crisis contexts can help children feel a sense of strength and pride and resilience.

Which harmful behaviour might suggest a child has a mental health concern? ›

A child or young person with persistent behavioural problems may: be argumentative, angry, uncooperative or irritable. have frequent tantrums and angry outbursts. be aggressive, provoke or bully others.

What are signs of schizophrenia in a child? ›

Signs and symptoms may include:
  • Delusions. These are false beliefs that are not based in reality. ...
  • Hallucinations. These usually involve seeing or hearing things that don't exist. ...
  • Disorganized thinking. ...
  • Extremely disorganized or abnormal motor behavior. ...
  • Negative symptoms.
19 May 2021

How long does a mental crisis last? ›

The Duration of a Nervous Breakdown Varies by Individual

These mental health crises are highly variable, lasting a few hours for one person or weeks for another. There are many risk factors for having a nervous breakdown, and the more an individual has, the greater the chance is that a breakdown will last longer.

How do you resolve a crisis? ›

How Can You Cope with a Crisis?
  1. 1) Understand normal reactions. When tragedies occur, horrific headlines and images often play in our minds again and again. ...
  2. 2) Realize the effects of other losses. ...
  3. 3) Consider past healing. ...
  4. 4) Be intentional in self-care. ...
  5. 5) Recognize the need for help.

What is the difference between stress and crisis? ›

Crisis is the buildup of stressors to beyond a point where a person can handle the situation. During stress a person can still function. During crisis the person will be unable to function and will need assistance to get back to functioning levels.

What can cause a mental health crisis? ›

Some examples of these factors include:
  • Genetic factors: having a close family member with a mental illness can increase the risk. ...
  • Drug and alcohol abuse: illicit drug use can trigger a manic episode (bipolar disorder) or an episode of psychosis. ...
  • Other biological factors: some medical conditions or hormonal changes.

What is the difference between a mental health crisis and a mental health emergency? ›

Others define a mental health emergency as a life threatening situation in which someone is a danger to themselves or others, while a crisis is non-life-threatening, but the person is still severely distressed.

What is an emotional crisis? ›

Emotional crisis (mental crisis) is a natural element of life and can be described as “temporary, periodic disturbance of mental balance caused by a threat associated with the meaning of life, important values, in confrontation with important life problems.

What are the 4 phases of crisis? ›

The Four Stages of a Crisis
  • Stage 1: Prodromal (Pre-Crisis)
  • Stage 2: Acute (Crisis)
  • Stage 3: Chronic (Clean-Up)
  • Stage 4: Crisis Resolution (Post-Crisis)
  • Crisis Intervention 101.

What are the signs of a mental health emergency? ›

Mental health crisis signs:
  • Rapid mood swings.
  • Agitation.
  • Aggressive behavior.
  • Confused thinking or irrational thoughts.
  • Verbally stating, writing, or insinuating they'd like to hurt themselves or someone else.
  • Talking about death or dying.
  • Extreme energy or lack of energy.
  • Changes in completion of daily tasks.

What are the four goals of crisis intervention? ›

A helper's primary goals in a crisis are to identify, assess, and intervene; to return the indi- vidual to his/her prior level of functioning as quickly as possible; and to lessen any negative impact on future men- tal health.

What are the signs of poor mental health in children? ›

Signs of a mental illness
  • getting significantly lower marks in school.
  • avoiding friends and family.
  • having frequent outbursts of anger.
  • changes to sleeping or eating habits.
  • acting out or rebelling against authority.
  • drinking a lot and/or using drugs.
  • not doing the things he or she used to enjoy.
  • worrying constantly.

How is the pandemic affecting children's mental health? ›

Although most children and adolescents infected with COVID-19 appear to have had mild to moderate symptoms, and limited mortality rates, 1 a recent review has identified various mental health problems among those exposed to the COVID-19 pandemic, including anxiety, stress, depression, panic, irritation, impulsivity, ...

What is the main cause of depression among the youth? ›

Many factors increase the risk of developing or triggering teen depression, including: Having issues that negatively impact self-esteem, such as obesity, peer problems, long-term bullying or academic problems. Having been the victim or witness of violence, such as physical or sexual abuse.

Why is youth mental health on the rise? ›

The COVID-19 pandemic has put more strain on the mental health of young people. In the United States alone, more than 140,000 children under the age of 18 lost a parent or carer to COVID-19 between April 2020 and June 2021, according to a 2021 study7. Lockdowns caused isolation and family conflict.

Can mental illness be inherited from parents? ›

Scientists have long recognized that many psychiatric disorders tend to run in families, suggesting potential genetic roots. Such disorders include autism, attention deficit hyperactivity disorder (ADHD), bipolar disorder, major depression and schizophrenia.

Can mental illness go away? ›

There's no cure for mental illness, but there are lots of effective treatments. People with mental illnesses can recover and live long and healthy lives.

At what age does bipolar start? ›

Although bipolar disorder can occur at any age, typically it's diagnosed in the teenage years or early 20s.

