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Children’s mental health - Every Mind Matters

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See tips and advice for parents and carers on how to support children and young people’s mental wellbeing, and give them the best chance to stay healthy.

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A decent night's sleep will help children to learn more effectively and make them less susceptible to minor ailments,

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Using CBT to support our children's anxiety

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Using CBT to support our children's anxiety

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Clinicians at Anna Freud have developed seven ways that we consider to be best practice in responding to children and young people's fears.

This resource is informed by a Cognitive Behaviour Therapy (CBT) approach to managing anxiety. CBT is one of the therapeutic approaches which is most commonly used to treat anxiety and depression. It is recognised by the NHS NICE guidelines as a suitable evidence-based treatment.

CBT is a talking therapy which can help people to manage their feelings or problems by changing the way that people think and behave. It offers a practical approach which aims to help people tackle problems that can feel overwhelming by breaking them down into smaller parts and by challenging negative thinking and/or behavioural patterns in order to improve the way that they feel.

This document is not intended as a substitute for therapy but to outline some of the principles that can be easily adopted to support children and young people.

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Seven ways to support children and young people who are worried

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This guide identifies seven ways you can use CBT to help children and young people who may be experiencing anxiety.

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7 ways to support children who are worried

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7 ways to support children who are worried

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Introduction

Mental health is as important to a child's safety and wellbeing as their physical health. It can impact on all aspects of their life, including their educational attainment, relationships and physical wellbeing. Mental health can also change over time, to varying degrees of seriousness, and for different reasons.

And we know it's an important issue for children. Over half of all Childline counselling sessions in 2022/23 related to mental or emotional health and wellbeing.

Negative experiences such as abuse and neglect can adversely impact a child's mental health. Mental health issues can also sometimes lead to safeguarding and child protection issues, for example if a child's mental health begins to put them or other people at risk of harm.

Supporting children with mental health issues

It can be hard for adults to recognise when a child needs support with mental health issues. And it can be difficult for young people to speak out about the challenges they're facing.

So it's crucial that anyone who works or volunteers with children is able to recognise the signs that a child may be struggling with their mental health. And that they know how to take appropriate action to support children and young people in getting the help they need.

We've put together some information to help you recognise and respond to concerns about children and young people's mental health.

What does mental health mean?

Mental health is an individual's cognitive, behavioural and emotional wellbeing (Mind, 2020). It's something we all have - including every child and young person.

We use the term "mental health issues" to refer to mental health problems, conditions and mental illnesses. These issues may or may not be medically diagnosed.

Who is at risk?

Who is at risk?

Any child or young person can develop mental health issues. But research has shown there are some factors that are associated with children and young people's long-term mental health.

Abuse and neglect

The traumatic impact of abuse and neglect increases the likelihood of children developing a range of mental health issues - both during childhood and in later life. These include anxiety, depression, eating disorders and post-traumatic stress disorder (PTSD) (Norman et al, 2012; Spatz Widom, 1999).

Specific types of abuse may be connected to certain mental health issues. Children who have experienced emotional abuse may be more likely to develop anxiety and depression compared with children who have experienced other types of abuse (Cecil et al, 2017; Gavin 2011). One study found that almost three quarters (74%) of young people who had experienced sexual assault developed PTSD (Lewis et al, 2019).

Abuse and neglect can also make children more vulnerable to developing more than one mental health condition at one time (known as composite mental health issues) (Chandan et al, 2019).

Providing effective mental health support for children who have experienced abuse and neglect can help them recover from its effects (NSPCC, 2019b).

d/Deaf and disabled children and young people

d/Deaf and disabled children and young people with complex or additional needs may face a range of challenges including:

reduced mobility

prejudice, discrimination and bullying.

These challenges may lead to lower self-confidence, difficulty forming peer networks and social exclusion, putting them at higher risk of developing mental health issues (Falcounbrige, Hunt and Laffan, 2019).

Adults may confuse the signs of learning disabilities with the symptoms of mental health issues. This can mean concerns aren't recognised and responded to quickly or appropriately.

Children from Black, Asian and minority ethnic communities

Children from black and minority ethnic groups may experience:

racism, discrimination and prejudice - this can be direct, indirect or institutional

an increased stigma around mental health issues in the community.

This can lead to inequalities and issues in accessing appropriate care and support for mental health needs (Bignall et al, 2020).

LGBTQ+ children and young people

LGBTQ+ children and young people may experience:

prejudice, discrimination and bullying

a fear of or an actual rejection from family and/or friends

feeling excluded or like an outsider.

They may also experience gender dysphoria: the unease felt when someone's sex registered at birth does not match their identity.

These factors and experiences mean they are more likely than their heterosexual and cisgender peers to experience a range of mental health problems (Chakraborty et al, 2011; Becerra-Culqui, et al 2018).

Living in care

Children in care are more likely than their peers to have a mental health difficulty (NSPCC, 2019c). This can be due to isolation and loneliness. Children in care may also have experienced abuse or neglect, which increases the likelihood of developing mental health issues (National Youth Advocacy Service, 2019).

Young carers

Young carers are more likely to experience mental health problems than peers who don't have caring responsibilities (Sharpe, 2021).

Young carers may:

feel worry or stress about the health and wellbeing of the person/s they care for

feel that they must manage or hide their emotions due to fear or guilt of upsetting the person/s they care for

feel that they don't have time for themselves and are missing out on opportunities or activities.

Excessive or inappropriate caring roles and a lack of support from services can be risk factors in a young carer experiencing poor mental health. (Carers Trust, 2023; 2016; 2023; Sharpe, 2021).

Life events

Stressful or traumatic situations and experiences, such as bereavement or sudden changes in environment, can trigger mental health issues.

Social isolation and loneliness

Anyone can experience loneliness, but risk factors include:

having a long-term health condition or disability

having caring responsibilities

living in care

being from an ethnic minority community

being LGBTQ+

(Mental Health Foundation, 2022).

Studies show that there is a strong association between social isolation and anxiety and depression in children and young people (Almeida et al, 2021).
> Find out more about our Building Connections service to help young people cope with loneliness

Recognising

Recognising issues

Professionals need to be able to recognise the signs that a child may be struggling. However, it's important to remember that some mental health issues may not have visible signs. There are also factors that might make it more difficult for a child or young person to ask for help.

Some children and young people may try to hide how they are feeling or what they are doing (Theodosiou L. et al, 2020). This might be because they:

worry they won't be taken seriously

believe others won't understand

have had a negative experience talking about their thoughts and feelings in the past

feel that no one can help them

fear being dismissed or labelled an attention seeker or 'crazy'

(Mental Health Foundation and Camelot Foundation, 2006).

Children and young people may not always have the language or ability to communicate how they feel. They may be unsure who to talk to and how to talk about their problems.

Some signs of mental health issues may also look like normal child behaviour. For example, tantrums in younger children or teenagers keeping feelings to themselves.

Children who have experienced abuse or neglect

Children who have experienced abuse may be reluctant to talk about how they are feeling, particularly if they haven't yet told anyone about the abuse. They may feel that something is wrong with them or that things may get worse if they talk about it.

Identifying and responding to mental health concerns may be one way of helping children who are experiencing abuse to get the support and protection that they need.

> Find out more about barriers to disclosure of abuse

Signs of child mental health issues

There are ways you can identify if a child needs support with their mental health.

By being attentive to a child or young person's mood and behaviour, you can recognise patterns that suggest they need support.

Common warning signs of mental health issues include:

sudden mood and behaviour changes

self-harming

unexplained physical changes, such as weight loss or gain

sudden poor academic behaviour or performance

sleeping problems

changes in social habits, such as withdrawal or avoidance of friends and family.

These signs suggest that a child may be struggling, but there could be a number of different explanations for them.
Don't attempt to diagnose mental health issues yourself or make assumptions about what's happening in a child's life.
Recognising that a child or young person may be struggling with their mental health is the first step in helping them. The next step is to respond appropriately.

Responding

Responding to child mental health issues

All children and young people should have someone they can talk to about whatever they're going through, regardless of whether they have a mental health condition.

Children may not want to talk specifically about their mental health, but about the struggles and issues in their daily lives (Mental Health Foundation and Camelot Foundation, 2006).

If you are concerned that a child may be struggling, it's important not to wait for them to talk to you before trying to start a conversation. Encourage them to talk with you or with other trusted adults.
> Take our mental health and wellbeing safeguarding children training
Talking with a child about their mental health

If you're talking with a child or young person about their mental health and wellbeing, be prepared that conversations may not be easy or straightforward. There are things you can do to make these conversations as easy as possible.
> Read our information and advice on how to have difficult conversations with children
The following principles will help you discuss mental health and wellbeing sensitively.

Use the right language

When talking with a child, use language that they understand. This will differ according to their age and stage of development. Avoid using technical or diagnostic language which children might find unfamiliar, confusing and distant from their experiences.

Make sure you understand the language the child is using and how they are using certain terms. For example, a child may use the word "anxiety" to describe a feeling of general nervousness or as a way to describe severe anxiety attacks.

By paying attention to the language children use to describe their feelings, you can reflect the terms they use in your own language. This will help them feel listened to.

Some children may have difficulty communicating, for example if they have additional needs or disabilities (Fuggle and Redfern, 2019). Make sure you give these children the time and support they need to talk.

> Find out more about how to have difficult conversations with children and young people

Create an open environment

It's important to create an open and safe environment where children and young people are comfortable speaking about their mental health. Make sure children and young people know who they can talk to - and make this pool of people as wide as possible.

In schools, for example, discussions about mental health and wellbeing can be integrated into the curriculum and put on an equal footing with physical health.

Some children with mental health problems will have experienced abuse. An open environment will help them talk about the challenges they are facing and may help them feel able to tell you what's been happening to them.

