How to Have a Mental Health Check-In With Your Teen and Preteen

Is your teen or tween behaving more differently than usual? I know, this probably seems like a trick question. The emphasis is on the word more. For example, has your usually uber-responsible fourteen-year-old neglected to take the dog out again, forgot two class assignments in a row, and just failed an exam in his easiest subject? Or has your outgoing, mild-tempered eleven-year-old started to disappear into her room for hours at a time and when she does come out, she is increasingly prone to tearful and aggressive outbursts?

Whether your child is a preteen or a teen, mental health symptoms are widespread around this age. Studies show that mental health and substance use had been rising among adolescents even prior to the pandemic. According to the CDC, 7.1% of children ages 3-17 have been diagnosed with anxiety and 3.2% with depression. In addition, the National Alliance on Mental Illness says that one in five teenagers from 13-18 will experience a “severe mental disorder,” as well as 13% of kids from 5-15 years old. 

So, the COVID-19 pandemic didn’t cause the decline in youth and adolescent mental health, but it certainly didn’t help.  

The puzzling changes that your child is going through will not go away if you ignore them. And with the strange 18 months we’ve all experienced, we need to check-in on our child’s mental health now more than ever. 

If you are struggling with how to check-in on your child’s mental health, here are some tips to get you started.

Keep an Eye Out on the Warning Signs

Preteens and teens have different developmental needs than adults. They are at a phase in life where their peer connections are incredibly important. Depending on their age, stage, and level of maturity, your preteen or tween may not fully comprehend how the past 18 months have impacted their world. Also, preteens and teens enter puberty with mood changes due to hormonal changes that have nothing to do with the pandemic. It’s important to watch out for these signs, particularly if they’re interfering with your teen’s life.

• Changes in school performance. Your child may be falling behind in school. Even if your child is not a “perfect” student, watch for changes in effort. An occasional poor grade is one thing, but it’s an entirely different matter if your child simply stops trying.
• Changes in sleep. Your child may have trouble falling asleep, waking up in the middle of the night, or is sleeping too much. There may be something more going on with them if they prefer to spend most of their days in bed.
• Intense moodiness. Your child may spend a lot of time crying or getting very angry. If this type of behavior goes on for at least two weeks, your child could be battling mental or emotional distress.
• Loss of interest in activities they enjoy. Teens like to have fun on the weekends with their friends or join clubs or sports to be more social. However, experiencing struggles like anxiety, despair, or depression can make them lose interest in things and people they once enjoyed, causing extreme isolation.
• Changes in appetite or weight. If your child is hardly eating, or hoarding food, or you see fluctuations in their weight, they could be struggling emotionally and/or with a food-related concern.

Ask Questions

Once you observe signs that your child may be struggling, it’s time to ask questions. It may feel awkward at first, but it’s better to ask a question imperfectly than not to ask it at all. The key here is to encourage them to open up. One way to create a connection is to share your stuff first. First, start off by sharing how your day went. This will help your child to establish trust that they can come to you. Afterwards, you can ask them if they can share something about their day. 

Avoid asking open-ended questions like: “Are you okay?” Otherwise, you’ll just get an “I’m fine” response.

Instead, ask them questions that involve somewhat lengthy responses like: 

• “What’s taking up most of your headspace today?”
• “What was your favorite part of your day?” 
• “What was difficult about your day?” 
• “What load are you carrying that feels particularly heavy today?”
• “When was the last time you hung out with your friends?”
• “When was the last time you went outside and moved your body?”
• “How can I encourage or support you better moving forward?”

This should inspire a dialogue between you two.

Offer Validation Instead of Solutions

Depending on how your child responds, as a parent, you may be quick to offer a solution to save your preteen or teen from struggling. However, whatever your child is going through is often too complex to have a simple solution. One of the most productive things you can do when your preteen or teen is struggling emotionally is to listen. Avoid giving advice, making cliché statements, or aggressively coaching them on what to do to get out of the slump. Unless they ask specifically for guidance, it’s better to listen to what they have to say with no interruptions or judgments. It’s great for your preteen and teen to know that you are listening and taking what they say seriously.

Validate that you understand they are having a tough time and compliment them on their efforts. Remind your preteen or teen that you are always there for them. Validation isn’t necessarily agreeing with your child’s assessment of their situation. Instead, validation is a communication tool that helps to shore up the parent-teen relationship foundation.

When you have a stable, nurturing relationship with your child, they will feel more comfortable coming to you for help when they are in trouble.

Refer Your Child to Other Sources

Generally speaking, keep whatever your child shares with you in confidence. Be sure to obtain permission before sharing the private details of their struggles with anyone. However, there’s a caveat to that. There is one occasion where you will need to share what you’ve heard. If your child shares something that places themselves or someone else in danger, seek immediate help from a mental health professional. 

If they share a struggle that doesn’t fall into that category (such as academic or social pressures), but your child would rather work through it with someone else, try not to take it personally. Simply refer them to another adult like a mental health therapist, pediatrician, school counselor, or youth leader. The important thing is that your preteen or teen gets the support they need.  

As awkward and uncomfortable as it may initially feel, daily mental health check-ins will help bring you closer to a stronger relationship with your preteen and teen. If you need additional support with a kid or teen struggling with anxiety or depression, consider grabbing a book I co-authored called Seen. 

In the book Seen: Healing Despair and Anxiety in Kids and Teens Through the Power of Connection, we outline five connection tools that will guide parents and caring adults to help kids and teens feel seen and heard. 

Chinwé Williams, PhD, LPC, NCC, is a licensed clinical therapist and owner of Meaningful Solutions Counseling & Consulting in Roswell, Georgia. Dr. Williams specializes in adolescent, young adult, and family mental and emotional wellness. She has most recently served as an associate professor, a college and high school counselor, a clinical therapist, and an executive coach. She is also a consultant for schools, non-profit, faith-based, and corporate work settings. A published journal author and a frequently featured expert and podcast contributor on topics related to child, adolescent, and adult mental health and parenting, she is the co-author of the book Seen: Healing Despair and Anxiety in Kids and Teens Through the Power of Connection. To find out more, please visit TheSeenBook.com