September is Suicide Awareness Month, and earlier this year there was a report put out by the CDC in regards to youth mental health that was – to put it mildly – alarming. One of the statistics included in these recent numbers stated that: “Over 1 in 5 youth (ages 13-18) either currently or at some point during their life, have had a seriously debilitating mental illness.” They also stated that 1 in 5 students have seriously considered suicide, while 1 in 10 have attempted. Those of us in the mental health field have seen the growing need for services since 2020, with clients coming in younger and younger dealing with complicated mental health symptoms. What we know is that getting help early and ensuring that children have supportive and connected relationships (including a supportive relationship with a trusted adult) are incredibly important early steps in prevention.
For parents unsure where to turn or how to move forward in supporting their child, below are some helpful tips.
When to Reach Out for Help
The first step is recognizing that what your child is experiencing is beyond normal developmental changes. Some “red flags” to be aware of are:
- Drastic Changes in Appearance
- This includes sudden weight gain or loss, wearing clothing that is more revealing, or clothing that covers them more than usual. Adolescents especially tend to project what they are feeling internally by creating an outside persona.
- Sudden Changes in Your Child’s Friend Group
- It’s not uncommon for children to change friend groups, but if you notice that all of a sudden they are no longer hanging out with their best friend with no explanation, or that they are becoming friends with a group you are unsure of, this could be an important factor to consider.
- Changes in Eating and Sleeping Habits
- If you notice your child is sleeping and eating more or less than normal, this can be cause for concern. When assessing for depression and anxiety, this is one of the concerns to be aware of.
- Sudden Mood Changes
- Mood dysregulation is one of the first warning signs that it’s time to reach out for help. If your child is experiencing more frequent mood changes, or they are having reactions that don’t seem to be appropriate to what is happening, this may mean they are struggling with some inner turmoil and it may require working with a professional to help them be able to better manage their moods.
- Changes in Activity Level or Avoidance of Activities
- If your child who normally loves playing baseball is no longer is interested, or they start to give away prized possessions, these are HUGE red flags that something deeper may be going on. In younger children, you may see them starting to have separation issues when it is time to go to school if they normally love going to school. Children also tend to say things like “I have a headache” (or a tummy ache) to avoid activities/school when they are dealing with stress and anxiety.
One sign that is often missed or not addressed is if your child is directly saying that they want to speak with someone – please don’t hesitate to reach out. If your child is recognizing that what they are experiencing is something that they need more support with, lean into that and find a supportive professional to assist your family. Taking care of your kids’ mental health by taking them to a professional is no more a failure in parenting than taking them to their pediatrician when they are physically sick.
Know Where to Ask for Help
Navigating the mental health system can be difficult, and knowing where to turn for help can be overwhelming.
- Start with Your Pediatrician
- Most pediatricians keep a referral list of licensed mental health professionals they can refer to. Depending on the age of your child, their pediatrician typically completes an assessment with them during their well-child visit to assess for signs of depression and anxiety – but you are the expert on your child, as you spend much more time with them than the pediatrician does. So don’t hesitate to ask if you are sensing something more is going on with your child and the pediatrician doesn’t mention it.
- Check with Your School Social Worker/Counselor or Other Support Staff
- Similarly to pediatricians, the support staff at your child’s school will be able to help you by referring you to trusted professionals, and they can also help you access any resources the school can provide.
- Check with Your Insurance Carrier
- If your insurance covers mental health services, you can call the phone number on the back of your insurance card and they will have a list of providers that accept your plan. Know that these lists aren’t always updated, so it’s important to check directly with the provider to ensure they are still accepting clients and that they are still in network with that insurance company. Many insurance plans have “out of network” benefits as well for providers not covered by your plan, but you would need to check directly with the insurance company.
- Use Local Directories
- There are several online directories available to locate a licensed mental health professional. Directories like PsychologyToday.com, TherapyDen.com, and Goodtherapy.org list therapists based on insurance accepted, type of therapy provided, location, and more. There are also target directories if you are looking for a certain therapist like BlackTherapistsinAZ.org, TherapyforLatinx.com, A4PT.org (Association For Play Therapy), and many more. When using an online directory, be sure to verify that the clinician is licensed in your area.
