Understanding children’s mental health and wellbeing

Introduction

Mental health and wellbeing moves back and forth along a continuum, it’s always changing. This can happen over a period of time or quite quickly. It’s important to have regular conversations with children and young people to help you understand how they’re feeling and identify any concerns and changes.

Our Childline counsellors use a number of tools and techniques to help them understand how a child is feeling.

The mental wellbeing continuum helps counsellors understand whether a child is doing OK, struggling, unwell or in crisis.
Scaling techniques are used to engage children in a discussion about how they are doing, and what support might help them feel better.

You can use the principles behind both these approaches in your own work with children and young people.

> Find out more about how organisations can take action to respond to children’s mental health concerns

Mental wellbeing continuum

Mental health continuum: Doing OK – Struggling – Unwell – In Crisis

There are many ways to engage with a child about their mental health or emotional wellbeing.

When you communicate with 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 older children’s and young people’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

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.
Has taken action or is planning action to end their life.

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

Scaling techniques

Using scaling techniques

Our Childline counsellors sometimes use “scaling” questions to support a child or young person who wants to work towards a change in their life.

A counsellor gives the child a clear scale – from 1 to 10 – and asks where they think they sit in relation to a specific question.

For example: if 1 is feeling the most anxious you've ever felt and you can't get out of bed for school, and 10 is feeling able to be in school all day and attend lessons, where are you at the moment?

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

what stops you from being a 4?
what would need to happen for you to be at a 6?

There are lots of strategies you can suggest to help children think about ways they can look after their mental health and wellbeing.

> Find out about strategies to help promote child mental health and wellbeing

If a child is struggling with their mental health, it’s important they get the support they need. Follow your organisation's procedures for sharing your concerns.