The Essential Parents’ Guide to Teen Mental Health

20 minute read

16 October 2024

In 2023, the NHS reported that around one in five (20.3%) children in England aged between eight and 16 had a probable mental health disorder. 

From depression and a loss of interest in school, to self harm and disordered eating, teenagers can face a myriad of complex mental health problems, and knowing how to approach these can feel completely overwhelming for parents.

This guide seeks to offer parents and carers information on spotting early warning signs of mental health concerns in your children, and advice on managing and minimising symptoms. It also explores the importance of parental mental health, both as a risk factor and as an effect of poor mental wellbeing in teens.

Teen Mental Health Statistics

  • Nearly half (49.5%) of teenagers have had a mental health disorder at some point in their lives 
  • The most common mental health challenges teenagers face are anxiety-related, with anxiety disorders occurring in nearly a third (32%) of 13-17-year-olds
  • Globally, the number of teens with clinically elevated anxiety symptoms nearly doubled during the first year of the COVID pandemic
  • Teens aged 11-16 with a probable mental disorder are less likely to report feeling safe in school (61.2%), than their peers (89.2%)
  • Rates of online bullying are more than doubled in children with a probable mental disorder (29.4%), versus their peers (12.6%)

School and Exam Anxiety

More than a quarter (28%) of secondary pupils in the UK say they have avoided going to school as doing so would make them anxious. The COVID pandemic had a clear impact on this pattern of mental-health linked ‘school refusal,’ with the Department for Education reporting that the number of absences in the Spring 2023 school term were 50% higher than before the pandemic. 

There can be a myriad of reasons that your child may be facing school-centred anxiety, including stress around doing well in exams, struggles with the workload, feelings of inadequacy, or bullying.

Signs and symptoms that your child may be suffering from school and/or exam anxiety:

  • They have become overly hard on themselves when a test or essay doesn’t go as well as they hoped. They may impose self-punishments, such as banning themselves from watching TV, or having to study for X hours every night.
  • They have started studying excessively, foregoing sleep to study until the early hours of the morning.
  • They are refusing to go to school, or are unable to get up in the mornings.
  • Teachers are reporting that they are acting out at school.
  • They have withdrawn from their old friendship group.
  • They are on their phone more often, and seem unhappier after being online.

Tips to minimise and help with school and/or exam anxiety:

  • Agree on break times together, and try to join in on these. For example, getting outside into the fresh air is important for both mental and physical health, so agree to take a walk in the middle of studying. Make sure this is a true break – avoid asking them probing questions about school or their homework.
  • If your teen appears to be struggling with the workload, consider setting up a meeting with their teacher or a member of the school’s support staff to discuss next steps.
  • Through talking with your child and their teachers, identify if there is a particular subject your child is struggling with, which is causing them stress. It can be beneficial to enlist the help of a tutor, who can provide 1:1 support on the subject outside of the pressure of a class setting, and help build confidence so they feel better able to tackle the class in school. 
  • If your child is getting overwhelmed by anxious feelings in class, discuss with their school the possibility of an ‘exit card,’ which allows them to take a short break in a designated calm space.

Top resource for parents dealing with school and exam anxiety: Not Fine In School

This resource is aimed at providing parents who are struggling with school refusal with a community, focused on support, empowerment and awareness. Not Fine in School offers a Facebook group, with over 59,000 parent and carer members, where parents can share their experience and find community in others.

Teen self-harm

Finding out that your child is engaging in self-injury can be very distressing. However, it is, unfortunately, an increasingly common occurrence. 

In the year ending March 2022, there were over 25,000 hospital admissions throughout the UK for self-harm among children ages eight to 17, a rise of 22% in just a year. This statistic, though upsetting, is also unlikely to tell the whole story, as one in four (25%) young women and one in ten (10%) young men say they have self-injured at some point in their lives.

Typically, teenagers turn to self-harming to help manage bad feelings. By experiencing physical pain, they may feel distracted, momentarily, from the emotional pain they are going through. Self-harm can also be a means of exerting control when they feel helpless. 

Self-harm is not restricted to cutting, as typically thought, but encompasses any reckless or painful self-sabotaging treatment, including: 

  • Burning oneself with lighters, matches, cigarettes, open flames, or scalding water
  • Punching oneself
  • Hitting ones head against the wall
  • Ingesting toxic chemicals
  • Unsafe sexual behaviour
  • Misusing drugs and alcohol
  • Exercising too much
  • Restricting food and/or water intake
  • Over-eating
  • Picking at scabs
  • Risky behaviour, such as provoking fights in which they are likely to get hurt

Signs and symptoms that your child may be self-harming:

  • Unexplained cuts, bruises, marks, or burns.
  • They are keeping themselves covered, for example wearing only long sleeves and long trousers, particularly in summer months or when this is different to their usual clothes.
  • They have withdrawn from activities they used to enjoy, such as swimming, as they don’t want to reveal their skin.
  • Changes in eating habits
  • Their mood is low and they are showing symptoms of depression.
  • They are more irritable than usual, and may be prone to outbursts of anger.