> Use our resources to find out how you can let children know you're listening if they tell you they have experienced abuse

> Find out how to recognise and respond to abuse

Promoting mental health and wellbeing

Anyone who works with children and young people has a responsibility to promote their mental health and emotional wellbeing. This can include:

helping with online wellbeing

encouraging exercise

maintaining routines.

> Get tips on promoting children and young people's mental health and wellbeing

Understanding

Understanding thoughts and feelings

Mental health moves back and forth along a continuum, it's always changing. This can happen over a period of time or quite quickly. So it's important to have conversations with children and young people so you can best understand how they're feeling - and any mental health issues that they are experiencing.

Doing OK - Struggling - Unwell - In Crisis

When you speak to a child for the first time, or during ongoing conversations, you may find it useful to think about whether they're doing OK, struggling, unwell or in crisis.

This continuum is based on a model used by Childline counsellors, alongside other tools, that helps them understand how a child is feeling at that particular point in time. You can use it to better understand a young person's mental health and wellbeing.

It's important to remember that a person's mental health changes continuously - so you should refer to this continuum regularly.

Doing OK

Communicates effectively with others

Seeks help when needed

Can focus on specific issues

Has healthy relationships

Identifies and tries to solve problems

Uses healthy coping strategies

Struggling

Struggles communicating with others

Is unsure how to access help

Relationships are beginning to suffer

Begins to use unhealthy coping strategies

Has some sleep issues, low energy and fatigue

Is able to engage well in some areas

Unwell

Feels overwhelmed and isolated

Struggles to focus on specific issues

Struggles to access and/or engage with services

Has disturbed sleep

May have suicidal thoughts

Relies on unhealthy coping strategies

May already have a mental health diagnosis

Is ambivalent towards change

In crisis

Has made recent suicide attempts

Is distrustful of support services

Mental health symptoms are unmanageable

Has escalating self-harming behaviours

Distress may not reduce when talking

Not engaging at home or school

Is resistant to change

Using scaling techniques

Our Childline counsellors sometimes use "scaling" questions to help them understand how a child or young person is doing.

A counsellor gives the child a clear scale - from 0 or 1 to 10 - and asks where they think they sit in relation to a specific question. For example:

If 1 is your mental health at its worst and 10 is at its best, how are you doing at the moment?

If 0 means that you are having a panic attack and 10 means that you feel completely calm and confident, how would you rate the way you feel before going to school?

Counsellors may be able to find out what support children would like by asking how they can move up the scale. For example:

What is it that puts you at a 5 rather than a 6?

What can we do to help you move from a 3 to a 4?

Using the continuum and scaling techniques can help you better understand how a child is feeling so that you take appropriate action to help and support them.

Taking action

Taking appropriate action

Mental health issues indicate that a child or young person needs support. If possible, discuss with them what help could be put in place.

What if a child doesn't want to talk to me?

If a child isn't able to engage with a discussion about their mental health you should still consider what support can be put in place for them.

Follow your organisation's procedures to share any concerns you have about a child's wellbeing. For example, you could talk to the person who is responsible for pastoral care in your school or organisation.

Safeguarding and child protection issues

You must always consider whether you need to take any action to protect a child or those around them from harm.

If you identify a safeguarding or child protection issue, you must follow your organisation's policies and procedures.

Safeguarding issues include:

a child being in immediate and/or significant danger

someone else being in immediate and/or significant danger

a child being at risk of or experiencing abuse.

> Find out more about responding to safeguarding and child protection concerns

Confidentiality

If a child is confiding in you about their mental health they may ask you not to tell anyone what they've said. But if you're concerned about someone's safety and welfare you must share this information with relevant professionals.

You should never promise to keep what a child tells you a secret. Explain from the outset that you might have to talk to someone else who can help.

Getting support

Getting support

There are lots of different types of support available for children with mental health issues. These include the following.

Contacting a GP

GPs may be able to diagnose mental health conditions, suggest next steps and provide medication.

>There is information on the Childline website about visiting GPs

Child and adolescent mental health services (CAMHS)

Across the UK, CAMHS is a free NHS service for children and young people that aims to help with mental health problems such as depression, anxiety, self-harm and eating disorders.

Teachers, social workers, GPs and parents can refer a young person to CAMHS. Services differ from area to area.

In England, you can find CAMHS services in your area through the NHS CAMHS webpage.

Counselling and therapeutic services

Counselling services are available to help children and young people with their mental health. Services can include helplines, one-to-one counselling sessions in person, online or by phone, and online chats and forums.

These services are available through a range of fee-paying and free services including schools and the NHS.

Childline

Children and young people can get free, confidential support from a Childline counsellor via online chat, email or phone.

Childline will listen and provide advice to any concerns about topics, ranging from exam stress to depression and suicidal thoughts.

Childline offers a range of resources for children and young people, including:

Art boxto write or draw about their feelings

Calm zonewith breathing exercises

Gamesto help relax and de-stress.

Childline also has dedicated resources for under 12s.

Download or order Childline posters and wallet cards to display across schools, encouraging children to contact Childline if they need to talk.

NSPCC services

We provide therapeutic services to help children, young people and families with their mental health.

Building Connections

Building Connections is an online service to help young people aged under 19 to find a way through loneliness.

Letting the Future In

Letting the Future In is a play-therapy service that helps children who have been sexually abused.

Consent for treatment

It's best practice to get parental consent for children's therapeutic and medical treatments. But there may be times when a child or young person does not want their parents to know. In this case, you should assess whether the young person has the capacity to make this decision for themselves.

The Gillick competency and Fraser guidelines help professionals assess whether a child is mature enough to make decisions.
> Read our information about Gillick competency and Fraser guidelines

Legislation and guidance

Legislation and guidance

Key legislation

In England and Wales, the Mental Health Act (MHA) 1983 covers the assessment, treatment and rights of people with a mental health condition. It applies to all children and young people under the age of 18. The Act allows for people to be detained in hospital if they need treatment for a mental health condition. It gives children the right to appeal against detention.

The Mental Health Act 1983 was amended by the Mental Health Act 2007. This strengthened safeguards for children, for example adding a duty to ensure an age-appropriate environment for children and young people.

In Northern Ireland, the Mental Health (Northern Ireland) Order 1986 is the main mental health legislation which applies to children and young people under 18. It covers the assessment, treatment and rights of people with mental health conditions.

In Scotland, the Mental Health (Care and Treatment) (Scotland) Act 2003 applies to all those with a 'mental disorder', including children and young people. It contains specific safeguards for under 18s regarding mental health treatment, including on named persons, promoting wellbeing and the welfare of children.

The Mental Health (Scotland) Act 2015 amended the provisions relating to children and young people in the Mental Health (Care and Treatment) (Scotland) Act 2003, including providing services and accommodation for mothers.

Strategy

In England, the Department of Health and Social Care is developing a Major Conditions Strategy that will focus on whole-person care and ensure mental health conditions are considered alongside physical health conditions (Department of Health and Social Care, 2023; Garratt, 2023).

In Northern Ireland, the Department of Health has published a mental health strategy for 2021-2031. This sets out actions under three overarching themes:

promoting mental wellbeing, resilience and good mental health across society

providing the right support at the right time

new ways of working.

It also includes actions to improve child and adolescent mental health services (CAMHS) (Department of Health, 2021a).

The Department of Health has also published a Mental Health Action Plan, which is comprised of 38 actions (Department of Health, 2021b).

In Scotland, the government has produced a framework for community mental health and wellbeing supports and services, which sets out an approach for the mental health and wellbeing support children and young people should be able to access in their community (Scottish Government, 2021).

In Wales, the government last published a strategy for mental health and wellbeing (PDF) in 2012. This covers children and young people as well as adults (Welsh Government, 2012). Consultation on the next strategy is expected to begin at the end of 2023 (Welsh Government, 2023).

Guidance

Schools

In England, the Department for Education (DfE)'s statutory guidance for schools highlights that child mental health problems may be an indicator that a child has experienced abuse or neglect. The guidance includes information on how schools and colleges should support children and young people's mental health (Department for Education, 2023).

The statutory guidance for schools in England on relationships, sex and health education includes guidance on how primary and secondary schools should teach children and young people about mental health and wellbeing (DfE, 2020).

The DfE has also published guidance for school staff on supporting children and young people whose mental health problems manifest in their behaviour. It emphasises the importance of a whole-school approach to mental health and gives guidance on risk and protective factors, identifying children that might need support and working with other agencies (DfE, 2018).

The PSHE Association has published guidance for teachers on teaching mental health and emotional wellbeing. The guidance covers creating a safe environment to talk about mental health and wellbeing, safeguarding children and young people, signposting sources of support and building teaching about mental health and wellbeing into the curriculum (PSHE Association, 2021).

Public Health England (PHE) has published guidance on promoting children and young people's emotional health and wellbeing in schools and colleges. This sets out eight principles for protecting and promoting young people's emotional health and wellbeing. (PHE, 2021).

In Northern Ireland, the Department of Education has published an emotional health and wellbeing in education framework, which provides guidance for education settings on supporting children and young people's mental health and wellbeing. It highlights that children in care and those who have experience abuse or other adverse childhood experiences might be more vulnerable to mental health problems (Department of Education, 2021).

In Scotland, the government has published guidance on Access to counselling in secondary schools. This provides a framework on developing access to counsellors within schools for education authorities (Scottish Government, 2020a).

In Wales, the government has published a Framework on embedding a whole-school approach to mental health and wellbeing for schools, pupil referral units and educational settings. The framework sets out how to develop plans to identify and address weaknesses and build on strengths. It also looks at how to evaluate whether the measures put in place meet the emotional and mental health needs of children and young people (Welsh Government, 2021).

Other sectors

The National Autistic Society and Mind have produced a free good practice guide to help professionals in the UK adapt talking therapies for autistic adults and children (National Autistic Society and Mind, 2021).

