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Talking mental health

How to get kids and teens to open up.

Article Author: Juice Staff

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They're conversations you never want to have: death, distress and despair. These are tough topics for anyone to discuss, let alone with your child or teenager. But you need to do it.

“Talking to kids about mental health keeps them safe. I’ve asked my own teens if they’ve thought about taking their lives. You just have to ask the hard questions,” said Terrie Andrews, PhD, clinical psychologist and administrator for Baptist Behavioral Health and Wolfson Children’s Behavioral Health.

Why the need?

Before COVID-19, one in five children lived with a significant mental illness. That increased to one in three children during the pandemic, said Dr. Andrews. Wolfson Children’s Hospital has seen a 200% increase in emergency behavioral health admissions (including overdoses, anxiety, depression and eating disorders) since the pandemic began.

Half of all lifetime mental health issues start by age 14. Suicide is the second-leading cause of death in people aged 15 to 25, and suicide attempts rose 50% in girls ages 12 to 17 in the first few months of 2021, according to the Centers for Disease Control and Prevention (CDC).

The pandemic worsened an already existing crisis.

Zachary’s story

Confiding in a friend helped a Jacksonville teen find hope. When mom Jennifer Sampson arrived home one afternoon in August 2020, the former crisis response counselor couldn’t believe police officers were at her front porch. The Jacksonville Sheriff’s Office was responding to a call that her then-15-year-old son, Zachary, was suicidal. She’s helped countless parents in emergency situations, but she didn’t see the signs in her own son.

A socially and academically strong kid in school, Zachary started to change his freshman year. He became withdrawn, irritable and depressed when the COVID-19 pandemic hit. His grades slipped and he started caring less about his appearance.

That August afternoon, Zachary was immediately admitted to Wolfson Children’s Hospital, where he was diagnosed with a major depressive disorder and ADHD. He was eventually discharged but admitted again in March 2021 following a second major depressive episode. With Wolfson Children’s expert care and support, Zachary, now 16, is home and managing his conditions with medication and outpatient counseling.

“Everyone at Wolfson Children’s who has interacted with him has been compassionate and caring,” Jennifer Sampson said. “There’s nothing I would have changed for such a difficult situation.”

Zachary refuses to let his diagnosis define him and he wants to inspire other struggling teens to reach out for help.

Youth in crisis

To help families like Zachary’s start critical conversations about mental health, Wolfson Children’s launched the national movement, On Our Sleeves, in Northeast Florida and Southeast Georgia in May 2021.

The program is based on the notion that it’s often difficult to know when kids are struggling because they don’t wear their thoughts on their sleeves. The goal is to give children a voice while breaking the stigmas tied to mental health conditions. On Our Sleeves provides free, easy-to-use educational tools and resources to parents, teachers and other advocates to encourage mental well-being, manage mental health conditions and prevent crises.

Conversation starters

Teens aren’t necessarily going to tell you they are depressed. Often parents – no matter how tuned in – are the last to know.

But surprisingly, once parents make that first move and start the conversation, teens often will open up, said Dr. Andrews.

“You just have to ask the right questions,” she said.

If you’re stumped on what to say, Dr. Andrews shared some examples.

  • Have you thought about hurting yourself?
  • Are there times when you feel you don’t want to keep going?
  • Have you felt nervous lately?
  • Are there things that bother you that you can’t shake from your mind?
  • What are your upcoming tests or activities? Tell me how you feel.
  • Do you have trouble sleeping?
  • Are you getting stomachaches?
  • Have you ever felt like you wanted to give up on your life?

No shame

Some kids and teens are more vocal. They may express feelings of hopelessness, but parents still avoid having difficult conversations.

“We would never question whether to take a child to the ER for heart pain, but with mental health parents too often say, ‘We will handle it behind closed doors where no one knows about it,’” Dr. Andrews said. “It’s crucial to get the word out about mental health and encourage parents to have the difficult discussions with their children. We need our community to wrap these kids up and help them.”

See the signs

You can look for possible clues your child or teen may need help, including:

  • Isolation, often in his or her room
  • Lack of participation in family activities
  • Changes in friend groups
  • Emotional or angry outbursts
  • Sleeping issues
  • Poor eating habits
  • Vague statements like, “This place sucks,” “I hate you,” or “I’m tired of this”

Constantly checking in with your kids is important, said Dr. Andrews.

“You can say what you want, as long as it comes from the heart and without anger. You know your child.”


You can sign up now for the On Our Sleeves monthly e-newsletter, which features timely, actionable resources for parents, caregivers and other concerned adults. If you need to speak to someone immediately, call the 24/7 Kids & Teens Helpline at 904.202.7900 or text LIFE to 741741.

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