- Utilizing Local and National Crisis Lines
- There are several local and national crisis lines that are designed to help you navigate getting help, such as:
- 988 National Suicide Prevention Line can text or call 24/7
- 1 (844) 534-4673 (HOPE) State Crisis Line
- (602) 248-TEEN (8336) Teen Crisis Line
- (602) 222-9444 Maricopa County Crisis Line
- There are several local and national crisis lines that are designed to help you navigate getting help, such as:
Know the Difference in Providers
The State of Arizona has over 16,000 licensed mental health professionals. In addition to those, there are also pastoral counseling, life coaching, and peer support providers. Knowing the difference in providers can ensure that when you do reach out, you are receiving the proper care. It’s important to know what the different credentials mean:
LMSW (Licensed Master’s Level Social Worker) and LCSW (Licensed Clinical Social Worker)
Has a minimum of a Master’s degree and has been approved by the Arizona Board of Behavioral Health Examiners to provide therapy. For LMSWs, they are approved to provide services while under the supervision of an LCSW, the LMSW is a non-independent license. LCSWs are independently licensed and work in both public behavioral health and private practice. The difference between an LMSW and an LCSW is that an LCSW has completed the required 1600 supervised clinical hours and has passed the ASWB (Association for Social Worker Boards) clinical exam. Though all of the folks on this list can provide therapy, the discipline of social work can be somewhat differentiated by it’s focus on a “person in environment” perspective for the therapy.
LAC (Licensed Associate Counselor) and LPC (Licensed Professional Counselor)
Like LMSWs/LCSWs, both LACs and LPCs are approved to provide therapy by the Arizona Board of Behavioral Health Examiners. LACs, like LMSWs, can work under supervision or in a supervised private practice. LPCs have completed the 1600 supervised clinical hours and have passed either the NCE (National Counselor Examination) or NCMHCE (National Clinical Mental Health Counselor Examination), and they practice either in public behavioral health or private practice.
LAMFT (Licensed Associate Marriage and Family Therapist) and LMFT (Licensed Marriage and Family Therapist)
Like the others mentioned above, LAMFTs are required to be under the supervision of an independently-licensed clinician and LMFTs are fully independently-licensed. Both have completed a Master’s degree in their field of study and LMFTs have completed the necessary supervised clinical hours and passed the Association of Marital and Family Therapy Regulatory Boards’ Marriage and Family Therapy National Exam. LAMFTs and LMFTs are also required to have a certain amount of clinical hours focused on Family Therapy and Couples Therapy before being independently licensed.
These are Doctoral-level practitioners, some PhDs/PsyDs provide individual therapy, and some focus solely on assessments and testing. They are licensed by The Board of Psychologist Examiners. To be approved to test and practice, they have completed their Doctoral degree as well as 3,000 hours of clinical experience including an internship and supervised clinical experience.
Psychiatrists (MD) and Psychiatric Nurse Practitioners (PNP)
Psychiatrists hold a medical degree and are licensed to not only provide supportive therapeutic services but also to prescribe medication to help manage mental health symptoms. Psychiatric Nurse Practitioners are also licensed within our state to provide medication management services.
Life Coaching, Peer Support Services, and Pastoral Counseling
Typically not regulated by one particular board. Some Life Coaches do seek certifications from different organizations, but at this time there is not one centralized path to life coaching. Peer Support Services are typically run by peers (those who also deal with the same issue being addressed), and often take place within the public behavioral health agency setting – where there may be a licensed clinician to assist with facilitation – but often the focus is working with peers who have been in the same position as you. Pastoral Counseling is provided by faith leaders. Though some possess additional degrees and may hold a license from the state board, there is no requirement to do so in the State of Arizona.
What Questions to Ask When Meeting with a Practitioner
Working with children and adolescents is a specialized treatment area. Reaching out for help can be overwhelming, so before getting started be sure to ask the right questions to ensure the right fit. Most mental health practitioners offer free or reduced-fee consultations for new clients, so some helpful questions to ask during a consultation call are:
- What additional training do you have to work with children and adolescents?
- As an example, many clinicians may say they use play therapy in session, but may not be certified in play therapy. Utilizing play vs. utilizing Play Therapy is different. It’s important to know that the clinician you are working with for your child has specialized training working with children and adolescents.
- Do you have any extra training working with (insert the issue your child is dealing with)?
- Making sure the clinician you are working with is trained to handle the issue your child is facing is important for proper outcomes and not all clinicians are trained in specialty areas. As an example, if your child has been diagnosed with ADHD it’s important to work with a clinician who has specialized training in therapy with children with ADHD.
- How will we partner together to help support my child?
- Helping your child navigate a difficult situation will require both you and the mental health professional to work together, and a good clinician may ask you to make some changes for the benefit of your child.
- What type of therapy do you provide?
- Knowing the theoretical basis the clinician comes from helps you understand what treatment will look like. There are several different types of therapy that have proven to be effective for children and adolescents, but knowing the grounding of the clinician gives you the ability to research and determine whether that theory makes sense to you so that you can be prepared to help your child outside the therapy room.
This list is not exhaustive of all the resources available but is meant to help get you started on your search for help.
If you are someone you know is dealing with a mental health crisis don’t hesitate to text or call 988