In England, PHE provides guidance on Improving the mental health of children and young people. This describes the importance of children's mental health and summarises what works in improving their mental health (PHE, 2016).

PHE has also produced guidance for health commissioners and professionals on Measuring the mental wellbeing of children and young people (PHE, 2015).

In Northern Ireland, the Department of Health has published guidance on risk assessment and management in mental health and learning disability services. This includes information about assessing whether a person might be a risk to themselves or others (Department of Health, 2012).

The Guidelines and Audit Implementation Network (GAIN) has published Guidelines on the use of the Mental Health (Northern Ireland) Order 1986 (PDF) (GAIN, 2011).

In Scotland, the government has produced guidance on the mental health and wellbeing of disabled children, young people and their families (Scottish Government, 2019).

It has also provided a CAMHS national service specification, outlining the available CAMHS provisions for young people and their families (Scottish Government, 2020b).

NHS Education for Scotland has produced an Early intervention framework for children and young people's mental health and mental wellbeing. The framework enables practitioners to compare different evidence-based prevention and early intervention approaches that have been designed to improve children and young people's mental health and wellbeing (NHS Education for Scotland, 2020).

In Wales, the government has published non-statutory guidance on Collaborative working between CAMHS and the counselling service. This outlines how services are organised and includes case studies on collaborative working (Welsh Government, 2016).

References

References

Becerra-Culqui, T. A. et al (2018) Mental health of transgender and gender nonconforming youth compared with their peers. Paediatrics, 141(5).

Bignall, T. et al (2020) Racial disparities in mental health: Literature and evidence review (PDF). London: Race Equality Foundation.

Carers Trust (2016) Invisible and in distress: prioritising the mental health of England's young carers (PDF). London: Carers Trust.

Carers Trust (2023) Being a young carer is not a choice it's just what we do (PDF). London: Carers Trust.

Cecil C.A.M. et al (2017) Disentangling the mental health impact of childhood abuse and neglect. Child Abuse & Neglect, 63, 106-119.

Chakraborty, A et al (2011) Mental health of the non-heterosexual population of England. The British Journal of Psychiatry, 198(2).

Chandan, J. S. et al (2019) The burden of mental ill health associated with childhood maltreatment in the UK, using The Health Improvement Network database: a population-based retrospective cohort study. The Lancet Psychiatry, 6(11).

Department for Education (DfE) (2023) Keeping children safe in education: statutory guidance for schools and colleges. [Accessed 01/09/2023].

Department for Education (DfE) (2020) Relationships and sex education (RSE) and health education. [Accessed 01/07/2022].

Department for Education (DfE) (2018) Mental health and behaviour in schools. [Accessed 01/07/2022].

Department of Education (2021) Children & young people's emotional health and wellbeing in education framework (final version). [Accessed 01/07/2022].

Department of Health (2021a) Mental health strategy 2021-2031. [Accessed 01/07/2022].

Department of Health (2021b) Mental Health Action Plan. Belfast: Department of Health.

Department of Health (2012) Promoting quality care: good practice guidance on the assessment and management of risk in mental health and learning disability. [Accessed 03/05/2023].

Department of Health and Social Care (2023) Government action on major conditions and diseases. [Accessed 02/05/2023].

Faulconbridge, J., Hunt, K. and Laffan, A. (eds) (2019) Improving the psychological wellbeing of children and young people: effective prevention and early intervention across health, education and social care. London: Jessica Kingsley.

Fuggle, P. and Redfern, S. (2019) Positive mental health and wellbeing in children and young people. Totnes: Research in Practice Suggestions for Practice.

GAIN (2011) Guidelines on the use of the Mental Health (Northern Ireland) Order 1986 (PDF).

Garratt, K., Parkin, E. and Laing, J. (2023) Mental health policy in England. London: House of Commons Library.

Gavin, H. (2011) Sticks and stones may break my bones: the effects of emotional abuse. Journal of Aggression Maltreatment and Trauma, 20(5): 503-529.

Jo Cox Foundation, Action for Children ([2017]) It starts with hello: A report looking into the impact of loneliness in children, young people and families. Watford: Action for Children.

Lewis S., Arsenault L., Caspi A. et al. The epidemiology of trauma and post-traumatic stress disorder in a representative cohort of young people in England and Wales. Lancet Psychiatry 2019; 6 (3): 247-256.

Mental Health Foundation and Camelot Foundation (2006) Truth hurts: report on the national inquiry into self-harm among young people. London: Mental Health Foundation.

Mind, 2020 Mental health problems - an introduction. [Accessed 01/07/2022].

Nanni, V et al (2012) Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression: a meta-analysis. The American Journal of Psychiatry, 169(2).

National Youth Advocacy Service (2019) Looked after minds: prioritising the mental health of care-experienced children and young people (PDF). [s.l.] National Youth Advocacy Service.

NHS Education for Scotland (2020) Early intervention framework for children and young people's mental health and mental wellbeing. [Accessed 04/07/2022].

Norman R. E. et al (2012) The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. [Accessed 04/07/2022].

NSPCC (2019b) Transforming mental health services for children who have been abused: July 2019 (PDF). London: NSPCC [Accessed 04/07/2022].

NSPCC (2019c) Looked after children: statistics briefing. London: NSPCC Knowledge and Information Service.

PSHE (2021) Teacher guidance: teaching about mental health and emotional wellbeing. [Accessed 04/07/2022].

Public Health England (2021) Promoting children and young people's emotional health and wellbeing [Accessed 04/07/2022]

Public Health England (PHE) (2016) Improving the mental health of children and young people. London: Public Health England.

Public Health England (PHE) (2015) Measuring the mental wellbeing of children and young people. London: Public Health England

Scottish Government (2021) Community mental health and wellbeing supports and services: framework [Accessed 04/07/2022].

Scottish Government (2020a) Child and Adolescent Mental Health Services: national service specification. Edinburgh: Scottish Government.

Scottish Government (2020b) Access to counselling in secondary schools: guidance. Edinburgh: Scottish Government.​

Scottish Government (2019) Supporting disabled children, young people and their families: guidance. Edinburgh: Scottish Government.

Sharpe, R. et al. (2021) A school-based cross-sectional study to understand the public health measures needed to improve the emotional and mental wellbeing of young carers aged 12 to 14 years. Families, Relationships and Societies, 12(2): 253-271.

Spatz Widom, C (1999) Posttraumatic stress disorder in abused and neglected children grown up. The American Journal of Psychiatry, 156(8).

Theodosiou L. et al (2020) Children and young people's mental health: early intervention, ongoing support and flexible evidence-based care. Pavilion: West Sussex.

Welsh Government (2012) Together for mental health: a strategy for mental health and wellbeing in Wales. Cardiff: Welsh Government.

Welsh Government (2016) Collaborative working between CAMHS and the Counselling Service. Cardiff: Welsh Government.

Welsh Government (2021) Framework on embedding a whole-school approach to emotional and mental wellbeing. Cardiff: Welsh Government.

Welsh Government (2023) Written response from the Welsh Government to the report by the Health & Social Care Committee entitled Connecting the dots: tackling mental health inequalities in Wales (PDF). Cardiff: Welsh Government.

Introduction

Mental health is as important to a child's safety and wellbeing as their physical health. It can impact on all aspects of their life, including their educational attainment, relationships and physical wellbeing. Mental health can also change over time, to varying degrees of seriousness, and for different reasons.

And we know it's an important issue for children. Over half of all Childline counselling sessions in 2022/23 related to mental or emotional health and wellbeing.

Negative experiences such as abuse and neglect can adversely impact a child's mental health. Mental health issues can also sometimes lead to safeguarding and child protection issues, for example if a child's mental health begins to put them or other people at risk of harm.

Supporting children with mental health issues

It can be hard for adults to recognise when a child needs support with mental health issues. And it can be difficult for young people to speak out about the challenges they're facing.

So it's crucial that anyone who works or volunteers with children is able to recognise the signs that a child may be struggling with their mental health. And that they know how to take appropriate action to support children and young people in getting the help they need.

We've put together some information to help you recognise and respond to concerns about children and young people's mental health.

What does mental health mean?

Mental health is an individual's cognitive, behavioural and emotional wellbeing (Mind, 2020). It's something we all have - including every child and young person.

We use the term "mental health issues" to refer to mental health problems, conditions and mental illnesses. These issues may or may not be medically diagnosed.

Who is at risk?

Who is at risk?

Any child or young person can develop mental health issues. But research has shown there are some factors that are associated with children and young people's long-term mental health.

Abuse and neglect

The traumatic impact of abuse and neglect increases the likelihood of children developing a range of mental health issues - both during childhood and in later life. These include anxiety, depression, eating disorders and post-traumatic stress disorder (PTSD) (Norman et al, 2012; Spatz Widom, 1999).

Specific types of abuse may be connected to certain mental health issues. Children who have experienced emotional abuse may be more likely to develop anxiety and depression compared with children who have experienced other types of abuse (Cecil et al, 2017; Gavin 2011). One study found that almost three quarters (74%) of young people who had experienced sexual assault developed PTSD (Lewis et al, 2019).

Abuse and neglect can also make children more vulnerable to developing more than one mental health condition at one time (known as composite mental health issues) (Chandan et al, 2019).

Providing effective mental health support for children who have experienced abuse and neglect can help them recover from its effects (NSPCC, 2019b).

d/Deaf and disabled children and young people

d/Deaf and disabled children and young people with complex or additional needs may face a range of challenges including:

reduced mobility

prejudice, discrimination and bullying.

These challenges may lead to lower self-confidence, difficulty forming peer networks and social exclusion, putting them at higher risk of developing mental health issues (Falcounbrige, Hunt and Laffan, 2019).

Adults may confuse the signs of learning disabilities with the symptoms of mental health issues. This can mean concerns aren't recognised and responded to quickly or appropriately.

