Children
Mental health problems affect about one in ten children and young people. They include depression, anxiety and conduct disorder, and are often a direct response to what is happening in their lives.
The emotional well-being of children is just as important as their physical health. Good mental health allows children and young people to develop the resilience to cope with whatever life throws at them and grow into well-rounded, healthy adults.
Things that can help keep children and young people mentally well include:
- being in good physical health, eating a balanced diet and getting regular exercise
- having time and the freedom to play, indoors and outdoors
- being part of a family that gets along well most of the time
- going to a school that looks after the well-being of all its pupils
- taking part in local activities for young people.
Other factors are also important, including:
- feeling loved, trusted, understood, valued and safe
- being interested in life and having opportunities to enjoy themselves being hopeful and optimistic
- being able to learn and having opportunities to succeed
- accepting who they are and recognising what they are good at
- having a sense of belonging in their family, school and community
- feeling they have some control over their own life
- having the strength to cope when something is wrong (resilience) and the ability to solve problems.
Most children grow up mentally healthy, but surveys suggest that more children and young people have problems with their mental health today than 30 years ago. That’s probably because of changes in the way we live now and how that affects the experience of growing up.
Dealing With Change
Mostly things that happen to children don’t lead to mental health problems on their own, but traumatic events can trigger problems for children and young people who are already vulnerable.
Changes often act as triggers: moving home or school or the birth of a new brother or sister, for example. Some children who start school feel excited about making new friends and doing new activities, but there may also be some who feel anxious about entering a new environment.
Teenagers often experience emotional turmoil as their minds and bodies develop. An important part of growing up is working out and accepting who you are. Some young people find it hard to make this transition to adulthood and may experiment with alcohol, drugs or other substances that can affect mental health.
Risk Factors
There are certain ‘risk factors’ that make some children and young people more likely to experience problems than other children, but they don’t necessarily mean difficulties are bound to come up or are even probable.
Some of these factors include:
- having a long-term physical illness
- having a parent who has had mental health problems, problems with alcohol or has been in trouble with the law
- experiencing the death of someone close to them
- having parents who separate or divorce
- having been severely bullied or physically or sexually abused
- living in poverty or being homeless
- experiencing discrimination, perhaps because of their race, sexuality or religion
- acting as a carer for a relative, taking on adult responsibilities
- having long-standing educational difficulties.
How Parents Can Help
If they have a warm, open relationship with their parents, children will usually feel able to tell them if they are troubled. One of the most important ways parents can help is to listen to them and take their feelings seriously. They may want a hug, they may want you to help them change something or they may want practical help.
Children and young people’s negative feelings usually pass. However, it’s a good idea to get help if your child is distressed for a long time, if their negative feelings are stopping them from getting on with their lives, their distress is disrupting family life or they are repeatedly behaving in ways you would not expect at their age.
Types of Mental Health Problems
These are some of the mental health problems that can affect children and young people. You can find out more from the Mental Health Foundation booklet Whatever Life Brings.
Depression affects more children and young people today than in the last few decades, but it is still more common in adults. Teenagers are more likely to experience depression than young children.
Self-harm is a very common problem among young people. Some people find it helps them manage intense emotional pain if they harm themselves, through cutting or burning, for example. They may not wish to take their own life.
Children and young people with generalised anxiety disorder (GAD) become extremely worried. Very young children or children starting or moving school may have separation anxiety.
Post-traumatic stress disorder can follow physical or sexual abuse, witnessing something extremely frightening of traumatising, being the victim of violence or severe bullying or surviving a disaster.
Children who are consistently overactive (‘hyperactive’), behave impulsively and have difficulty paying attention may have Attention Deficit Hyperactivity Disorder (ADHD) Many more boys than girls are affected, but the cause of ADHD isn’t fully understood.
Eating disorders usually start in the teenage years and are more common in girls than boys. The number of young people who develop an eating disorder is small, but eating disorders such as anorexia nervosa and bulimia nervosa can have serious consequences for their physical health and development.
