Kids are naturally curious and have questions about mental illnesses. Understanding mental illnesses can be challenging for adults as well as for children. Myths, confusion, and misinformation about mental illnesses cause anxiety, create stereotypes, and continue stigma. During the past 50 years, great advances have been made in the areas of diagnosis and treatment of mental illnesses. Parents can help children understand that these are real illnesses that can be treated.

In order for parents to talk with a child about mental illnesses, they must be knowledgeable and reasonably comfortable with the subject. Some parents may have to do a little homework to be better informed. Parents should have a basic understanding and answers to questions such as, what are mental illnesses, who gets them, what causes them, how are diagnoses made, and what treatments are available.

When explaining to a child about how mental illnesses affect a person, it may be helpful to make a comparison to a physical illness. For example, many people get sick with a cold or the flu, but only a few get really sick with something serious like pneumonia. People who have a cold are usually able to do their normal activities. However, if they get pneumonia, they will have to take medicine and may have to go to the hospital. Similarly, feelings of sadness, anxiety, worry, irritability, or sleep problems are common for most people. However, when these feelings get very intense, last for a long period of time, and begin to interfere with school, work, and relationships, it may be a sign of a mental illness.

Parents should be aware of their child's needs, concerns, knowledge and experience with mental illnesses. When talking about mental illnesses, parents should:

• communicate in a straightforward manner


• communicate at a level that is appropriate to a child's age and development level


• have the discussion when the child feels safe and comfortable


• watch their child's reaction during the discussion


• slow down or back up if the child becomes confused or looks upset


• Considering these points will help any child to be more relaxed and understand more of the conversation.

Pre-school age children

Young children need less information and fewer details because of their more limited ability to understand. Preschool children focus primarily on things they can see, for example, they may have questions about a person who has an unusual physical appearance, or is behaving strangely. They would also be very aware of people who are crying and obviously sad, or yelling and angry.

School-age children

Older children may want more specifics. They may ask more questions, especially about friends or family with emotional or behavioral problems. Their concerns and questions are usually very straightforward. "Why is that person crying?" "Why does Daddy drink and get so mad?" "Why is that person talking to herself?" They may worry about their safety or the safety of their family and friends. It is important to answer their questions directly and honestly and to reassure them about their concerns and feelings.

Teenagers

Teenagers are generally capable of handling much more information and asking more specific and difficult questions. Teenagers often talk more openly with their friends and peers than with their parents. As a result, some teens may have already have misinformation about mental illnesses. Teenagers respond more positively to an open dialogue that includes give and take. They are not as open or responsive when a conversation feels one-sided or like a lecture.

Talking to children about mental illnesses can be an opportunity for parents to provide their children with information, support, and guidance. Learning about mental illnesses can lead to improved recognition, earlier treatment, greater understanding and compassion, as well as decreased stigma.

© Copyright © 1997 by the American Academy of Child and Adolescent PsychiatryAmerican Academy of Child and Adolescent aPsychiatry