Children from Black, Asian and minority ethnic communities

Children from black and minority ethnic groups may experience:

racism, discrimination and prejudice - this can be direct, indirect or institutional

an increased stigma around mental health issues in the community.

This can lead to inequalities and issues in accessing appropriate care and support for mental health needs (Bignall et al, 2020).

LGBTQ+ children and young people

LGBTQ+ children and young people may experience:

prejudice, discrimination and bullying

a fear of or an actual rejection from family and/or friends

feeling excluded or like an outsider.

They may also experience gender dysphoria: the unease felt when someone's sex registered at birth does not match their identity.

These factors and experiences mean they are more likely than their heterosexual and cisgender peers to experience a range of mental health problems (Chakraborty et al, 2011; Becerra-Culqui, et al 2018).

Living in care

Children in care are more likely than their peers to have a mental health difficulty (NSPCC, 2019c). This can be due to isolation and loneliness. Children in care may also have experienced abuse or neglect, which increases the likelihood of developing mental health issues (National Youth Advocacy Service, 2019).

Young carers

Young carers are more likely to experience mental health problems than peers who don't have caring responsibilities (Sharpe, 2021).

Young carers may:

feel worry or stress about the health and wellbeing of the person/s they care for

feel that they must manage or hide their emotions due to fear or guilt of upsetting the person/s they care for

feel that they don't have time for themselves and are missing out on opportunities or activities.

Excessive or inappropriate caring roles and a lack of support from services can be risk factors in a young carer experiencing poor mental health. (Carers Trust, 2023; 2016; 2023; Sharpe, 2021).

Life events

Stressful or traumatic situations and experiences, such as bereavement or sudden changes in environment, can trigger mental health issues.

Social isolation and loneliness

Anyone can experience loneliness, but risk factors include:

having a long-term health condition or disability

having caring responsibilities

living in care

being from an ethnic minority community

being LGBTQ+

(Mental Health Foundation, 2022).

Studies show that there is a strong association between social isolation and anxiety and depression in children and young people (Almeida et al, 2021).
> Find out more about our Building Connections service to help young people cope with loneliness

Recognising

Recognising issues

Professionals need to be able to recognise the signs that a child may be struggling. However, it's important to remember that some mental health issues may not have visible signs. There are also factors that might make it more difficult for a child or young person to ask for help.

Some children and young people may try to hide how they are feeling or what they are doing (Theodosiou L. et al, 2020). This might be because they:

worry they won't be taken seriously

believe others won't understand

have had a negative experience talking about their thoughts and feelings in the past

feel that no one can help them

fear being dismissed or labelled an attention seeker or 'crazy'

(Mental Health Foundation and Camelot Foundation, 2006).

Children and young people may not always have the language or ability to communicate how they feel. They may be unsure who to talk to and how to talk about their problems.

Some signs of mental health issues may also look like normal child behaviour. For example, tantrums in younger children or teenagers keeping feelings to themselves.

Children who have experienced abuse or neglect

Children who have experienced abuse may be reluctant to talk about how they are feeling, particularly if they haven't yet told anyone about the abuse. They may feel that something is wrong with them or that things may get worse if they talk about it.

Identifying and responding to mental health concerns may be one way of helping children who are experiencing abuse to get the support and protection that they need.

> Find out more about barriers to disclosure of abuse

Signs of child mental health issues

There are ways you can identify if a child needs support with their mental health.

By being attentive to a child or young person's mood and behaviour, you can recognise patterns that suggest they need support.

Common warning signs of mental health issues include:

sudden mood and behaviour changes

self-harming

unexplained physical changes, such as weight loss or gain

sudden poor academic behaviour or performance

sleeping problems

changes in social habits, such as withdrawal or avoidance of friends and family.

These signs suggest that a child may be struggling, but there could be a number of different explanations for them.
Don't attempt to diagnose mental health issues yourself or make assumptions about what's happening in a child's life.
Recognising that a child or young person may be struggling with their mental health is the first step in helping them. The next step is to respond appropriately.

Responding

Responding to child mental health issues

All children and young people should have someone they can talk to about whatever they're going through, regardless of whether they have a mental health condition.

Children may not want to talk specifically about their mental health, but about the struggles and issues in their daily lives (Mental Health Foundation and Camelot Foundation, 2006).

If you are concerned that a child may be struggling, it's important not to wait for them to talk to you before trying to start a conversation. Encourage them to talk with you or with other trusted adults.
> Take our mental health and wellbeing safeguarding children training
Talking with a child about their mental health

If you're talking with a child or young person about their mental health and wellbeing, be prepared that conversations may not be easy or straightforward. There are things you can do to make these conversations as easy as possible.
> Read our information and advice on how to have difficult conversations with children
The following principles will help you discuss mental health and wellbeing sensitively.

Use the right language

When talking with a child, use language that they understand. This will differ according to their age and stage of development. Avoid using technical or diagnostic language which children might find unfamiliar, confusing and distant from their experiences.

Make sure you understand the language the child is using and how they are using certain terms. For example, a child may use the word "anxiety" to describe a feeling of general nervousness or as a way to describe severe anxiety attacks.

By paying attention to the language children use to describe their feelings, you can reflect the terms they use in your own language. This will help them feel listened to.

Some children may have difficulty communicating, for example if they have additional needs or disabilities (Fuggle and Redfern, 2019). Make sure you give these children the time and support they need to talk.

> Find out more about how to have difficult conversations with children and young people

Create an open environment

It's important to create an open and safe environment where children and young people are comfortable speaking about their mental health. Make sure children and young people know who they can talk to - and make this pool of people as wide as possible.

In schools, for example, discussions about mental health and wellbeing can be integrated into the curriculum and put on an equal footing with physical health.

Some children with mental health problems will have experienced abuse. An open environment will help them talk about the challenges they are facing and may help them feel able to tell you what's been happening to them.

> Use our resources to find out how you can let children know you're listening if they tell you they have experienced abuse

> Find out how to recognise and respond to abuse

Promoting mental health and wellbeing

Anyone who works with children and young people has a responsibility to promote their mental health and emotional wellbeing. This can include:

helping with online wellbeing

encouraging exercise

maintaining routines.

> Get tips on promoting children and young people's mental health and wellbeing

Understanding

Understanding thoughts and feelings

Mental health moves back and forth along a continuum, it's always changing. This can happen over a period of time or quite quickly. So it's important to have conversations with children and young people so you can best understand how they're feeling - and any mental health issues that they are experiencing.

Doing OK - Struggling - Unwell - In Crisis

When you speak to a child for the first time, or during ongoing conversations, you may find it useful to think about whether they're doing OK, struggling, unwell or in crisis.

This continuum is based on a model used by Childline counsellors, alongside other tools, that helps them understand how a child is feeling at that particular point in time. You can use it to better understand a young person's mental health and wellbeing.

It's important to remember that a person's mental health changes continuously - so you should refer to this continuum regularly.

Doing OK

Communicates effectively with others

Seeks help when needed

Can focus on specific issues

Has healthy relationships

Identifies and tries to solve problems

Uses healthy coping strategies

Struggling

Struggles communicating with others

Is unsure how to access help

Relationships are beginning to suffer

Begins to use unhealthy coping strategies

Has some sleep issues, low energy and fatigue

Is able to engage well in some areas

Unwell

Feels overwhelmed and isolated

Struggles to focus on specific issues

Struggles to access and/or engage with services

Has disturbed sleep

May have suicidal thoughts

Relies on unhealthy coping strategies

May already have a mental health diagnosis

Is ambivalent towards change

In crisis

Has made recent suicide attempts

Is distrustful of support services

Mental health symptoms are unmanageable

Has escalating self-harming behaviours

Distress may not reduce when talking

Not engaging at home or school

Is resistant to change

Using scaling techniques

Our Childline counsellors sometimes use "scaling" questions to help them understand how a child or young person is doing.

A counsellor gives the child a clear scale - from 0 or 1 to 10 - and asks where they think they sit in relation to a specific question. For example:

If 1 is your mental health at its worst and 10 is at its best, how are you doing at the moment?

If 0 means that you are having a panic attack and 10 means that you feel completely calm and confident, how would you rate the way you feel before going to school?

Counsellors may be able to find out what support children would like by asking how they can move up the scale. For example:

What is it that puts you at a 5 rather than a 6?

What can we do to help you move from a 3 to a 4?

Using the continuum and scaling techniques can help you better understand how a child is feeling so that you take appropriate action to help and support them.

Taking action

Taking appropriate action

Mental health issues indicate that a child or young person needs support. If possible, discuss with them what help could be put in place.

What if a child doesn't want to talk to me?

If a child isn't able to engage with a discussion about their mental health you should still consider what support can be put in place for them.

Follow your organisation's procedures to share any concerns you have about a child's wellbeing. For example, you could talk to the person who is responsible for pastoral care in your school or organisation.

Safeguarding and child protection issues

You must always consider whether you need to take any action to protect a child or those around them from harm.

If you identify a safeguarding or child protection issue, you must follow your organisation's policies and procedures.

Safeguarding issues include:

a child being in immediate and/or significant danger

someone else being in immediate and/or significant danger

a child being at risk of or experiencing abuse.

> Find out more about responding to safeguarding and child protection concerns

Confidentiality

If a child is confiding in you about their mental health they may ask you not to tell anyone what they've said. But if you're concerned about someone's safety and welfare you must share this information with relevant professionals.

You should never promise to keep what a child tells you a secret. Explain from the outset that you might have to talk to someone else who can help.

Getting support

Getting support

There are lots of different types of support available for children with mental health issues. These include the following.

Contacting a GP

GPs may be able to diagnose mental health conditions, suggest next steps and provide medication.

>There is information on the Childline website about visiting GPs

Child and adolescent mental health services (CAMHS)

Across the UK, CAMHS is a free NHS service for children and young people that aims to help with mental health problems such as depression, anxiety, self-harm and eating disorders.