Professional Help
If your child is having problems at school, a teacher, school nurse, school counsellor or educational psychologist may be able to help. Otherwise, go to your GP or speak to a health visitor. These professionals are able to refer a child to further help. Different professionals often work together in Child and Adolescent Mental Health Services (CAMHS).
Talking it Through
Assessments and treatments for children and young people with mental health problems put a lot of emphasis on talking and on understanding the problem in order to work out the best way to tackle it. For young children, this may be done through play.
Most of the time, the action that professionals recommend is not complex. and it often involves the rest of the family. Your child may be referred to a specialist who is trained to help them explore their fee
Medication
Most research into medications for mental health problems has focused on adults, rather than children. Children and young people need to be assessed by a specialist before they are prescribed any drugs. There is a lot of evidence that talking therapies can be effective for children and young people, but drugs may be also help in some cases.
Confidentiality
The professionals supporting your child will keep information about them and your family confidential. Young people can seek help on their own, either by ringing a helpline or by approaching a professional directly, but your consent is usually needed for them to get medical care if they are under 16. Young people have a right to privacy if they do not want to talk to you about their conversations with professionals, but you should still respond sensitively if they seem to be upset.
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Christmas
Christmas can be a challenging time for our stress levels and it’s even harder for those of us with mental ill-health.
So many things that are part of our routines and we take for granted become disrupted by the change of pace in our lives.
Leaving all your preparations for Christmas until the last minute can cause unnecessary stress, but planning ahead can save you time and money. Making lists for jobs to do, presents to buy and groceries you’ll need helps to organise your thoughts, prevents you forgetting something (or someone) and makes it easier to stick to a budget.
Shopping online can save you even more money, as well as avoiding the stress and crowds of the Christmas shopping season. Some online stores will even deliver as late as Christmas Eve and many offer Click and Collect services. If the expense of Christmas is causing you anxiety, you may find this advice from a Money Saving Expert useful.
Alcohol
The celebratory spirit of Christmas and New Year often involves social drinking and although the consumption of alcohol might make you feel more relaxed, it is important to remember that alcohol is a depressant and drinking excessive amounts can cause low mood, irritability or potentially aggressive behaviour. By not exceeding the recommended number of safe units, you will be better able to sustain good mental and physical wellbeing.
Food
The festive period has become synonymous with over-indulgence, which in turn prompts a pressing desire for many of us to lose weight in the New Year. Where possible, maintain a good balance of fruit, vegetables, carbohydrates, protein and omega 3 sources throughout the year in order to be in good physical condition and have sufficient energy. Maintaining a healthy diet and weight can improve your mood and can work towards preventing symptoms of lethargy and irritability that many of us feel during the busy festive season and dark winter months.
Exercise
Physical activity releases the feel-good chemicals, endorphins, which help you to relax, feel happy and boost your mood. By undertaking simple tasks such as cycling to work, walking in the park, or joining in with Christmas games, you can benefit from experiencing reduced anxiety, decreased depression and improved self-esteem. In addition, recent research has indicated that regular exercise can help to boost our immune systems, enabling us to better fight off colds and flu viruses that are prolific in winter months.
5 ways to stay active over the Christmas period
- Go ice-skating! At this time of year there are a number of outdoor ice-rinks around various locations to enjoy.
- Go for a winter walk! It is a less strenuous form of exercise than going for a hard-core session in the gym. Prefer to be indoors? Why not dance to some festive tunes. A fun way to burn off the Christmas turkey!
- Take advantage of the Christmas weather. If it snows perhaps build a snowman or have a snowball fight.
- Do activities as a family. Over indulgence is hard to avoid around Christmas so why not decide to go for a winter walk with all the family after dinner.
Make a plan to protect your mental health at Christmas time. See our five steps to a less stressful Christmas time in our Plan to Protect section.
Get Involved
The festive period provides us with an ideal opportunity to talk to, visit or engage with the people around us. Face-to-face communication has been shown to improve our mental and physical wellbeing as this interaction produces the hormone, oxytocin, which can benefit our immune system, heart health and cognitive function.
