How Can I Support a Child Experiencing Mental Health Challenges? Professor Marc Grimmett Shares the Importance of Relationships, Listening and Seeking Professional Help from a Counselor

Editors note: This article contains discussion of mental health issues, including suicide. If you or someone you know is experiencing thoughts of self-harm, please contact the National Suicide Hotline at 1-800-273-8255 or utilize these available resources for crisis support. 

This is part of the monthly “Ask the Expert” series in which NC State College of Education faculty answer some of the most commonly asked questions about education.

Over the past two years, the impacts of the COVID-19 pandemic made typical developmental challenges more difficult for K-12 students. As a result, Professor Marc Grimmett said youth may be experiencing more mental health issues. 

Grimmett, a professor of counselor education in NC State’s College of Education and the founding director of the Community Counseling, Education, and Research Center (CCERC), said the pandemic led to increased feelings of isolation among many students, who were separated from friends and prevented from participating in normal events like school dances. In addition, many students experienced feelings of depression related to isolation and anxiety related to changing restrictions. 

“All of that can kind of create more stress, not just for school-aged kids, but their families and so they might experience more mental health challenges than they’re accustomed to,” Grimmett said. “If you had other issues and other challenges before COVID, then the pandemic probably made those a little bit worse.”

How Do I Know if My Child is Experiencing Mental Health Struggles?

There are several signs that could be indicators for parents, caregivers or educators that a child or teenager might be experiencing a change in their mental health, Grimmett said. 

• Changes in behavior: If a child who is normally really happy or outgoing suddenly seems to be withdrawn.
• Changes in appetite: If a child suddenly or gradually starts eating significantly more, or significantly less, than they would typically eat.
• Sudden reluctance to engage: If a child suddenly or gradually stops hanging out with or engaging with friends in the way they typically would, or if they express reluctance to engage with certain adults in their lives.
• Constant worry: If a child appears to be “getting stuck” in negative thoughts and worrying more than they used to.

If an adult notices any of these changes in a child they are close with, Grimmett said it is important that they follow up and have a conversation about what might be going on. 

When a conversation happens, Grimmett notes that it is important to approach the discussion in an open, honest and caring way and to remind children that as the parent, caregiver or teacher in their lives, you care about them and want to check-in to make sure they’re OK. 

“We want to have the type of relationship with our children where they feel like they can tell us just about anything, where we will not judge them and where they will not get into trouble if they tell us something that’s really scary for them,” Grimmett said. “The relationship that you have with your child is probably one of the most important things to influence their total health and wellness, including their mental health.” 

What are Some Common Mental Health Struggles Among Children and Adolescents? 

Among mental health struggles often seen among K-12 students, Grimmett said depression can be common. This involves a feeling of sadness that lasts longer than would reasonably be expected for a particular situation. 

“That [time frame] varies, but if a person is unable to feel better, then you might consider that that person may have depression,” he said. 

Anxiety, Grimmett said, is also common among children and adolescents. While people of all ages experience worry now and again, anxiety is characterized by excessive worry that cannot be controlled or that a person can’t stop thinking about. 

“We all worry about things. We all get stressed out. But, if that starts to take control of your life, or you are unable to prevent yourself from doing it, and it’s really interfering with going to school or relationships or being happy, then it’s a problem,” Grimmett explained. 

Over the past few years, Grimmett said mental health professionals have also seen an increased risk of suicide among school-aged children. These feelings, Grimmett said, can be scary, but they are not necessarily uncommon among people who feel like they don’t have options for coping or don’t have people to talk to about what they are experiencing. 

The most important thing, he said, is that children know that if they are experiencing suicidal thoughts or feelings, that they can and should communicate them to a trusted adult who can help.  

“We want to encourage children and adolescents, if you’re having these thoughts or these feelings of hurting themselves or ending their lives, please communicate those feelings with someone you trust — a school counselor, a parent, a friend — and try to get help because there are other options to support you,” Grimmett said. “Professionals like me, or even some of your family and friends are really familiar with helping people who have these thoughts. Having thoughts in your head, without someone to talk them through with you, can make things seem a lot worse than they may be.” 

What Can I Do to Support a Child Experiencing Mental Health Struggles?

The option to visit a mental health professional, such as a counselor or therapist, isn’t always available when a child begins experiencing mental health challenges. 

When a counselor is not immediately available, Grimmett said there are several things adults can do that can be helpful to a child experiencing a mental health crisis or even a child who is just dealing with a difficult situation. 