Tips to help teenagers who are self-harming:

  • When talking with your child, talk about the feelings behind the action, rather than the self-harm itself. If your teen struggles to discuss this with you, engage the help of a therapist by contacting CAMHS (child and adolscent mental health services).
  • Work together to find ways of venting their frustrations that don’t involve harming themselves. This could be something like writing down their feelings and then ripping the paper up, or screaming into a pillow.
  • Make suggestions on other means of physical distractions, such as snapping a hairband on their wrist or squeezing ice (both of which cause physical discomfort, without scarring). Keep in mind that this swap should not be the end goal, but a safer physical distraction while they learn to confront their feelings.
  • If you are unable to meaningfully engage with your teen about their self-harm, ensure they have access to first-aid supplies, such as plasters and antiseptic. This is a form of ‘harm-reduction,’ which means minimising the risk and trying to make the act of self-injury as safe as possible.

Top resource for teens who are self-harming: Alumina

This is a free online course for young people aged 10-17, run by trained counsellors and volunteer youth workers. The course lasts seven weeks, and is accessed online via a chat forum, so teens don’t need to speak out loud or show their face. It covers tools to help young people quit-self harming, and facilitates reflection to uncover the individual causes behind the self-injury.

Eating Disorders in Teens

Of the 24,300 UK hospital admissions for patients with eating disorders in 2020-21, almost half were under the age of 25 (11,700).  Instances of eating disorders in young people also rose following the COVID pandemic – while the NHS anticipated 2,700 diagnoses between 2020 and 2022, 3,862 were reported, indicating a 42% increase on the expected trend.

Typically, people think of disordered eating as simply restriction, and therefore weight loss, however overeating is also a common outcome. There are several different types of eating disorders, including anorexia nervosa, bulimia, and binge-eating disorder. Sometimes, symptoms do not fit into one of these categories, so a diagnosis of Other Specified Feeding or Eating Disorder (OSFED) may be given. 

Social media can be a minefield for triggering low self-esteem, particularly in teenagers, whose bodies are naturally changing. The prevalence of filters and edited content can fuel feelings of unattractiveness and unworthiness in teenagers, who long to look like the others they see on the internet.

Unfortunately, there are also communities online where users encourage and support each other’s disordered eating, referred to as pro-ana (anorexia) and pro-mia (bulimia) groups. While we cannot control what our teen is doing online, it’s important to be aware of groups like this so you can be aware of the signs of engagement in your children.

Disordered eating is not only borne out of poor body image, but can also be caused by feeling a lack of control. Restricting food intake can feel like a way to exercise control and certainty, when other parts of life appear to lack this.

Signs and symptoms that your child may be suffering from disordered eating:

  • Leaving the table quickly after meals – this may be a sign of purging (being sick) or trying to hide uneaten food.
  • Exercising an excessive amount.
  • Changes in attitudes to mealtimes, such as refusing to eat around others.
  • Lack of self-confidence, particularly related to appearance
  • If you are finding excessive amounts of food wrappers, particularly when hidden somewhere they think you won’t find.

Tips to minimise and help disordered eating:

  • As a family, agree that you will not discuss portion sizes or calorie counts around the affected teen.
  • Build meal plans with your child to find a level that you both agree on. However, at mealtimes, if you are concerned they are becoming overly involved with preparation as a means of control, divert them to other dinner-related tasks, such as setting the table or washing up.
  • Eating disorders are very complex, and often cannot be managed by a family alone, you should contact CAMHS or your child’s GP in order to access specialised eating disorder support.
  • If your child is receiving treatment from a doctor, consult with them on how to manage mealtimes.

Top resource for disordered eating in teens: Beat

Beat is the UK’s leading charity for those struggling with eating disorders. They have resources directly targetted at helping teens seek support, as well as a wealth of information on looking after yourself and where and how to find help.

Having difficult conversations about mental health with your teenager

Overwhelming, distressing, confusing – you are bound to feel a huge range of emotions if you have noticed signs of mental health struggles in your child. It can be exceptionally difficult to know how to broach these worries, as you may feel uncomfortable, scared of what they’ll say, or worried you will say the wrong thing.

When approaching these difficult conversations it can help to feel prepared. Be sure to pick a time and place that you think will work for both of you – avoid times when they have homework weighing on their mind, or when you are unable to give them your full attention. You may also find it helpful to practice what you want to say or how you wish to start the conversation. 

Be sure to de-centre yourself from the conversation. While it can be helpful to start the chat by saying “I’ve noticed you’ve been feeling down recently” or “I’d like to talk to you about something,” the focus of the conversation should not be about how their actions or emotions are making you feel. It’s important that they feel heard and that you are interested in what they have to say.