Teachers, social workers, GPs and parents can refer a young person to CAMHS. Services differ from area to area.

In England, you can find CAMHS services in your area through the NHS CAMHS webpage.

Counselling and therapeutic services

Counselling services are available to help children and young people with their mental health. Services can include helplines, one-to-one counselling sessions in person, online or by phone, and online chats and forums.

These services are available through a range of fee-paying and free services including schools and the NHS.

Childline

Children and young people can get free, confidential support from a Childline counsellor via online chat, email or phone.

Childline will listen and provide advice to any concerns about topics, ranging from exam stress to depression and suicidal thoughts.

Childline offers a range of resources for children and young people, including:

Art boxto write or draw about their feelings

Calm zonewith breathing exercises

Gamesto help relax and de-stress.

Childline also has dedicated resources for under 12s.

Download or order Childline posters and wallet cards to display across schools, encouraging children to contact Childline if they need to talk.

NSPCC services

We provide therapeutic services to help children, young people and families with their mental health.

Building Connections

Building Connections is an online service to help young people aged under 19 to find a way through loneliness.

Letting the Future In

Letting the Future In is a play-therapy service that helps children who have been sexually abused.

Consent for treatment

It's best practice to get parental consent for children's therapeutic and medical treatments. But there may be times when a child or young person does not want their parents to know. In this case, you should assess whether the young person has the capacity to make this decision for themselves.

The Gillick competency and Fraser guidelines help professionals assess whether a child is mature enough to make decisions.
> Read our information about Gillick competency and Fraser guidelines

Legislation and guidance

Legislation and guidance

Key legislation

In England and Wales, the Mental Health Act (MHA) 1983 covers the assessment, treatment and rights of people with a mental health condition. It applies to all children and young people under the age of 18. The Act allows for people to be detained in hospital if they need treatment for a mental health condition. It gives children the right to appeal against detention.

The Mental Health Act 1983 was amended by the Mental Health Act 2007. This strengthened safeguards for children, for example adding a duty to ensure an age-appropriate environment for children and young people.

In Northern Ireland, the Mental Health (Northern Ireland) Order 1986 is the main mental health legislation which applies to children and young people under 18. It covers the assessment, treatment and rights of people with mental health conditions.

In Scotland, the Mental Health (Care and Treatment) (Scotland) Act 2003 applies to all those with a 'mental disorder', including children and young people. It contains specific safeguards for under 18s regarding mental health treatment, including on named persons, promoting wellbeing and the welfare of children.

The Mental Health (Scotland) Act 2015 amended the provisions relating to children and young people in the Mental Health (Care and Treatment) (Scotland) Act 2003, including providing services and accommodation for mothers.

Strategy

In England, the Department of Health and Social Care is developing a Major Conditions Strategy that will focus on whole-person care and ensure mental health conditions are considered alongside physical health conditions (Department of Health and Social Care, 2023; Garratt, 2023).

In Northern Ireland, the Department of Health has published a mental health strategy for 2021-2031. This sets out actions under three overarching themes:

promoting mental wellbeing, resilience and good mental health across society

providing the right support at the right time

new ways of working.

It also includes actions to improve child and adolescent mental health services (CAMHS) (Department of Health, 2021a).

The Department of Health has also published a Mental Health Action Plan, which is comprised of 38 actions (Department of Health, 2021b).

In Scotland, the government has produced a framework for community mental health and wellbeing supports and services, which sets out an approach for the mental health and wellbeing support children and young people should be able to access in their community (Scottish Government, 2021).

In Wales, the government last published a strategy for mental health and wellbeing (PDF) in 2012. This covers children and young people as well as adults (Welsh Government, 2012). Consultation on the next strategy is expected to begin at the end of 2023 (Welsh Government, 2023).

Guidance

Schools

In England, the Department for Education (DfE)'s statutory guidance for schools highlights that child mental health problems may be an indicator that a child has experienced abuse or neglect. The guidance includes information on how schools and colleges should support children and young people's mental health (Department for Education, 2023).

The statutory guidance for schools in England on relationships, sex and health education includes guidance on how primary and secondary schools should teach children and young people about mental health and wellbeing (DfE, 2020).

The DfE has also published guidance for school staff on supporting children and young people whose mental health problems manifest in their behaviour. It emphasises the importance of a whole-school approach to mental health and gives guidance on risk and protective factors, identifying children that might need support and working with other agencies (DfE, 2018).

The PSHE Association has published guidance for teachers on teaching mental health and emotional wellbeing. The guidance covers creating a safe environment to talk about mental health and wellbeing, safeguarding children and young people, signposting sources of support and building teaching about mental health and wellbeing into the curriculum (PSHE Association, 2021).

Public Health England (PHE) has published guidance on promoting children and young people's emotional health and wellbeing in schools and colleges. This sets out eight principles for protecting and promoting young people's emotional health and wellbeing. (PHE, 2021).

In Northern Ireland, the Department of Education has published an emotional health and wellbeing in education framework, which provides guidance for education settings on supporting children and young people's mental health and wellbeing. It highlights that children in care and those who have experience abuse or other adverse childhood experiences might be more vulnerable to mental health problems (Department of Education, 2021).

In Scotland, the government has published guidance on Access to counselling in secondary schools. This provides a framework on developing access to counsellors within schools for education authorities (Scottish Government, 2020a).

In Wales, the government has published a Framework on embedding a whole-school approach to mental health and wellbeing for schools, pupil referral units and educational settings. The framework sets out how to develop plans to identify and address weaknesses and build on strengths. It also looks at how to evaluate whether the measures put in place meet the emotional and mental health needs of children and young people (Welsh Government, 2021).

Other sectors

The National Autistic Society and Mind have produced a free good practice guide to help professionals in the UK adapt talking therapies for autistic adults and children (National Autistic Society and Mind, 2021).

In England, PHE provides guidance on Improving the mental health of children and young people. This describes the importance of children's mental health and summarises what works in improving their mental health (PHE, 2016).

PHE has also produced guidance for health commissioners and professionals on Measuring the mental wellbeing of children and young people (PHE, 2015).

In Northern Ireland, the Department of Health has published guidance on risk assessment and management in mental health and learning disability services. This includes information about assessing whether a person might be a risk to themselves or others (Department of Health, 2012).

The Guidelines and Audit Implementation Network (GAIN) has published Guidelines on the use of the Mental Health (Northern Ireland) Order 1986 (PDF) (GAIN, 2011).

In Scotland, the government has produced guidance on the mental health and wellbeing of disabled children, young people and their families (Scottish Government, 2019).

It has also provided a CAMHS national service specification, outlining the available CAMHS provisions for young people and their families (Scottish Government, 2020b).

NHS Education for Scotland has produced an Early intervention framework for children and young people's mental health and mental wellbeing. The framework enables practitioners to compare different evidence-based prevention and early intervention approaches that have been designed to improve children and young people's mental health and wellbeing (NHS Education for Scotland, 2020).

In Wales, the government has published non-statutory guidance on Collaborative working between CAMHS and the counselling service. This outlines how services are organised and includes case studies on collaborative working (Welsh Government, 2016).

References

References

Becerra-Culqui, T. A. et al (2018) Mental health of transgender and gender nonconforming youth compared with their peers. Paediatrics, 141(5).

Bignall, T. et al (2020) Racial disparities in mental health: Literature and evidence review (PDF). London: Race Equality Foundation.

Carers Trust (2016) Invisible and in distress: prioritising the mental health of England's young carers (PDF). London: Carers Trust.

Carers Trust (2023) Being a young carer is not a choice it's just what we do (PDF). London: Carers Trust.

Cecil C.A.M. et al (2017) Disentangling the mental health impact of childhood abuse and neglect. Child Abuse & Neglect, 63, 106-119.

Chakraborty, A et al (2011) Mental health of the non-heterosexual population of England. The British Journal of Psychiatry, 198(2).

Chandan, J. S. et al (2019) The burden of mental ill health associated with childhood maltreatment in the UK, using The Health Improvement Network database: a population-based retrospective cohort study. The Lancet Psychiatry, 6(11).

Department for Education (DfE) (2023) Keeping children safe in education: statutory guidance for schools and colleges. [Accessed 01/09/2023].

Department for Education (DfE) (2020) Relationships and sex education (RSE) and health education. [Accessed 01/07/2022].

Department for Education (DfE) (2018) Mental health and behaviour in schools. [Accessed 01/07/2022].

Department of Education (2021) Children & young people's emotional health and wellbeing in education framework (final version). [Accessed 01/07/2022].

Department of Health (2021a) Mental health strategy 2021-2031. [Accessed 01/07/2022].

Department of Health (2021b) Mental Health Action Plan. Belfast: Department of Health.

Department of Health (2012) Promoting quality care: good practice guidance on the assessment and management of risk in mental health and learning disability. [Accessed 03/05/2023].

Department of Health and Social Care (2023) Government action on major conditions and diseases. [Accessed 02/05/2023].

Faulconbridge, J., Hunt, K. and Laffan, A. (eds) (2019) Improving the psychological wellbeing of children and young people: effective prevention and early intervention across health, education and social care. London: Jessica Kingsley.

Fuggle, P. and Redfern, S. (2019) Positive mental health and wellbeing in children and young people. Totnes: Research in Practice Suggestions for Practice.

GAIN (2011) Guidelines on the use of the Mental Health (Northern Ireland) Order 1986 (PDF).

Garratt, K., Parkin, E. and Laing, J. (2023) Mental health policy in England. London: House of Commons Library.

Gavin, H. (2011) Sticks and stones may break my bones: the effects of emotional abuse. Journal of Aggression Maltreatment and Trauma, 20(5): 503-529.

Jo Cox Foundation, Action for Children ([2017]) It starts with hello: A report looking into the impact of loneliness in children, young people and families. Watford: Action for Children.