A third of us have a close friend or family member we think is lonely, a Christmas or new year’s resolution to see our friends and family more often can help to boost both our own mental wellbeing, and that of others.
You could arrange a shared experience as a gift for a friend or loved one such as a cookery lesson or cinema outing.
If you’re travelling to visit family or friends for Christmas booking travel in advance can often be much cheaper.
If you are apart from your family then volunteering for a charity or local community organisation can provide that same human contact, as well as help provide essential support and encouragement for others in need. These interactions can easily be sustained throughout the coming year and need not just be for Christmas.
Stay in Touch
There’s nothing better than catching up with someone face-to-face, but that’s not always possible. Give them a call, drop them a note or chat to them online instead. Keep the lines of communication open – it’s good for you! If you’re feeling out of touch with some people, Christmas can be a good opportunity to reconnect with a card, email or phone call. Talking can be a good way to cope with a problem you’ve been carrying around in your head. If something is worrying you, whether it’s work, family problems or other feelings, just being listened to can help you feel supported and less alone. It works both ways: if you open up, it might encourage others to do the same and get something off their mind.
Try to Relax
hristmas can be a very busy and stressful time as we prepare to entertain family and friends, worry about cooking a delicious Christmas dinner, and fit in some last minute present shopping. These feelings of being under pressure can produce symptoms of anxiety, anger and difficulty sleeping which, if prolonged, could have a long-term detrimental impact on your mental health and wellbeing. By exercising more regularly or practicing mindfulness – a combination of meditation, yoga and breathing techniques – you can help to both alleviate the symptoms of your stress and gain more control when coping with difficult situations.
Christmas presents aside, implementing a new exercise regime or signing up for a course in mindfulness – such as Mental Health Foundations online course in mindfulness-based stress reduction – could be your best investment for a more relaxed Christmas and New Year.
You may also find their relaxation podcasts useful.
Do Good
Helping others is good for your own mental health and wellbeing. It can help reduce stress, improve your mood, increase self-esteem and happiness and even benefit your physical health.
Christmas is a good opportunity to volunteer for a charity or local community organisation and provide essential support and encouragement for others in need.
Sleep
Despite many of us having time off work during Christmas and the New Year, our sleep patterns can be disturbed between catching up with friends and family and partying late in to the night. There is mounting evidence on the link between sleep and mental wellbeing, meaning improvements in the quality of your sleep could result in improvements to your overall mental health.
There are several steps you can take towards achieving a better night’s sleep: attempting to get back in to your regular sleep routine as soon as possible after the party period, consuming less alcohol during the festivities, implementing regular exercise into your weekly routine, and taking measures to alleviate your stress. You might find Mental Health Foundations sleep and relaxation podcast useful, and you can find lots more useful advice in their Sleep Well pocket guide.
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Cognitive Behavioural Therapy
Cognitive Behavioural Therapy – commonly known as CBT – is a type of therapy that works by helping you to understand that your thoughts and actions can affect the way you feel.
It teaches you to observe the way your behavior and thoughts can affect your mood, then work to build new habits that help you to feel better.
How does CBT work?
CBT is a talking therapy based on scientific methods. After medication it is the most effective treatment for reducing the symptoms of almost all mental health problems, but especially anxiety and depression. When used to treat anxiety disorders it has also been found to improve overall quality of life.
CBT can help you to stop negative cycles of thoughts, behaviour and emotions by helping you to notice what is making you feel anxious, unhappy or frightened and helping you to manage these factors. By helping you to work out what to change to improve your mood, CBT can allow you to take control of your mental health.
What conditions are treated with CBT?
It can tackle a range of problems including depression, anxiety, obsessive compulsive disorder, eating disorders, post-traumatic stress and schizophrenia. The therapy usually takes place in a series of clearly structured sessions, either with a therapist or as part of a self-help programme. Unlike most traditional talking therapies, CBT sessions focus on current problems and practical solutions rather than problems from your past.
