When Families Need Help But Youth Mental Health Only Matters After Something Goes Wrong

Caveat - This article is a follow-up to one we published last week titled, “We Never Saw It Coming: Understanding Teen Self-Harm and Suicide: Some Thoughts for Parents and Caregivers” (1). The conversation we had with the parent whose experience inspired that original article stayed with us and prompted us to take the discussion one step further. That interaction became the impetus for this follow-up and for a broader conversation about what we can do earlier, before a young person’s mental health challenges reach the point of crisis.

There is something we believe deserves far more attention in the conversation surrounding youth mental health than just a reactive approach. Too often, mental health appears to become a priority only after something has gone significantly wrong. A young person can struggle quietly for weeks, months, and sometimes much longer without their emotional wellbeing generating the same urgency that suddenly appears when their distress becomes visible through anger, aggression, threats, self-harm and suicidal ideations, substance use, property damage, running away, violence, or another behaviour that causes adults to become frightened for the safety of the young person or those around them. At that point, parents, caregivers, schools, emergency services, and sometimes police become involved, and what may have been developing quietly for a considerable period of time is suddenly treated as an urgent mental health crisis.

We believe this raises an uncomfortable but necessary question, “Why does a young person’s mental health sometimes seem to matter more once their pain begins affecting everyone around them?” A teenager experiencing anxiety who continues attending school may receive little attention. A young person struggling with depression who retreats into their bedroom may be described as moody, lazy, antisocial, or simply “being a teenager.” A child who is experiencing bullying but becomes quieter rather than disruptive can easily disappear into the background of a classroom. However, when that same emotional distress eventually emerges through an explosive confrontation, a threat, an assault, damaged property, suicidal behaviour, or another serious incident, suddenly everyone wants to know what happened and what needs to be done.

The challenge is that what happened immediately before the crisis may only represent the final few minutes of a story that has been developing for months.

One of the challenges parents and caregivers face is that children and teenagers do not always communicate emotional distress in ways adults immediately recognize as a request for help. We sometimes imagine that a young person experiencing significant anxiety, depression, loneliness, trauma, bullying, relationship difficulties, academic pressure, family conflict, or social rejection will eventually come to us and clearly explain what they are experiencing. Certainly, some young people will. However, many will often not have the language, confidence, emotional awareness, or relationship with an adult that allows them to say, “I’m struggling and I think I need help.” Instead, their emotional distress may begin appearing through changes in their behaviour.

A teenager who once enjoyed spending time with family may suddenly retreat to their bedroom. A young person who normally enjoyed school may begin finding reasons not to attend. Someone who previously handled frustration reasonably well may suddenly become angry over seemingly insignificant things. Grades may decline, sleep patterns may change, friendships may disappear, substance use may begin, gaming may become an escape, or a young person’s online behaviour may change dramatically. Sometimes the change is loud and obvious, while other times it is quiet and incredibly easy to miss.

This does not mean that every behavioural challenge should be interpreted as evidence of a mental health condition. Young people become angry, teenagers test boundaries, and children make poor decisions. Adolescence includes emotional, neurological, social, and developmental changes, and sometimes inappropriate behaviour is simply inappropriate behaviour that requires reasonable boundaries and accountability. However, accountability and curiosity do not have to be mutually exclusive, we can address the behaviour while simultaneously asking what might be happening underneath it.

Rather than only asking, “How do we stop this behaviour?” perhaps we also need to ask, “What might this behaviour be trying to tell us?” Sometimes the behaviour is the problem. Sometimes the behaviour is the smoke telling us that there may be a fire somewhere we haven’t yet seen.

One of the realities we have witnessed over many years of working with young people and families is that quiet suffering can be remarkably easy for adults and institutions to overlook. The teenager who continues attending school despite significant anxiety may not attract attention because they are still functioning. The child who sits quietly at the back of the classroom while struggling with depression may not become a behavioural concern. The young person who spends most evenings isolated in their bedroom may simply be described as introverted. The teenager being socially excluded may continue smiling around their parents because they don’t want them to worry.

Then something changes. Perhaps the teenager refuses to go to school, perhaps there is an explosive confrontation at home, perhaps they punch a hole in a wall, perhaps they threaten someone, perhaps they become intoxicated, perhaps they run away, perhaps a parent or caregiver discovers evidence of self-harm, or perhaps the young person says something that causes someone to believe they may hurt themselves or another person. Suddenly, the response becomes very different.

Teachers, administrators, counsellors, parents, doctors, emergency departments, crisis teams, and sometimes police may become involved. Resources that previously appeared difficult to access may suddenly become available because the situation has crossed a threshold where the young person’s emotional distress is now considered an immediate safety concern. However, why do families have to wait for a crisis to evolve to get the help they need?