You may not feel successful, and that’s okay. It’s natural for your child to be avoidant about difficult feelings, and this may manifest in them getting angry or lashing out. It’s important to not push the conversation if this happens, as this is likely to upset them further. Remind them that you are there for them, and suggest some resources if they are not ready to talk about their worries yet.

Although you may wish that, as their parent, you are the one your child will want to turn to, you need to be open to the fact that they may not feel comfortable discussing their mental health with you. If your child has indicated this, be sure to let them know that there are other adults in their life that they can turn to – other older relatives, their teachers or someone trusted at school, or their GP.

Tips for broaching conversations about mental health with your child:

  • Consider alternate settings for chatting – for instance, your child may be more open if you broach the conversation while driving, as they may feel more comfortable when you’re not looking directly at them.
  • They may find it hard to express themselves, particularly if they feel confused about their feelings themselves. Offer them the chance to write down their feelings over text or through a letter, if they appear to struggle with direct conversation.
  • Remain calm. You may feel upset or even angry at what your child says, but it’s important to keep the conversation calm, otherwise they may not feel able to come to you again in the future, for fear of your reaction.
  • A conversation does not need to be long to be impactful. You may feel you have a lot to say and a lot you would like to hear, but the thought of a long, in-depth conversation may be overwhelming for your child. It’s okay to have a touching-base conversation to find out how they are feeling, and to let them know that you are available to talk to whenever they feel ready.

Top resource for handling difficult conversations: Young Mind’s glossary

When preparing to discuss mental health and wellbeing with your child, you may be worried about finding the right words to say, or understanding your teen’s worries. Young Mind’s glossary is an excellent tool for empowering and informing your speech.

Don’t forget to look after yourself, too

Dealing with your teen’s mental health can take a big toll on your own, and you won’t be best equipped to help your child if you are struggling too. It’s important that you take time for yourself, and that you reach out to friends or other family members for support.

Some parents, particularly those from marginalised communities, may feel stigmatised for having a child with mental health problems, which can deter them from seeking help. However, if you feel uncomfortable reaching out to your own network or community, there are spaces dedicated to helping parents who are coping with child mental health issues.

The Charlie Waller Trust offers a service called PLACE parent support. The PLACE network offers parents and carers the ability to connect with others facing similar issues, as well as access to monthly support meetings with other parents and professionals to share advice and comfort.

The link between parental and child mental health issues

Being a parent is no easy task, with Unicef UK reporting that seven in ten (70%) parents believe that it is getting harder and harder to be a parent in Britain, and more than six in ten (61%) reporting concerns about their own mental health, including feeling overwhelmed, anxious, and lonely.

No man is an island, and no child grows up in isolation. Research from Harvard University has identified that children whose parents suffer from poor mental health are more likely to suffer from these issues themselves.

The study found that depressed teens are five times more likely than their non-depressed peers to have a parent suffering from depression, while anxious teens are around three times more likely than non-anxious teens to have an anxious parent.

These statistics highlight the importance of managing our own mental health, in looking after that of our children. This idea, confounded as providing ‘care for the caregivers,’ emphasises the importance of addressing mental health issues in parents, so that these healthy approaches are reflected in children.

A key way to address the link between parental and child mental health, is to seek family therapy options as part of your teens’ treatment plan. Rather than considering your child’s struggles in isolation, it’s important to consider them in the context of the broader family, allowing them to air their worries about family life.

Other Helpful Teen Mental Health Resources

There are a wealth of resources online that can help you broach the subject of mental health with your children. Along with advice for parents, these sites also offer tools for children to learn how to look after their emotional wellbeing.

Action for Children

Action for Children is dedicated to ensuring that every child and teenager has a safe and happy childhood, basing their work on helping children build the foundations they need to thrive.

The charity’s work is divided into three stages of action: intervention, prevention, and advocacy. 

Action for Children’s ‘Blues Programme’ aims to teach children emotional resilience and give them the tools to open up to friends and family. Nearly four-fifths (77%) of students who have participated in the programme said that it improved their confidence.

stem4

stem4 is a digital mental health charity which aims to meet young people on their terms, online. 

The charity has created five evidence-based mental health apps teaching wellbeing tools across a range of common mental health concerns, including self-harm, anxiety, depression, and eating disorders.

The charity also champions the emotional wellbeing of parents, as the founders of Parent Mental Health Day. This is marked every January 30th and aims to develop understanding and awareness of the importance of parents’ mental health and wellbeing and its impact on the whole family system.

Young Minds

In 2020 Young Minds set out their ‘You Matter’ strategy to prevent children reaching a crisis point with their mental health, and parents play a big role in this.

Alongside ‘Never Alone,’ which aims to help young people look after their emotional wellbeing, and ‘Powerful Young Voices,’ the building of a youth-led movement, Young Minds has set out their ‘Someone To Turn To’ programme.

This programme aims to teach adults the tools to help the young people in their lives, ensuring children always have someone to turn to.

Young Minds also offers a parents’ helpline, available over the phone and via online chat, where you can access advice and support for parents and carers of children and young people aged 25 and under.

References

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