Treatment is usually short-term and for a set length of time (between six and 24 one-hour sessions). CBT is offered by the HSE, especially for treating common problems such as depression and anxiety, and is beneficial for people who want a therapy that works towards solutions, with clear goals and using practical techniques.
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Colleagues
It can be hard to know what to do when someone you work with is going through a tough time or has a mental health problem. But knowing how to support your colleagues can make a huge difference to them.
For many of us, work is a major part of our lives. It is where we spend much of our time, where we may have most contact with other people, where we make our money and where we sometimes make our friends. Having a fulfilling job is good for your mental health and general well-being.
We all go through tough times and work can help us cope or make us feel worse.
Someone you work with may be feeling the distress that comes with life events, such as the loss of someone close. They may say they are at the end of their tether, but feel unable to take time off. Or they may be experiencing panic attacks or a mental health problem like depression.
However powerless you may feel at first, knowing the basics about how to support your colleague can really help you – and them. Working in a supportive team that cares about the well-being of its members can make a huge difference to their ability to cope. You can’t solve your colleague’s problems for them, but there are a few simple steps you can take.
How Do I Know if a Colleague Has A Mental Health Problem
Sometimes it will seem obvious when someone you work with is going through a hard time, but there is no simple way of knowing if they have a mental health problem and sometimes you don’t need to know.
It’s more important to respond sensitively to someone who seems troubled than to find out whether or not they have a diagnosis.
Signs of Depression
People who are depressed may:
- be tearful, nervous or irritable
- have low confidence
- lose interest in their work and find it difficult to concentrate
- feel overwhelmed and unable to deliver what is expected of them
- lose their appetite
- get tired easily.
At worst, they may feel suicidal.
Signs of Anxiety?
Anxiety takes many forms, from general anxiety to anxiety triggered by a particular situation (a phobia). People experiencing anxiety may seem unusually worried or fearful in most situations. They may:
- appear pale and tense
- be easily startled by everyday sounds
- have difficulty concentrating
- be irritable
- try to avoid certain situations.
Panic Attacks
These are usually a sign of anxiety and are common in the workplace. Someone experiencing a panic attack may breathe rapidly, sweat, feel very hot or cold, feel sick or feel faint. A task that other people consider simple may seem impossible to them. The symptoms of a severe panic attack can be quite similar to a heart attack, and someone experiencing one may be convinced they are going to die. Find out more about panic attacks.
Obsessive Compulsive Disorder (OCD)
This is a common form of anxiety involving distressing repetitive thoughts. Compulsions are actions that people feel they must repeat to feel less anxious or stop their obsessive thoughts.
For example, some people cannot stop thinking about germs and the diseases they could catch. To cope with this anxiety, they may wash their hands over and over again. Compulsions commonly involve ritualised checking, cleaning, counting or dressing.
Self Harm
Some people deliberately harm themselves when they are distressed, usually secretly, as a way of dealing with intense emotional pain.
They may cut, burn, scald or scratch themselves, injure themselves, pull out their hair or swallow poisonous substances. Self-harm can be a sign of other mental health problems. Find out more about self-harm.
Why Don't We Talk About Mental Health
I haven’t got bi-polar written on my forehead, but for me it’s not an issue. Some people at work know about it just because it has come up in conversation.
There are good reasons why someone with a mental health problem might not want other people to know. Mental ill health is one of the last taboos. It’s an area many people don’t understand much or talk about often and, as a result, we often act on prejudices. This can lead to unfair treatment – discrimination.
A survey has shown that most people with mental health problems expect to experience discrimination if they talk about their difficulties, but the number who actually experienced discrimination when they did tell someone was much lower.
The media often portray people with mental health problems as dangerous, but people with mental health problems are more likely to be the victims of violence or to harm themselves than to be violent towards other people. See Headline for information about reporting on mental health in the media http://www.headline.ie/
How Can I Help a Colleague in Mental Distress?
When a colleague tells you they have a mental health problem, becomes distressed or starts behaving out of character, it can be very confusing.
