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 physical wellbeing, relationships and educational attainment. Mental health can also change over time, to varying degrees of seriousness, and for different reasons.
We know it's an important issue for children. Over half of all Childline counselling sessions in 2024/25 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'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. It's also important to know how to take appropriate action to support babies, 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 babies', children's and young people's mental health.
What does mental health mean?
Mental health is an individual's cognitive, behavioural and emotional wellbeing.1 It's something we all have - including every baby, 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.
Any baby, child or young person can develop mental health issues. But research has shown there are some factors that are associated with children'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).1,2
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.3,4 One study found that almost three quarters (74%) of young people who had experienced sexual assault developed PTSD.5
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).6
Watch experts discuss how child abuse and neglect might adversely affect mental health.
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.
An open environment will help them communicate the challenges they are facing and may help them feel able to tell you what’s been happening to them.
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.
Providing effective mental health support for children who have experienced abuse and neglect can help them recover from its effects.7
d/Deaf children and children who have disabilities
d/Deaf children and children who have 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.8
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.
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.10,11
Statistics suggest that children in care are more likely than their peers to have a mental health difficulty. 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.12
Children may come to you directly with worries about their mental health and wellbeing. It’s important you feel confident having these conversations with children. You could try some of the techniques and strategies used by our Childline counsellors to help you talk to children about their mental health.
There are lots of factors that might make it difficult for a child or young person to ask for help.
Children and young people may not have the language or ability to communicate how they feel. Or they may be unsure who to talk to and how to talk about their problems.
Babies and young children aren’t able to verbally communicate their feelings. Older children and young people may not want, or feel able, to discuss their mental health.1 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'. 2
Creating an environment where mental health and wellbeing are both promoted and openly discussed can help children feel able to speak about their worries.
If you’re concerned that a child may be struggling, don’t wait for them to come to you.
Make sure you are familiar with the potential signs a child is experiencing mental health concerns. Encourage them to share their worries with yourself or another trusted adult and take action to help them get the support they need.
Different children may show different signs of poor mental health at different ages and stages of development. Indicators of poor mental health can be influenced by many factors, including children’s personalities, identities, needs and experiences.3
Some signs of mental health issues may look like normal child behaviour. For example, ‘tantrums’ in younger children or teenagers keeping feelings to themselves. Other mental health issues may not have visible signs.
It’s helpful to think about the context and patterns of the emotions and behaviours children display. For example, is there a known cause, such as a stressful event at home? Are the intensity of emotions or frequency of behaviours unusual for the individual child?4
There could be a number of different explanations for potential signs of mental health issues.
Don't attempt to diagnose mental health issues yourself or make assumptions about what’s happening in a child's life.
Do look out for signs, talk to the child about how they’re feeling and share any safeguarding concerns in line with your organisation’s child protection policies and procedures.
Babies and young children
In the first years of a child’s life they are developing the ability to understand and manage their emotions and build meaningful relationships. How parents and carers bond with and emotionally support their children can significantly shape babies and young children’s mental health. When working with babies and young children it’s important to observe the parent-child relationship and note any concerns.
Babies and young children sometimes display behaviours that could indicate potential mental health concerns. This can include characteristics of anxiety disorders, depression and post-traumatic stress disorder.5
Behaviours that babies might display include:
persistent crying which cannot be soothed
changes in behaviour around, or struggles with, settling, feeding or playing
becoming rigid, arching their back, squirming to physically escape feelings of distress
finding it difficult to respond to their caregiver’s cues
after a change in routine or separation from a caregiver they struggle to self soothe (if they have already started being able to self soothe).6
Behaviours that young children might display include:
frequently being unable to manage their emotions or behaviours, these are sometimes called ‘temper tantrums’
an increase in signs of fearfulness when being separated from their caregivers
an increase in angry or aggressive behaviours, for example towards caregivers and peers
being withdrawn or showing little interest in social interaction
being very overactive, restless or not being able to concentrate.6
Many of these signs and behaviours can happen when there are no concerns regarding mental health. However, these signs combined with other information about a family’s situation could point towards concerns and the need for further assessment.