Lewis S., Arsenault L., Caspi A. et al. The epidemiology of trauma and post-traumatic stress disorder in a representative cohort of young people in England and Wales. Lancet Psychiatry 2019; 6 (3): 247-256.

Mental Health Foundation and Camelot Foundation (2006) Truth hurts: report on the national inquiry into self-harm among young people. London: Mental Health Foundation.

Mind, 2020 Mental health problems - an introduction. [Accessed 01/07/2022].

Nanni, V et al (2012) Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression: a meta-analysis. The American Journal of Psychiatry, 169(2).

National Youth Advocacy Service (2019) Looked after minds: prioritising the mental health of care-experienced children and young people (PDF). [s.l.] National Youth Advocacy Service.

NHS Education for Scotland (2020) Early intervention framework for children and young people's mental health and mental wellbeing. [Accessed 04/07/2022].

Norman R. E. et al (2012) The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. [Accessed 04/07/2022].

NSPCC (2019b) Transforming mental health services for children who have been abused: July 2019 (PDF). London: NSPCC [Accessed 04/07/2022].

NSPCC (2019c) Looked after children: statistics briefing. London: NSPCC Knowledge and Information Service.

PSHE (2021) Teacher guidance: teaching about mental health and emotional wellbeing. [Accessed 04/07/2022].

Public Health England (2021) Promoting children and young people's emotional health and wellbeing [Accessed 04/07/2022]

Public Health England (PHE) (2016) Improving the mental health of children and young people. London: Public Health England.

Public Health England (PHE) (2015) Measuring the mental wellbeing of children and young people. London: Public Health England

Scottish Government (2021) Community mental health and wellbeing supports and services: framework [Accessed 04/07/2022].

Scottish Government (2020a) Child and Adolescent Mental Health Services: national service specification. Edinburgh: Scottish Government.

Scottish Government (2020b) Access to counselling in secondary schools: guidance. Edinburgh: Scottish Government.​

Scottish Government (2019) Supporting disabled children, young people and their families: guidance. Edinburgh: Scottish Government.

Sharpe, R. et al. (2021) A school-based cross-sectional study to understand the public health measures needed to improve the emotional and mental wellbeing of young carers aged 12 to 14 years. Families, Relationships and Societies, 12(2): 253-271.

Spatz Widom, C (1999) Posttraumatic stress disorder in abused and neglected children grown up. The American Journal of Psychiatry, 156(8).

Theodosiou L. et al (2020) Children and young people's mental health: early intervention, ongoing support and flexible evidence-based care. Pavilion: West Sussex.

Welsh Government (2012) Together for mental health: a strategy for mental health and wellbeing in Wales. Cardiff: Welsh Government.

Welsh Government (2016) Collaborative working between CAMHS and the Counselling Service. Cardiff: Welsh Government.

Welsh Government (2021) Framework on embedding a whole-school approach to emotional and mental wellbeing. Cardiff: Welsh Government.

Welsh Government (2023) Written response from the Welsh Government to the report by the Health & Social Care Committee entitled Connecting the dots: tackling mental health inequalities in Wales (PDF). Cardiff: Welsh Government.

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support a child with mental health issues

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Child mental health: recognising and responding to issues | NSPCC Learning

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Anyone can have mental health issues, including children and young people. Learn how to recognise the signs, respond to issues, take the right action and support a child.

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It's okay to reach out for help. Your situation is unique and no parent has all the answers. We all need a little extra support sometimes, and we hear from parents and carers just like you all the time.

So, if you're worried about the mental health and wellbeing of a child or young person up to the age of 25, you can chat to us by phone, email or webchat.

Our Parents Helpline is also accessible for those who are hard of hearing or speak English as an additional language. If English is not your first or preferred language, we can arrange for a language translator to support you on a call with one of our helpline advisers. Or if you would like to use our webchat or email service, we offer a digital translation service.

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Parents Mental Health Support | Advice for Your Child

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Practical tips, advice and where you can get help if your child or teenager is struggling with their mood, feelings, or their behaviour seems different.

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Videos for children to understand about mental health

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Videos for children to understand about mental health

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Explore Newsround’s reports and guides relating to mental health and how we feel.

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5 ways to teach mindfulness to kids

Of course, you can always ask your kids to join you in your meditation practice. But there are plenty of other mindfulness activities for kids that can also have a big impact. Just remember: It doesn't really matter which activity you choose. The most effective way to teach children about mindfulness is to practice it yourself. After all, kids are constantly watching how their parents act and what they say, soaking up information like sponges. That's why modeling a regular meditation practice can go a long way in helping them to establish their own mindfulness habits. Here are 5 different ways to teach your child mindfulness:

Breathing. Focusing on the sounds of their own breath and motion of their bellies rising and falling helps children learn to be in the present moment. Here's an idea that's particularly fun - and effective! - for young children. On the inhale, tell them to pretend they're smelling something yummy, like their favorite flower or chocolate brownies in the oven; on the exhale, they can pretend to blow out candles. And, if your child can't sit still for more than a couple of minutes, don't sweat it: start with 10 breaths and over time, build up to several minutes.

Create a mindful bedtime ritual. A regular mindfulness ritual at the end of the day can help your child to calm their body and reflect on their day. One way to do this is with a short body scan: Have your child close their eyes and focus on their head, arms, belly, etc., working their way through all the body parts. Or, you can do a simple gratitude meditation by having them share one thing they are thankful for.

Take a walk. This activity is not only a great way for kids to practice mindfulness and notice the present moment, but they also get exercise and fresh air. On the walk, take a few minutes to be completely silent and pay attention to all the sounds that you hear: passing cars, wind rustling dry leaves, a dog barking. Afterwards, talk about what you and your child heard, and how that made you both feel.

Eat a snack ... mindfully. Mindful eating is a practice that engages all five senses, and it's fun and easy to do. Before eating the snack, ask your kids to think about its appearance, shape, size, color, smell, and texture. Then, when they place it in their mouths, think about the sensation and the process of eating it. By learning to slow down and notice food, kids are more likely to savor it, digest better, and enjoy the meal more.

Meditate together with Headspace. It's critical to introduce meditation and mindfulness at an early age, which is why Headspace offers fun, engaging activities that teach kids the basics of mindfulness. These activities involve everything from breathing exercises and visualizations to focus-based meditation. And because different exercises work best for different ages, Headspace offers customized sessions for three age groups: 5 and under, 6 through 8, and 9 through 12.

Try a kids meditation:

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Mindfulness Activities for Kids - Headspace

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Of course, you can always ask your kids to join you in your meditation practice. But there are plenty of other mindfulness activities for kids that can also have a big impact. Just remember: It doesn't really matter which activity you choose. The most effective way to teach children about mindfulness is to practice it yourself.

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Children's Mental Health Week 2024 is taking take place from 5-11 February this year, with the theme 'My Voice Matters'.

The event is run and organised by the children's mental health charity Place2Be, and the theme this year is about encouraging children and young people to feel confident that they can express themselves.

The charity says that allowing young people to speak up has a positive impact on wellbeing and that children who feel that their voices are heard are more connected to their communities which can raise their self-esteem.

What is the theme of Children's Mental Health Week 2024?

This year's goal is about encouraging young people to have their say, and to remind them that they have the right to speak and be heard.

The charity quotes the UN Convention on the Child saying: "Every child has the right to express their views, feelings and wishes in all matters affecting them, and to have their views considered and taken seriously."

The charity said: "This year we want children of all ages, backgrounds and abilities to be empowered to work together to create a positive change for their mental health and wellbeing.

"We want all children and young people, whoever they are, and wherever they are in the world, to be able to say - and believe - 'My Voice Matters'".

What is Children's Mental Health Week?

Place2Be launched the first-ever Children's Mental Health Week in 2015 to shine a spotlight on the importance of children and young people's mental health.

Its purpose is to encourage more people than ever to get involved, spread the word, and raise vital funds for children's mental health.

It's something schools, families and communities across the UK can get involved in and can help to raise awareness about some of the difficulties children and young people can experience.

What is mental health?

Mental health describes our emotional, psychological, and social wellbeing.

It affects how we think, feel, and act but also helps determine how we handle stress, relate to others, and make choices.

But sometimes people can experience mental health problems, which can massively affect their thinking, mood, and behaviour.

They can come from our genes, or a family history of mental health problems.

Some people who have never had mental health problems before can also develop them due to a very stressful or traumatic experience,

Why do people find it hard to talk about mental health problems?

There can be many reasons why people might find it hard to talk about mental health problems, particularly when it comes to sharing with others.

This could be because of fear people won't understand, or might find it 'weird' and treat you differently as a result.

Others might think people will either make a big deal of it or else not take it seriously.

It is completely normal to have these concerns but overcoming these worries - and speaking to someone - can have a really positive impact, and in many cases can contribute to taking steps to improve your mental health.

If you are worried about mental health problems or are finding it difficult to talk about how you are feeling, there is lots of support out there.

The first thing you should do is speak to an adult who you trust about it. That might be a parent or family member, a family friend or even a teacher at school.

If you're not sure who you would like to talk to, visit Childline or ring them on 0800 1111 who will be able to help you with how you are feeling.

What are some creative things you can do to practice self-care?

Self-care means taking care of yourself so that you can be healthy physically, feel better mentally and you can help and care for yourself and others

The mental health charity Mind has said that self-care techniques and general lifestyle changes can help manage the symptoms of many mental health problems.

They can also help prevent some problems from developing or getting worse.

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Children's Mental Health Week 2024: What's it all about?

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The event is run and organised by the children's mental health charity Place2Be, from 5-11 February this year, with the theme Let's Connect.

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Creating a culture of positive mental wellbeing

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Creating a culture of positive mental wellbeing

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Parenting foster/adopted children with Alison Knowles

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In this episode we are discussing parenting foster/adopted children with emotional therapist and creator of the Ollie Model, Alison Knowles.