It may distress you, too. It can seem easier to ignore the situation than to try to provide support. But providing support at work can make a huge difference to someone’s life.
The most important thing you can do is treat them with respect and dignity. Talking with your colleague is the first step towards finding out how they would like you to support them.
Why is it Important to Talk?
It can be a very big deal for a person to discuss how they feel and they may feel ashamed to ‘admit’ their problem. Be open and tell them that you care.
Let your colleague know that you are there if they want to talk. Make sure you can talk somewhere quiet and private. You may want to have lunch or a coffee or go for a walk together to keep the conversation between the two of you.
Once you have found a time and place for a private chat, make sure that you won’t have to run off to a meeting or take a phone call. Make sure the time is convenient for both of you.
- Let your colleague share as much or as little as they want to. Ask questions to help you understand what they are going through, but tell them that they don’t have to answer any questions that make them feel uncomfortable. Make it clear that you don’t blame them for their problems.
- Don’t try to diagnose someone or second guess their feelings. You probably aren’t a medical expert and, while you may be happy to talk and offer support, you aren’t a trained counsellor. Try not to make assumptions about what is wrong or jump in too quickly with your own diagnosis or solutions.
- Keep your questions open-ended. Say “Why don’t you tell me how you are feeling?” rather than “I can see you are feeling very low”, and try to keep your language neutral. Give the person time to answer and try not to grill them with too many questions.
- Reassure them that what they tell you is private. Ask them if they have discussed their situation with others and if they do or don’t want you to mention it to anyone else. Ask them how they would like you to help them.
- Talk about well-being. Exercise, good diet and relaxation can all help improve everyone’s mental well-being. Talk about ways of de-stressing and ask your colleague if there is anything that they find helps. Ask if your colleague is in touch with any self-help groups or has supportive friends.
The Power of Words
The words you use can have a powerful effect on how people feel. Jokes and banter may seem harmless, but saying “Keep taking the pills” or calling someone a ‘nutter’ can be hurtful, and makes it less likely they will open up.
It’s worth remembering that this can be classed as harassment and bullying and can result in disciplinary action. If you aren’t sure if a comment is offensive, think about how you would feel if it was directed at you.
What are The Tips for Listening?
Sometimes the most important part of talking is letting the other person know that you are listening.
- Listen carefully to what your colleague is saying to you and repeat what they have said back to them to ensure you have understood it
- Try to interpret the words in terms of feelings so you could respond “I can see that it makes you very unhappy when…”
- You don’t have to agree with what your colleague is saying, but by showing you understand how they feel, you are letting them know that you respect their feelings
- If you disagree, be open and honest about it, and continue to listen to what they have to say.
How Do I Respond To A Crisis?
People with mental health problems sometimes experience a crisis, such as breaking down in tears, having a panic attack, feeling suicidal, or losing touch with reality. This can be a response to a build-up of stress at work or at home. You may feel a sense of crisis too, but it’s important to stay calm yourself.
There are some general strategies that you can use to help.
- Listen to your colleague without making judgements.
- Reassure them and offer practical information or support.
- Ask your colleague what would help them.
- Avoid confrontation, even if they become agitated or aggressive.
- Don’t send them home if they would prefer some quiet time to themselves.
- Encourage them to get appropriate professional help.
- If you are aware that a colleague has self-harmed, make sure they get the first aid they need.
Seeing, hearing or believing things that no one else does can be the symptom of a mental illness. It can be frightening and upsetting. Gently remind your colleague who you are and why you are there. Don’t reinforce or dismiss their experiences, but acknowledge how they are making your colleague feel.
Helping someone with a mental health problem through a crisis can be stressful and upsetting. It is important to talk it through with your HR manager or boss or a friend without identifying your colleague.
How Do I Respond If a Colleague is Suicidal?
If your colleague says they are feeling suicidal or can’t go on, or if you suspect they are thinking of taking their own life, it is very important to encourage them to get help.
They could contact The Samaritans straight away. They can call 116 123 at any time (free phone).