Older children and young people
By being attentive to a child or young person's mood and behaviour, you can recognise patterns that may suggest they need support.
Common warning signs of mental health issues in older children 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.
Mental health issues indicate that a child or young person needs support. If possible, discuss with them what help could be put in place. If you are supporting a baby or young child, this conversation could be had with their parent or carer.
If a child isn't able, or doesn’t want, to talk about their mental health needs 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.
Watch practitioners talk about how mental health issues can lead to a safeguarding concern.
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
If a child is confiding in you about their mental health they may ask you not to tell anyone what they've expressed.
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.
If you're concerned about someone's safety and welfare you must share this information with relevant professionals.
Sources of support
There are lots of different types of support available for children’s mental wellbeing and to help with mental health issues.
Midwives and health visitors
During the perinatal period, from pregnancy up to a year after birth, mothers can be affected by a number of mental health problems. These can range from antenatal and postnatal depression to anxiety and postpartum psychosis.1 Fathers can also experience mental health concerns, such as depression and anxiety.2
If perinatal mental illnesses go untreated they can have long-term implications for the wellbeing of parents and their children.3
Midwives and health visitors play a key role in identifying and responding to parents and families affected by perinatal mental illness.
GPs may be able to diagnose children’s mental health conditions, suggest next steps and provide medication, if appropriate. There is information for children and young people about visiting GPs on the Childline website.
Child and adolescent mental health services (CAMHS)
Across the UK, CAMHS is a free NHS service for children 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.
Pregnancy in Mind is a preventative mental-health service designed to support parents-to-be who are experiencing or at risk of mild to moderate anxiety and depression.
Look, Say, Sing, Play is a set of resources which encourage interaction between parents and their babies to help positively shape brain development.
Letting the Future In is a play-therapy service that helps children who have been sexually abused.
Building Connections is an online service to help young people aged under 19 to find a way through loneliness.
Consent for treatment
It's best practice to get parental consent for children's therapeutic and medical treatments. You should have an organisational policy about seeking and obtaining consent from the child or young person and their parents. But there may be times when a child or young person does not want their parents to know. In this case, your policy should set out how you would assess whether the young person has the capacity to make the decision for themselves to consent to treatment.
The Gillick competency and Fraser guidelines help professionals assess whether a child is mature enough to make decisions.
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 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.2,3 An interim strategic framework setting out the key elements of this new approach was published in 2023.4
In Northern Ireland, the Department of Health has published a mental health strategy for 2021-2031.5 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).
The Department of Health has also published a Mental Health Action Plan, which is comprised of 38 actions.6
In Scotland, Getting It Right For Every Child (GIRFEC) includes eight wellbeing indicators and lists resources professionals can use or adapt for conversations with children, young people and families.7
In England, the Department for Education’s (DfE’s) Early years foundation stage (EYFS) statutory framework covers the standards that school and childcare providers must meet while caring for children in their early years. It includes guidance on children’s personal, social and emotional development.10
In Northern Ireland, the Public Health Agency has an Infant Mental Health Framework (PDF) that gives guidance on prioritising and supporting the development of positive social and emotional wellbeing in children 0-3 years.11
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, neglect or exploitation. The guidance includes information on how schools and colleges should support children and young people’s mental health.14
The DfE has 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.15
The DfE has also published guidance for schools and colleges on the help available for developing a whole school approach to mental health and wellbeing.16
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.17
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.18
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 experienced abuse or other adverse childhood experiences might be more vulnerable to mental health problems.20
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.21
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.22
Children with additional needs and disabilities
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.23
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.24
The Department of Education’s resource to support children who have or may have special educational needs includes a chapter on Social behaviour and emotional wellbeing.25 This highlights that social behaviour and emotional wellbeing (SBEW) ias an identified need for every single member of the school community. It provides guidance on developing a supportive and nurturing whole school ethos.
If you work or volunteer with children in sport, the Child Protection in Sport Unit (CPSU) has information about supporting mental health in a sporting environment.