According to Mental Health: A Report of the Surgeon General (1999), 1 in 5 will experience signs and symptoms of a psychiatric disorder during the course of the year. Some nine million children have serious emotional problems at any point in time. Yet, only 1 in 5 of these children are receiving appropriate treatment. When parents or teachers suspect that a child may have an emotional problem, they should seek a comprehensive evaluation by a mental health professional specifically trained to work with children and adolescents. Signs and symptoms of childhood and adolescent emotional problems may include:

School problems
Frequent fighting
Trouble sleeping
Feeling sad
Thoughts about suicide or running away
Stealing or lying
Mood swings
Setting fires
Obsessive thoughts or compulsive behaviors
Excessive weight loss or gain
Troubling or disturbing thoughts
Use of drugs or alcohol
Withdraw or isolation
Injuring or killing animals
Dangerous or self destructive behavior
Trouble paying attention
Anxiety or frequent worries

Throughout the evaluation process, parents should be directly involved and ask many questions. It's important to make sure you understand the results of the evaluation, your child's diagnosis, and the full range of treatment options. If parents are not comfortable with a particular clinician, treatment option, or are confused about specific recommendations, they should consider a second opinion.

Before a child begins treatment, parents may also want to ask the following:

What are the recommended treatment options for my child?
How will I be involved with my child's treatment?
How will we know if the treatment is working?
How long should it take before I see improvement?
Does my child need medication?
What should I do if the problems get worse?
What are the arrangements if I need to reach you after-hours or in an emergency?

You may also need to advocate to have your child seen in a timely way, by the most appropriate clinician. Most insurance plans now include some form of managed care, which may utilize provider panels with few mental health professionals. However, many states now have laws concerning reasonable access to specialists. If you have problems or questions, try calling the Department of Insurance, the Patient Ombudsman/Advocate, or the Department of Consumer Affairs at your insurance company.

Ongoing parental involvement and support are essential to the overall success of treatment. Depending on the nature of your child's problems, it may also be important to involve the school, community agencies, and/or juvenile justice system. In addition, it may be helpful to learn how to access other support services such as respite, parent skill building, or home-based programs. Local advocacy groups can also provide valuable information, experience and support for parents.

Although serious emotional problems are common in childhood and adolescence, they are also highly treatable. By advocating for early identification, comprehensive evaluation and appropriate intervention, parents can make sure their children get the help they need, and reduce the risk of long term emotional difficulties.

© Copyright © 1997 by the American Academy of Child and Adolescent Psychiatry.American Academy of Child and Adolescent Psychiatry