› recognizing-mental-health... ›

Parents and family members are usually the first to notice if a child has problems with emotions or behavior. Your observations, along with those of teachers an...
Children can suffer from the following mental illnesses: Anxiety disorders: Children with anxiety disorders respond to certain things or situations with fear an...
50% of mental illness begins by age 14, and 3/4 begin by age 24. Major mental illnesses such as schizophrenia or bipolar disorder rarely appear “out of the blue...

How can you tell if a child is mentally ill? ›

What are the warning signs of mental illness in children?
  1. Persistent sadness that lasts two weeks or more.
  2. Withdrawing from or avoiding social interactions.
  3. Hurting oneself or talking about hurting oneself.
  4. Talking about death or suicide.
  5. Outbursts or extreme irritability.
  6. Out-of-control behavior that can be harmful.

Which harmful Behaviour might suggest that a child has a mental health concern? ›

Identifying the signs

A child or young person with persistent behavioural problems may: be argumentative, angry, uncooperative or irritable. have frequent tantrums and angry outbursts. be aggressive, provoke or bully others.

What are the five major types of childhood disorders? ›

Childhood Mental and Behavioral Disorders

This chapter limits the discussion to the following five conditions: childhood anxiety disorders, attention-deficit hyperactivity disorder (ADHD), conduct disorder, autism, and intellectual disability (intellectual developmental disorder).

How do you assess a child's mental health? ›

The types tests that mental health professionals can conduct, include:
  1. Psychiatric evaluation.
  2. Psychological evaluation.
  3. Psychoeducational evaluation.
  4. Developmental evaluation.
  5. Neuropsychological evaluation.
  6. Psychosexual evaluation.
  7. ADHD testing.
  8. Individualized Education Plan (IEP) testing.

How do you deal with an emotionally unstable child? ›

  1. Teach About Emotions.
  2. Explain Feelings and Behaviors.
  3. Validate Feelings.
  4. Show Acceptance.
  5. Teach Emotion Regulation.
  6. Avoid Reinforcing Outbursts.
  7. Challenge Your Child.
  8. When to Seek Help.
25 Apr 2021

At what age do mental health issues start? ›

50% of mental illness begins by age 14, and 3/4 begin by age 24.

What happens if mental health goes untreated in children? ›

Untreated mental health problems can disrupt children's functioning at home, school and in the community. Without treatment, children with mental health issues are at increased risk of school failure, contact with the criminal justice system, dependence on social services, and even suicide.

When should a child see a psychologist? ›

Kids and teens need therapy when they have problems they can't cope with alone. Or they need help when problems affect how well they do, feel, or act. If things don't get better on their own, kids may need therapy so things can improve.

How do you get a child sectioned? ›

Who decides if I need to be sectioned? Before you can be sectioned, a group of health professionals have to meet with you. And they must all agree that you need to go into hospital to get treatment and support for your mental health problem. You might hear this called an assessment or Mental Health Act Assessment.

How do you raise a child with good mental health? ›

How can you improve children's mental health?
  1. Be intentional and attuned. ...
  2. Balance closeness and compliance. ...
  3. Allow your child to experience distress and failure. ...
  4. Let children be bored. ...
  5. Provide structure. ...
  6. Encourage connections. ...
  7. Model good behavior. ...
  8. Make healthy choices.
1 May 2020

What are the 6 common behavioral disorder? ›

Mental health disorders (MHD) are very common in childhood and they include emotional-obsessive-compulsive disorder (OCD), anxiety, depression, disruptive (oppositional defiance disorder (ODD), conduct disorder (CD), attention deficit hyperactive disorder (ADHD) or developmental (speech/language delay, intellectual ...

Can a child be born with mental illness? ›

Contrary to traditional beliefs that infants cannot have mental health problems “because they lack mental life,” even young infants can react to the meaning of others' intentions and emotions because they have their own rudimentary intentions and motivating emotions, according to an article by Tronick and Marjorie ...

What is Peter Pan disorder? ›

Peter Pan Syndrome describes people who have difficulty “growing up.” They may find it hard to manage typical adult responsibilities, such as keeping a job and maintaining healthy relationships. According to Kiley, people with Peter Pan Syndrome behave irresponsibly and may display narcissistic personality traits.

Why would a child need a psych eval? ›

A psychological assessment offers insights into a child's learning, social, behavioral and personality development, with the goal of tailoring recommendations to plan a child's educational and mental health needs.

How do you treat anxiety in children? ›

Talking therapies, such as counseling and cognitive behavioral therapy (CBT), are popular and effective treatment options for anxiety in children. As part of CBT, a mental health professional can teach a child about anxiety and how it affects the body.

How do you screen a child for depression? ›

The most common screening tests for MDD in children and teens are the Patient Health Questionnaire for Adolescents (PHQ-A) and the Beck Depression Inventory- Primary Care Version.

› health › publications › childr... ›

Mental disorders can begin in childhood. Examples include anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, depressi...


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