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Grounding techniques

A grounding technique is a coping strategy for managing intense feelings and emotions. These techniques help to 'ground' us, which means they help us to notice the present moment we are in.

When we focus on our present moment this can reduce the intensity of the emotions and feelings we might be having. We focus less intensely on the future or on the past.

You could encourage your child to:

use their five senses - concentrating on what they can see, touch, hear, smell, and taste. For example, you could think together about five things they can see, four things they can touch, three things they can hear, two things they can smell and one thing they can taste

take deep "belly breaths" - taking slow, deep breaths can help ease the feelings of anxiety and worry. To help your child do this, have them take a deep breathe through their nose, placing their hand on their stomach, and breathing in until their belly expands. Have them hold this for a few seconds, release slowly, and repeat

try the "roots" technique - focusing on a specific image can help to ground someone. Talk with your child and help them imagine that they are trees with roots extending from their feet into the ground. Get them to push their feet into the floor, imagining their "roots" reach deep into the earth, creating the image they are stable and firm, instead of feeling unsteady and unsure

Talking about, and naming, feelings

You could use the image to the right to talk about anxiety with your child.

1. Name the feeling and some of the possible affects your child may have experienced.

"Anxiety - when we feel anxious we can sometimes experience; difficulty remembering we are present in our current location, time and space, breathing can get faster, racing thoughts, heart rate increases", for example.

2. Ask them how they feel when they are anxious or worried. You could use the blank bubbles to add other feelings they have experienced or are experiencing.

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Strategies for coping with anxiety and worry

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Learn how to help your child cope with overwhelming feelings from our mental health experts

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Signs and symptoms of anxiety

Anxiety feels different for everyone. But if your child has been excessively anxious or worrying for a few months about different events or activities, it's worth reaching out for help.

Some young people may be anxious about certain things. For example, if you have an overwhelming fear of social situations, it is sometimes called social anxiety disorder (social phobia).

When a young child is feeling anxious, they might not be able to understand or put into words how they're feeling. Instead, they might:

Older children may experience physical, mental, or emotional symptoms such as:

feeling nervous, restless or "on edge" all the time

having lots of negative thoughts or believing that terrible things are going to happen

feeling tired and fatigued

difficulty concentrating

feeling grumpy and irritable

having difficulty sleeping

feeling lightheaded and dizzy

headaches or stomach aches

trembling or shaking

loss of appetite

withdrawing from friends and family

feeling disconnected from their mind, body, or the world around them

It can be difficult to know if there's something worrying a child. But you know your child better than anyone. If you are concerned, talk to them about how they're feeling and remind them that you're here to help.

What causes anxiety?

Everyone experiences anxiety differently, so it's not always easy to pinpoint a cause.

There are a lot of reasons why a child may feel anxious. But they may be more likely to feel anxious if they:

have experienced a lot of change in a short space of time, such as moving house or school

are around someone else, such as a parent, who is very anxious

struggle at school and feel overwhelmed by work and exams

have responsibilities beyond their age, for example, if they're a young carer

have gone through a distressing or traumatic experience, such as being bullied or being in a car accident or house fire

have experienced family conflict, abuse, or neglect

have experienced grief or bereavement

How to help a child with anxiety

There are lots of different strategies you can try with your child if they are struggling with anxiety or worry.

Every child is unique, and the techniques that will work for them may differ to other children. It's all about finding what works best for your child to better support them when they're feeling anxious. You can read more about strategies for coping with anxiety and worry here.

Treatment for anxiety in children

If your child's anxiety is impacting their day-to-day life, don't hesitate to get help. There are many different places you can get support. For instance, they could speak to:

Their GP - They can provide information, advice, and discuss therapy and medication if needed. They can also refer them to a mental health specialist or to Child and Adolescent Mental health Services (CAMHs), depending on your child's needs

School -If your child is struggling, it can sometimes help to speak with the school to let them know what's going on. However, make sure your child feels comfortable with this beforehand. As well as counselling, their school might be able to provide mental health support such as drop-in chat sessions or a peer buddy. Depending on your circumstances, they can also refer your child to CAMHS or other mental health services

A counsellor or therapist - Your child's GP or school may be able to refer them to a counsellor or therapist. They will be able to help your child better understand any difficult thoughts and feelings and teach them healthy ways to cope

Charity helplines - Sometimes it can help just to have a listening ear and a safe space where you can talk about what's troubling you. If your child is struggling and they don't know where to turn, they could contact helplines from charities such as The Mix, Childline, Samaritans, or Shout

What treatment your child is offered will depend on their age and the cause of their anxiety. It may include:
Therapy
Cognitive behaviour therapy (CBT) is one of the most common forms of talking therapy for anxiety. It's based on the idea that your thoughts, feelings, physical sensations, and actions are all connected.

It also teaches us that people can learn unhelpful thinking patterns, which can leave them feeling stuck in a negative loop, but that we can break free from them. By tuning into our feelings and noticing negative thinking patterns, CBT can teach us how to change things and deal with problems in a more positive way.

If a child is struggling with anxiety, they might also find counselling useful. Counselling is a type of talking therapy where a trained therapist will listen to you talk about any emotional problems you're facing and help you find better ways to cope.
Medication
In some cases, a doctor may be able to offer your child medication if they are severely struggling to cope with their anxiety and the strategies that they are actively putting in place from their talking therapies don't seem to be helping. However, there are a number of talking therapies that are recommended first.

Mental health support we offer

Supporting your child's mental health is an important part of parenting or caregiving.

We offer mental health services across the UK to help children, young people and families who are dealing with anxiety, such as:

cognitive behavioural therapy (CBT)

one-to-one and group counselling

school-based programmes that teach young people about emotional wellbeing and mental health.

Some support you may be able to access yourself, on behalf of the child in your care. This is called a self-referral. Other times, a GP, teacher, or social worker will need to request this support for your child.

Remember, supporting other people's mental health can feel challenging. Go easy on yourself and make sure to reach out for support if you need it too. You can find further support for parents and carers here.

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Explore the common symptoms of anxiety in children, simple ways you can help the young person in your life, as well as the services we offer.

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We’ve got you. Whether you need practical support or some advice, find out about our services near you.

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How To Make A Worry Box: A Guide For Parents

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If your child struggles with anxiety, creating a worry box together might help. Find out what a worry box is and how to make one in this guide.

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How a self soothe box could work for your child

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How a self soothe box could work for your child

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Having an activity to complete can really help you self-soothe. Reading and colouring in are the more obvious options and both of these work for me. You can find plenty of inexpensive beautiful colouring books, pretty much anywhere nowadays - The Works, Amazon and Waterstones all have a good variety to choose from. You can also find a lot of printable colouring sheets online. I keep some colouring pencils and a pad to fill in.

Colouring is a very simple task and having something beautiful that you made can feel very rewarding. You might like to write about how you are feeling, or try some creative writing or poetry; for that you can include a pen and notepad. I also keep a book that is an easy, light read.

I would recommend avoiding books that could be potentially triggering, particularly if you are in a vulnerable mindset. However, this can vary from person to person. I know for some people, emotionally dense poetry or literature can help reduce feelings of loneliness or isolation. Other activities can include: word searches, word games, sudoku, knitting, crocheting, collaging, games on your phone etc.

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Having an activity to complete can really help you self-soothe. Reading and colouring in are the more obvious options and both of these work for me. You can find plenty of inexpensive beautiful colouring books, pretty much anywhere nowadays - The Works, Amazon and Waterstones all have a good variety to choose from.

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What is anxiety?

Anxiety is when you feel scared, worried or panicked about something. It's a normal, human feeling and your body's natural response to stress or danger. Anyone can experience anxiety, regardless of age, gender, race, culture or faith.

We all feel anxious from time to time. Day-to-day things like friendship, money, exams or work can cause anxiety. Or certain situations, such as travelling home at night, starting a new school or giving a presentation. But the feeling usually passes once we feel safe or solve the problem we had. Generally the worries stop and we're able to carry on with our lives.

As humans evolved, our brains developed an inbuilt alarm system. It warns us when something isn't right and we need to keep ourselves safe. This alarm triggers what is known as the 'fight or flight' response - this is when your body prepares to either run away, fight, or freeze.

Think about what happens in your body when you feel anxious. You might feel a churning feeling in your stomach, dizzy or light-headed or hot and sweaty. These symptoms are all part of the fight or flight response.

This can make us feel like we're in physical danger, but it's important to remember that feeling this way doesn't necessarily mean you are in danger.

What happens to our body in fight-or-flight mode?

When our brains are in fight-or-flight mode, our thinking brain - the part that helps you think clearly, learn and solve problems - switches off. This makes it hard to stay calm and control your emotions and behaviour. We evolved to have this response to help us react to dangerous situations our ancestors faced, like being chased by a predator.

But in modern life, we don't tend to face dangers like this anymore. Instead, our anxiety can be triggered by more complicated situations or feelings where it might not help us to run away, fight or freeze. Yet we still experience the fight-or-flight response.

There are things you can do to help when you feel this way. You can use activities that soothe or distract you and bring your attention back to your body and senses. This calms the fight-or-flight response and switches the thinking brain back on so you can start to feel better.

When does anxiety become a problem?

Anxiety becomes a problem when it is more long term and you feel stuck in your worries or fears. They may last for a long time, even after a stressful situation has passed. You might feel upset and overwhelmed, as if your worries are too big to manage. Or they may stop you from doing everyday things.

When anxiety becomes a problem, it is sometimes called an anxiety disorder. There are different types of anxiety disorders and they can affect your life in different ways. Speaking to your GP, or someone else you trust, can help you find out what the problem is and how you can take care of yourself.

For more advice on reaching out for help, take a look at our guide.

