YOUR HEALTH | Behind the behavioural issues, recognising youth mental health

Behind a child's behavioural issues

Q: Will my child grow out of their behavioural issues?

Children who have difficulties with their mental health tend to present with two types of behavioural problems: externalised behaviours where they may 'act out'; and internalised behaviours, such as anxiety.

Children who externalise generally can't be at school as they can't tolerate any distress.

Children exhibiting internalising behaviours display anxiety, are very reserved and shy, and can't easily separate themselves from their parents.

Separation anxiety, and being unable to manage interacting with other small children, can show up as early as pre-school and can continue into primary school, where children might find it hard to engage with their peer groups.

In order to recognise any subtle symptoms before they become a disorder, early intervention is important.

Untreated mental health disorders can lead to problems in later adolescence, where youth can suffer from mood disorders and anxiety that may unable them to function at school. We are even seeing young people at crisis point, with suicide becoming a real problem.

Ideally a child psychiatrist should become involved in the initial assessment and management of any child displaying common signs of mental health issues.

However, it becomes even more crucial among children and young people presenting with complex, severe symptoms and who face increased risk to themselves and others.

An assessment of a child's mental health would include all aspects of their life, from what's happening within the family, to what's happening in their school life.

It's not just about the symptoms, it's about understanding what else is happening and how we can support the child.

We try to address any issues the parents might be experiencing, and how parents can be supported in their own way, to better support their kids.

Seeing a child psychiatrist doesn't necessarily mean treatment will involve medication - a fear I hear from many parents.

It's about looking holistically at what's going on for this child in different environments, and then figuring out what's going to work.

Getting help from a mental health professional involves many different options, with the involvement of both parents and adolescents to find a treatment that works best.

Do I need a formal diagnosis?

Some families like to get a diagnosis in order to access support. With autism for example, the diagnosis can mean the school recognises the problem and the child receives early intervention support.

However, some families don't want the diagnosis, saying: "No, that means my child has got a disability, and a lot of people will look at them as a kid with a severe disability."

But whether a child is struggling with their language problem or their social skills, it's still affecting them.

It's not just about the label, it's about others understanding what this child's difficulties are, so they can support them.

If you feel your child does need help, the first point of contact would be your family doctor to talk through what's happening, what your worries are, and what the next step for help is. This might be a further referral to a child psychiatrist directly.

Other resources include the NSW parenting information portal Resourcing Parents, and the Australian and New Zealand College of Psychiatrists site yourhealthinmind.org.