They could also get help from their friends, family, GP or mental health services.
You can ask your colleague how they are feeling and let them know that you are available to listen. Talking can be a great help to someone who is feeling suicidal, but it may be distressing for you too.
It is important for you to talk to someone about your own feelings and Samaritans can help you as well. Or you may just want to talk to a friend or family member, without mentioning your colleague’s name.
What Can I Do As A Manager?
Managers often find it difficult to deal with someone they think has a mental health problem, particularly if the person or they themselves are reluctant to talk about it. But it’s important to talk.
- Take time to talk to the person privately and ask if something is wrong. Take your steer from them. Don’t try to diagnose what you think is the matter.
- Ask what would help them at work. They may need a quiet place to work or more time to perform certain tasks.
- If they haven’t been performing as well as usual, they may feel guilty or fearful about it. Be honest in assessing their performance – they may feel their performance is worse than it is.
- It can be useful to agree in advance how to handle any continuing problems. Encourage your colleague to identify factors that might play a role in them becoming unwell and consider how to deal with them. You may also want to agree how best to respond to a crisis.
- Don’t make assumptions about what someone can and can’t do.
- Be aware that new computer systems or other changes, restructuring or the risk of redundancy can be especially difficult for someone who is also coping with a mental health problem.
- In the language you use and the attention you give them, treat them with respect and act as a model to encourage other colleagues to do the same.
- Suggest they ask for advice from your occupational health advisor or contact any support service your organisation uses such as the Employee Assistance Programme.
- After your first conversation, fix another meeting to check how your colleague is coping and whether further changes to their working arrangements are needed. Then keep the dialogue going.
What About Keeping In Touch and Returning to Work?
Keeping in touch
Many people who have mental health problems dread returning to work after they have been off sick. And it can be awkward to know what to say when people have been ill, especially if it has never been talked about. There are ways of keeping in touch that will help overcome that awkwardness later on.
- Ask the person who is off work what they would like their colleagues to be told. Try to get a balance between maintaining their confidentiality and letting people understand what’s happening.
- Invite them out when staff are spending leisure time together. They may decline, but still appreciate being asked.
- Send cards and call your colleague if you would normally socialise with them – just as you would if they had a physical health problem.
- Have a ‘cup of tea’ policy where someone can come into the office informally before returning to work.
Returning to work
Coming back to work after a period off sick due to mental ill health can be exhausting. In some jobs, the person could begin by doing a task at home.
Sometimes a phased return to work can be helpful, with someone working a few hours a day and building back up to working their contracted hours. If you’re unsure what is reasonable, ask for advice from your HR manager or occupational health advisor.
How can I create a healthy workplace?
You don’t have to have a mental health problem to have mental health or well-being needs. A workplace that is positive about mental health supports the well-being of all employees, as well as encouraging openness about mental health problems.
Looking after staff has benefits. It encourages loyalty and brings out the best in all employees.
Job design and matching people to the right role is also key. Advice from your HR manager or an external HR advisor can be a great help in making sure your workplace is healthy.
What Does The Law Say?
Employers and staff should be aware of the law relevant to mental health at work.
Ireland’s equality legislation exists to protect people from certain kinds of discrimination. People with mental health difficulties are covered under this law, as part of the disability category. The law applies to you if you are currently experiencing mental health difficulties, or if you have experienced mental health difficulties in the past. The aim of equality legislation is to help you:
- Access employment
- Participate and advance in employment
- Undertake training
There are two main equality laws:
- The Employment Equality Acts, 1998- 2011 protect people from employment discrimination. This includes discrimination in finding a job, keeping a job or doing work experience or vocational training. They also include advertising, equal pay, promotion and dismissal.
- The Equal Status Acts, 2001-2011 protect people against discrimination when buying or accessing goods and services. This could include discrimination when accessing healthcare, education, social opportunities or while looking for accommodation.
MentalHelp.ie have some useful information about employment law and mental health in Ireland.http://mentalhelp.ie/equality-law/
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