Young people have told us that their anxiety has sometimes been dismissed as perfectionism or the normal ups and downs of being a teenager. But if it's impacting your life, it's important to get the help you need. Remember, however you're feeling is valid, even if you're not sure why you feel the way you do.

Anxiety can feel lonely and impact your self-esteem, but you are not alone. Things can improve and get better. Our section on looking after yourself if you have anxiety has lots of information to help you find what works for you.

We asked young people what it's like to live with anxiety. Here's what they said:

Just remember that if you're struggling with anxiety or panic attacks, you are not alone.

What causes anxiety?

There are lots of things that can cause anxiety. It could be how you feel in specific situations, however big or small, or life events that are out of your control. It might be because of something that happened in the past, worries about the future or things that you know could happen.

We all experience stressful situations in different ways. What makes you feel anxious might not make someone else feel anxious at all. That doesn't make your feelings wrong. We all have different things that we find difficult and that's okay.

Sometimes it's really clear what's making us anxious, but sometimes it's not. You might feel like your anxiety comes out of nowhere and this can be upsetting and confusing. But how you feel is valid. There's no right or wrong thing to feel anxious about.

Some common things that can cause anxiety include:

Discrimination and anxiety

Experiencing discrimination against your identity can also be a big source of anxiety. This could be because of your race, religion, abilities, sexuality, gender identity or something else. You might experience abuse, injustice or be scared to be yourself. Discrimination is never okay, and you deserve to feel proud of who you are.

We know that if you're experiencing discrimination, talking to someone you trust can really help. But it can help to talk to someone who understands you and your background. See the bottom of this page for a list of organisations that work with specific groups of young people to offer tailored support.

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Illustration by @fiorenza_art. A sitting fox has a thinking bubble with a heart inside and text on their tail reads, 'at this very moment, someone somewhere feels the same way you do. And that makes me feel a bit less alone.'

Real stories from young people about what caused their anxiety

Symptoms and signs of anxiety

Anxiety looks and feels different for everyone. We might notice anxiety in:

stomach problems, such as pains, feeling sick or diarrhoea

heart beating really fast

fast, shallow breathing

feeling light-headed, dizzy or faint

grinding your teeth

shaking or trembling

sweating more than usual

nervous, on edge and unable to relax

overwhelmed

like something bad is going to happen

out of control

tired and grumpy

needing reassurance or worrying you've upset someone

self-conscious

Anxiety is a healthy human emotion that we all feel sometimes. That means most of us will have felt some of these feelings at some point. So if some of these symptoms feel familiar, that doesn't mean you have a problem.

But if any of them are affecting your everyday life or causing you distress, it's a good idea to tell someone you trust or speak to your GP. We have lots of advice and information in our guide on how to talk to your GP.

These physical symptoms can be so frustrating and a huge discomfort. And when we don't know how common they are, it can leave us feeling all alone.

Types of anxiety disorders

Understanding different types of anxiety disorders can help you understand your own experience better and explain it to people you trust. As there are many ways to experience anxiety, you might recognise your experience in more than one anxiety disorder, or you might not recognise your experience here at all. That doesn't mean that your experience isn't valid.

The important thing is that you speak to your GP if you are struggling with anxiety, however that looks. They can help you find the support that's right for you, whatever you're going through.

If you have GAD you might find it difficult to control your worries. You can feel symptoms of anxiety often or all the time. This might be completely out of the blue or triggered by a range of situations. This can include situations where you might not expect to feel anxious.

Symptoms of GAD can include:

feeling restless, irritable or on edge

being unable to control worries

having difficulty concentrating

getting tired easily

sleep problems

pain such as headaches, muscle aches and stomach aches

It's normal to experiences nerves, worry or stress when you're studying. Especially when you have exams or assignments coming up. But if your anxiety feels too overwhelming and you're finding it hard to cope, it's time to reach out for help. Speaking to someone you trust is the first step towards getting support. This could be someone at school or university, your GP or someone close to you.

Our bloggers share their experiences of anxiety

Treating anxiety disorders

Illustration by Emily @21andsensory. Black text in the centre of a white background reads, 'believe in yourself and magic will happen.'

Feeling constant anxiety can be a sign that something isn't right, and you may need some help figuring out what that is. Your GP can suggest different types of treatment that can help if they think you're suffering from anxiety. They can also offer regular check-ups to see how you're doing.

There are a few different ways of treating anxiety disorders. Your treatment will depend on your age and the cause of your anxiety. You might try one, or end up using a combination of treatment options. The important thing is to find what works best for you.

Take a look below at the different types of treatment you may be offered.

Talking therapy can help you get to the root of what is causing your anxiety. One of the most common types of talking therapy used to treat anxiety is cognitive behavioural therapy (CBT). With CBT, you work with a therapist who helps you understand your thoughts and feelings. They then help you explore ways to change how they affect you. You also learn practical techniques to help you relax and cope better in everyday life.

Have a look at our counselling and therapy guide to find out more about different types of talking therapies and what happens in a therapy session.

Applied relaxation can help you manage the physical symptoms of anxiety. The focus is to learn how to relax your muscles in a particular way. You can then use this technique when you're in situations that usually cause anxiety.

Take a look at Eve's blog on how Progressive Muscle Relaxation helps her when she feels anxious or panicked.

If anxiety is stopping you from going to the doctor

It can be difficult if making appointments and going to the doctor gives you anxiety. If your anxiety is stopping you from getting treatment, let your GP know. They will be able to make arrangements to help.

For example, they could arrange phone calls or home visits. You could take someone with you to appointments or ask someone to call the GP for you. It's okay to tell your GP if you are struggling and need to make adjustments.

You may have heard that waiting times for mental health support can be quite long. The reality is that this will vary on the type of support that your GP thinks you need and where you are in the country. The waiting times vary in different areas. If you would like to know more about this, it's okay to ask your GP when they refer you. They may not know exactly, but they might be able to give you a rough timeframe.

This can feel really frustrating. But it's important to remember that how you're feeling is valid, however long you have to wait for support. Also, there are lots of things you can do to help yourself while you're waiting. Take a look at some tips that young people have told us helped them.

I noticed behaviours, mindsets and thought patterns that were having a negative effect on my mental health, and I still use the techniques I learnt in CBT to cope with these.

To this day, I still use these methods if I feel a wave of anxiety coming on, and they have truly helped me become stronger and more able to cope with difficulties in life.

Ways to look after yourself if you have anxiety

If you're struggling with anxiety, there are things you can do and support available to help you feel better. Different techniques will work for different people, and there might be one or two activities that you know you can use at different times.

For example, breathing and mindfulness. This could help you feel calm before doing something that you know makes you anxious. But this might not help in an anxious moment. Instead, you might move or stretch your body, play a game, or focus your attention on your senses and what's around you.

Below are some coping technique ideas that you can try.

Self-help techniques for anxiety aren't a replacement for getting help or a way for you to fix anxiety on your own. They are ways of looking after your mental health, like we would our physical health. Take a look at some ideas below.

Keeping a diary of your thoughts, worries and about times when you feel anxious can help you recognise signs or patterns in your anxiety. This empowers you to know when you need to ask for help or do something to help yourself.

Playing games with your friends or on your own is a great way to take time out from daily life. This could be sports, jigsaws, card games or video games. There are also lots of apps to help us relax and feel calmer, such as puzzles, classic arcade games or playing with patterns and colours.

Express yourself in creative ways. This could be anything from drawing and painting to photography or baking. Keeping ourselves busy and making something can help us manage our worries and feel present.

Relax by listening to a playlist of songs or a podcast that you find soothing. Or rewatch your favourite TV show or movie that feels familiar to you.

How to make a self-soothe box

Our Activists explain what a self-soothe box is, how it can help you when you're feeling anxious or panicky, and what they have in theirs. Have a look at Eve's blog for more ideas on what you could put in your self-soothe box.

What is a self-soothe box?

In its simplest form, self-care is just the little things we do to look after our mental health. Alongside relaxing activities, self-care can also be showing ourselves compassion, setting boundaries or not comparing ourselves to others. Self-care will look different for everyone.

Take a look at our guides for more advice on finding out what self-care means for you.

Our bloggers share their coping techniques for anxiety

How to support a friend with anxiety

It can be difficult to know what to do if your friend or someone close to you is struggling with anxiety. It's normal to feel worried, confused or scared of saying or doing the wrong thing. But remember that it's not your responsibility to fix anything. Sometimes just listening to how they're feeling can be a really big help.

If a friend opens up to you about struggling with anxiety, here are some things you can do to support them.

It's important to remember to look after your own mental health too and only support them in ways that feel manageable for you. It's not all on you to support your friend with anxiety. For more information and advice, have a look at our guide on supporting a friend with their mental health.

We never really spoke of my troubles explicitly; he just knew that I was struggling and was always on hand to suggest fun activities and encourage me to do them with him.

Where to get help

If anxiety is taking over, you are not alone. Here are some services that can help you get through this.

This page was reviewed in June 2023. It was co-created by young people with lived experience of anxiety. We will next review the page in 2026. YoungMinds is a proud member of PIF TICK - the UK's quality mark for trusted health information.

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Anxiety and Anxiety Disorders | Signs and symptoms

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Anxiety is a feeling of fear or panic that many young people experience. Find out about the causes and symptoms of anxiety and where to get help.

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Dan Siegel's Hand Model of the Brain, Flip Your Lid

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Fight Flight Freeze – A Guide to Anxiety for Kids

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NSPCC supporting your child with anxiety

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NSPCC supporting your child with anxiety

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How to support a child with depression or anxiety

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Recognise the signs of anxiety and depression in children and get advice on how you can best support a child who needs your help. How to support a child with childhood depression or anxiety.

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We provide free, 24/7 crisis support across the UK through Shout

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Helping your child with fear and worries

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Helping your child with fear and worries

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Facing Mighty Fears About Trying New Things

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Facing Mighty Fears About Trying New Things

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