1. Be present and listen: Before an adult can help a child experiencing emotional distress, they need to slow down and listen to what the child has to say. Grimmett advises sitting down, using open body language and listening quietly while the child shares what is bothering them. What Dr. Grimmett suggests saying: ‘I’m noticing something is going on with you. I want to learn what’s going on so I can be helpful to you, but right now, I just want to listen.”
2. Be intentional: When speaking to a child who might be experiencing emotional distress, Grimmett says adults need to differentiate between what they think will help and what will actually help. For example, while an adult may think a physical gesture like a hug would be comforting, that might actually make the child more uncomfortable. He recommends adults share everything they plan to do before they do it and let kids know that they can tell adults if they’re uncomfortable. What Dr. Grimmett suggests saying: “I would like to talk with you to see what’s going on. Would that be OK? I’m going to sit right here, and we’re just going to have a conversation if that’s alright. If we start talking about anything, or if I’m doing something that bothers you, please let me know, and I’m happy not to do that.” 
3. Let them know when you need additional support: Depending on what the child shares, a caregiver or teacher may realize they are not equipped to handle it on their own and need help from a professional. When that is the case, the adult should communicate this fact with the child in a way that lets them know they will be supported throughout the process. Not doing so, Grimmett said, could make a child feel more anxious about the problems they’re already experiencing. What Dr. Grimmett suggests saying: “There’s a lot going on right now. I’m not really sure how to handle all of it, but we’re going to start here, and I might have to reach out to some other people that I know to help us. But, I’m going to be here with you through it.” 

How Can a Counselor Help Youth Through Mental Health Struggles? 

While parents, caregivers and teachers may be able to provide support to a student experiencing mental health challenges, Grimmett said a counselor is often the best solution because they are trained to help individuals deal with their emotions and understand life experiences. 

A counselor is also often able to provide a more neutral space for children to talk about certain issues in their lives. For example, Grimmett noted that a child talking to their mother or father may sometimes feel pressure to pretend they feel better about a situation than they really do because they worry that their negative feelings might cause additional stress for their parents. 

“Of course, a lot of parents do want their children to let them know when they’re not feeling well, but the child might not know exactly how to do that. Working with a counselor, there’s a little bit more freedom to explore those areas that may feel unsafe with their parents because the child thinks they need to protect them from how they’re actually feeling,” he said. “I think having a neutral, nonjudgmental, trained expert can be very helpful.” 

Another benefit of speaking with a counselor, Grimmett said, is that a counselor will focus all of their attention and energy on the person they are working with. For approximately an hour at a time, the student can share their thoughts and problems, and the counselor will listen and help the child work through them. 

This is a key difference from talking to a caregiver or teacher, who likely have other children they need to pay attention to, or a friend, who may want the person they’re helping  to listen to their problems in return. 

“Sometimes, we just want to talk about ourselves and sometimes we need help that goes beyond what our friends can offer,” Grimmett said. “Professional counselors are experts in feelings and emotions and learning parts of your life that may have influenced how you see things or how you go through things. These are parts of your life that typical, everyday people like friends might not have the knowledge to help you through.” 

Grimmett acknowledges that some people may feel wary of speaking with a counselor, or taking their child to see one, as it takes a lot of trust to be able to share private information and personal problems with a stranger. While he believes that it is the job of the counselor to demonstrate they are trustworthy by building relationships with reluctant groups, there are also steps that parents and caregivers can take to feel more comfortable.

For example, a good counselor, Grimmett said, will welcome questions from parents and caregivers about themselves and the counseling process. An interview session to get to know a potential counselor, he said, is usually free of charge and can help determine if a counselor is the right fit for a child. 

“Even with my own counseling, I definitely interview my counselors,” he said. “Every counselor is not going to be a great fit for you, so it makes sense to take some time to read about them on their website, maybe do an initial interview and then decide if that person seems like they’ll be a good match.”

Providing Counseling Where it’s Most Needed

Unfortunately, for many people, counseling services are out of reach because of financial or even geographical barriers. For this reason, Grimmett founded the Community Counseling, Education, and Research Center (CCERC) at NC State. 

CCERC helps educate and train master’s and doctoral students in the College of Education’s Counselor Education Program by having them provide counseling services to people in the community who do not have health insurance or could not afford to pay out of pocket for mental health services. 

Master’s students who provide counseling services at CCERC are under clinical supervision, meaning that they are receiving feedback from doctoral students and faculty on their sessions — which are recorded with client permission — based on best practices. 

“Here, you know that while your student counselor is in training, they are getting a lot of support from their clinical supervisor, their faculty members, and they are getting regular guidance on how to be helpful,” Grimmett said. 

Although CCERC does have some limitations (i.e. it’s closed during the summer months and does not provide 24/7 crisis counseling services), Grimmett said their counselors are equipped to help people through issues that range from depression and anxiety to relationship issues and trauma. 

“We have a world class standard. We don’t want there to be any difference between someone who has a whole lot of money and someone who has no money in terms of the quality of services that they receive,” he said.