A Parent’s Guide to Child and Teen Mental Health

If you are worried about safety

If your teen may act on thoughts of suicide right now, call 911 or go to the nearest ER, stay with them, and keep dangerous items out of reach. If you need support or are not sure how urgent this is, call or text 988 (988 Suicide & Crisis Lifeline) any time. You can contact 988 about your child, and you do not need to be certain first.

Warning signs include talking about wanting to die or being a burden, feeling hopeless or trapped, withdrawing from people, and sudden changes in sleep, mood or behavior. If you see them, ask your teen directly whether they are thinking about suicide, stay close, and get help the same day. Studies show that asking does not cause or increase such thoughts. See teen suicide warning signs.

Self-harm is a sign of real distress, even if your teen says it is nothing. Self-harm without intent to die is different from a suicide attempt, but the two are linked, so every instance deserves an evaluation. Stay calm and listen without judgment. Leave the details to a clinician, and do not ask your teen to describe in detail what they did. Talk of wanting to die, or an injury that may need medical care, means 988, 911 or the nearest ER. See what to do if your teen is self-harming.

How to tell a phase from something more

NIMH says children commonly feel sad, anxious, irritable or aggressive at times, and that most of the time this is typical development. These questions help:

• How long has it lasted? NIMH advises considering help when a behavior or emotion lasts for weeks or longer.
• How much distress is there? Look for signs that your child is unhappy about it too, or stuck in it.
• What does it get in the way of? Look at school, sleep, eating, friendships, activities and family life.
• Is it a change? A shift from your child's own baseline often tells you more than a comparison with other kids.

A clear cause, such as a move, does not rule out needing help. Normal phase or something more? goes further.

Problems that are easy to miss

OCD. Many children hide it, and some do not see it as a problem. Families often adapt without noticing, and that adapting is linked to more severe symptoms and a weaker response to treatment. A clinician can show you how to change it. Read signs of OCD parents miss.

Bullying. The CDC says it increases the risk of depression, anxiety and sleep difficulties. Many children do not tell an adult, so notice reluctance to go to school, a drop in grades, or stomachaches on school mornings. See bullying and your child's mental health.

Social media. Heavy use is linked with teen anxiety and depression, but research has not proven that it causes them across all teens. A lasting change in mood deserves a closer look whatever the screen time is. See social media and teen mental health.

Family therapy, individual therapy, or both

Research does not crown one winner. Family or parent-focused work may fit when the problem is closely tied to patterns at home. Individual therapy may fit when your child needs private space or focused skill work. Many children end up with some of each, and the first plan can change. See family or individual therapy.

Play therapy may be a good fit for some young children, but its research is more limited than for behavioral and cognitive behavioral therapies. It is fair to ask whether a better-studied option should come first or alongside it. Read what play therapy is.

Therapy, medication, or both

Whether to begin with therapy, medication or both depends on the diagnosis and how severe things are. AACAP says psychiatric medication should not be used alone and should be one part of a broader treatment plan. Antidepressant labels carry an FDA boxed warning on suicidal thoughts and behaviors in children, adolescents and young adults. That is a reason for careful monitoring and an informed conversation, so ask for the monitoring plan before starting. Decisions belong with you, your child and the prescriber, and medication should never be started, changed or stopped on your own. If you are worried, call the prescriber right away. If your child talks about suicide or self-harm, call or text 988, call 911, or go to the nearest ER. See questions parents ask about medication.

When weekly therapy may not be enough

Raise this with your teen's clinician soon if symptoms keep getting worse despite consistent treatment or if your teen is unable to get through the day. If there have been thoughts of suicide or self-harm, call the clinician or pediatrician today. If there is danger now, or you cannot reach anyone quickly, use 988, 911 or the nearest ER.

Level	Typical intensity	Lives at
Outpatient	Scheduled visits, commonly weekly	Home
Intensive outpatient (IOP)	9 to 19 hours a week	Home
Partial hospital (PHP)	At least 20 hours a week	Home
Residential	Around the clock	Facility

Programs vary, so ask the intake team what is and isn't available here. See when a teen needs more than weekly therapy.

For repeated self-harm, the clearest research so far is for multi-part DBT programs for adolescents, and those results cannot be assumed to apply to individual DBT alone. At Mind Body Seven, DBT is individual only, with no DBT group or full DBT team. A clinician can talk through whether that fits your teen or whether a fuller program elsewhere makes more sense. If your teen is in danger now, use 988, 911 or the nearest ER.

School support: IEP or 504 plan

An IEP is a written special education plan for a student who has a listed disability and needs special education because of it. A 504 plan comes from a civil rights law and provides supports for a student whose impairment substantially limits a major life activity such as learning. A diagnosis can support a request, but it does not settle the question by itself. Ask yourself: does my child need different teaching, or the same teaching with changes around it? The school team or Committee on Special Education decides eligibility, and you have rights if you disagree. Details can vary, and this is not legal advice. See 504 plans and IEPs in New York.

Make the first call

You can begin with your pediatrician or go directly to a child and adolescent mental health clinician. To start here, request a consultation through the child and adolescent psychiatry and therapy page. The intake team confirms fit, scheduling and costs. Mind Body Seven is an out-of-network practice and does not accept Medicare or Medicaid. The fees and insurance page has the details.

Get ready for the evaluation

AACAP says an evaluation usually requires a few hours over one or more office visits. It does not commit you to any treatment. Details differ between clinicians, so ask for specifics when you book. Clinicians commonly ask about thoughts of self-harm or suicide, even when nothing suggests a problem. If you think your child is in danger, do not wait for the appointment: call or text 988, call 911, or go to the nearest ER.

It helps to gather:

• A short timeline of when the concerns started and what changed around then
• Medications and supplements, past and present, and any reactions
• Report cards, teacher notes, and any 504 plan or IEP
• Reports from earlier evaluations or therapy

A diagnosis may not be clear after one visit. Read what happens at a child psychiatric evaluation.

Tell your child ahead of time

Use plain words suited to their age. Say they will be seeing someone whose job is helping kids with feelings and problems, and that nothing is wrong with them for going. AACAP advises supportive terms that are not accusatory. Avoid making the visit sound like a punishment. Keep the first talk short. See how to talk to your child about starting therapy.

Ask about privacy and consent at the start

A common approach in teen therapy is that the details of what a teen says stay private, while parents hear the broad picture, including anything serious about safety. The exact rules depend on your teen's age, the type of care, who consented to it, and the setting. Ask the therapist to explain their approach to you and your teen together. Read what parents are told in teen therapy.

Who needs to consent also depends on the setting, and rules can change. Ask any provider how the law applies to them, and see minors and consent in New York for background. This is general information, not legal advice. In a crisis, do not hold back because of a consent question. Call 911 or go to the ER. Anyone can call or text 988.

Bring the school in with care

Therapists and schools usually work together through the parent. You sign a release saying who can talk to whom and about what. Share the minimum that gets the job done, and let an older child or teen have a say. Ask your clinician what they can provide. In New York, a parent can start the special education process by putting a request in writing. See how therapists and schools work together.