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Mental Health Problems

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Definition

  • Mental health problems that often need urgent help
  • Examples are anxiety attacks, depression, substance (drug) abuse and acting out
  • Resources include hotlines, mental health experts and your child's doctor

Types of Serious Mental Health Problems

  • Suicide thoughts, threats or attempts
  • Homicide thoughts or threats
  • Child abuse
  • Drug or alcohol abuse
  • Anxiety attacks or panic attacks
  • Depression

Types of Non-Serious Behavior Problems

Many childhood behavior problems are common and not serious. Your child's doctor can often manage them. Pediatricians are often the first point of contact for these problems. Examples are:

  • Temper tantrums
  • Sleep problems
  • Toilet training problems
  • Eating problems
  • Developmental delays

Behavior Scale: How to Judge Severity

  • Mild Symptoms: Symptoms do not keep the child from any normal activities. School, play, relationships and sleep are not changed. Treatment: parenting groups or books.
  • Moderate Symptoms: Symptoms keep the child from doing some normal activities. New behaviors mainly occur at home. They affect how the child and parent interact. They may also keep him or her from going to child care or school. Your child may not sleep well because of these symptoms. Treatment: Most often, brief counseling from a mental health provider or your child's doctor.
  • Severe Symptoms: Symptoms keep the child from doing most normal activities. They affect the way the child acts with parents. Symptoms also impact relations with siblings and friends. Adults at child care or school may also be impacted by the child's actions. Treatment: These patients often need to be seen urgently by a mental health provider.
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When To Call

Call 911 Now

  • Physical harm or abuse is occurring now. Reason: police are needed.
  • Child is threatening serious harm to others now. Reason: police are needed.
  • Child has attempted or is threatening suicide now

Go to ER Now

  • Threats of harm to self or others, but not present now
  • You do not feel safe at home now
  • Substance abuse suspected and has symptoms now
  • Confused or bizarre behavior
  • Child is very upset (can't be calmed down)
  • Child is very angry (out-of-control)
  • You want an urgent psych exam for your child
  • You think your child needs to be in a hospital
  • Child abuse concerns and physical findings are present

Call Doctor or Seek Care Now

  • Child abuse concerns and no physical findings. You can also call your local Child Protection Services.
  • Needs mental health services and symptoms are urgent. You can also call a local mental health resource.

Call Doctor Within 24 Hours

  • Substance abuse or alcohol abuse suspected, but no symptoms now
  • Symptoms are constant and keep patient from doing their normal tasks of daily living
  • Needs mental health services and symptoms are not urgent. You can also call a local mental health resource.

Call Doctor During Office Hours

  • Common behavior problems (such as temper tantrums)
  • Toilet training problems
  • Sleep problems
  • Eating problems
  • School problems
  • You have other questions or concerns

Self Care at Home

  • Needs a resource or info on getting help for a mental health problem
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Care Advice

  1. Threats of Harm to Self or Others - How to Respond:
    • Children who threaten harm to self or other people need to be seen now. Emergent psych exams are done in the ER no matter the time of day.
    • The risk assessment for suicide or homicide must be made in person. It should not be done by phone. It is usually made by a mental health expert. ER doctors may do the first screening.
    • Some of these children may need to be in the hospital.
    • If anyone is in danger, call the police (911). Examples are spouse abuse.
    • For child abuse concerns, call the Child Protection Services (CPS) Hotline in your state.
  2. Child or Teen Already In Treatment With A Mental Health Provider:
    • Contact your mental health provider first.
    • If can't reach your provider and problem is urgent, call another resource. See #3.
  3. Local and National Mental Health Hotlines and Helplines (US numbers):
    • Call your local mental health resource first, if you have the number. If not, call a national hotline for help. They often can refer you to the best local resource.
    • National Suicide Prevention Lifeline: 1-888-784-2433
    • Domestic Violence Hotline: 1-800-799-7233
    • Child Abuse Hotline: 1-800-422-4453. Crisis counselors answer calls 24//7.
    • Substance Abuse Hotline: 1-800-662-4357. This is a 24/7 substance abuse and mental health referral line. They can give you local treatment choices and numbers for support groups.
    • Mental Health Helpline: 1-800-950-6264. This is an information and referral source for finding local mental health programs.
    • Postpartum Depression Helpline: 1-800-944-4773
    • National Poison Control Number: 1-800-222-1222
  4. Website Resources for Mental Health Concerns:
    • American Academy of Pediatrics parenting website: www.healthychildren.org
    • American Academy of Child and Adolescent Psychiatry: www.aacap.org
  5. Call Your Doctor If:
    • You think your child needs to be seen
    • Your child becomes worse
    • You have other questions or concerns

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2018. Schmitt Pediatric Guidelines LLC.
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