This is where we believe we need to challenge ourselves. If our systems become most responsive only when emotional pain becomes dangerous, disruptive, or impossible to ignore, then what we have created is primarily a crisis response system rather than a crisis prevention system and there is an important difference between the two.

Having spent 30 years in policing, Darren learned very quickly that police officers frequently meet people during some of the worst moments of their lives. Officers rarely arrive when everything is going well. They are often called because something has happened, somebody is frightened, somebody may be in danger, or a situation has deteriorated beyond what those present believe they can safely manage.

Youth mental health calls are no different. From the perspective of the police officer arriving at the scene, the situation may appear to have started minutes earlier. There may be an angry teenager, a frightened parent, damaged property, threats, allegations of violence, concerns about self-harm, or family members who simply do not know what to do anymore. The officer must quickly determine what has happened, whether anyone is in immediate danger, whether an offence has occurred, whether medical or mental health intervention may be necessary, and how to stabilize a highly emotional situation involving people they may never have met before.

However, the story behind that police call may have started long before the officer arrived. There may have been months of deteriorating mental health. There may have been bullying at school that nobody knew about. There may have been an abusive relationship, social exclusion, family conflict, academic pressure, sexual exploitation, sextortion, online harassment, sleep deprivation, substance use, trauma, or the loss of an important friendship. Parents and caregivers may have already tried to access counselling. Teachers may have noticed behavioural changes without understanding their significance. Friends may have known something was wrong but didn’t know whom to tell. The young person may have attempted to communicate their distress indirectly without anyone recognizing what they were trying to say.

Then something finally breaks, and police are now being asked to enter a situation that may have taken months or even years to develop and somehow help resolve it within minutes, and that is an enormous expectation to place on policing. More importantly, it raises the question of why we sometimes allow a struggling young person to travel so far down the road toward crisis before meaningful intervention occurs.

We want to be very clear about something, there are circumstances where police involvement in a mental health crisis is absolutely necessary. When there is an immediate threat to life, serious violence, a weapon, an imminent risk of someone being seriously harmed, or circumstances where a situation cannot otherwise be safely managed, police may play an essential role in protecting the young person, their family, and the community. The concern is not that police should never be involved, the concern is why they became necessary.

Police officers are trained to respond to rapidly evolving situations, establish safety, protect life, prevent further harm, investigate potential offences, and connect people with additional emergency resources when appropriate. Those are important responsibilities. However, asking police to become the primary point of intervention for a young person, or even an adult, experiencing a mental health crisis means we are often asking someone trained primarily for public safety to enter at the most complicated and volatile point of an emotional problem that may have been developing for a very long time.

The better question is not simply, “How do we improve police response to youth mental health crises?” That conversation certainly matters. However, we believe an equally important question is, “How do we reduce the number of young people whose mental health deteriorates to the point where police intervention becomes necessary in the first place?” That is where prevention and treatment needs to become central to the conversation.

When people hear the words “mental health intervention,” they often think immediately about psychologists, psychiatrists, therapists, counsellors, diagnoses, assessments, medication, or hospitalization. Those resources can be incredibly important, but mental health prevention begins long before a young person reaches the point where any of those interventions may become necessary.

Prevention begins with emotional literacy. It begins when children learn that sadness, anxiety, embarrassment, anger, rejection, jealousy, loneliness, fear, and disappointment are emotions that can be discussed rather than hidden. It begins when adults model healthy ways of handling frustration and conflict. It begins when children learn that asking for help is not evidence of weakness. It begins when schools ensure students know who their trusted adults are. It begins when coaches, teachers, parents, grandparents, and caregivers recognize that significant changes in behaviour sometimes deserve a second question rather than an immediate judgment.

It also begins with the language we use. When a young person’s behaviour changes, our instinct may be to ask, “What’s wrong with you?” Imagine how differently that conversation might begin if we asked, “What’s happening with you?” The first question can sound accusatory. It focuses attention on the young person as the problem. The second question creates space for a story. It communicates curiosity rather than judgment and recognizes that behaviour does not occur in a vacuum. Sometimes that second question is where prevention begins.

Parents and caregivers are often encouraged to watch for “warning signs” of mental health concerns. These lists can certainly be useful, but they can also create an unintended problem if we begin treating youth mental health like a checklist where a certain number of symptoms automatically tells us whether something is wrong. Children are far more complicated than that.

A behaviour that is perfectly normal for one teenager may represent a significant change for another. One child may naturally spend considerable time alone and be perfectly happy doing so. Another may normally be incredibly social, meaning sudden isolation could be significant. One teenager may have always struggled academically. For another, a dramatic decline in grades may represent an important change. One child may naturally stay up late. Another suddenly remaining awake throughout the night may deserve closer attention. This is why we encourage parents and caregivers to think about changes from their child’s normal baseline rather than simply looking for individual warning signs.

Has your child stopped doing something they previously loved? Has their personality noticeably changed? Have they withdrawn from important friendships? Are they suddenly struggling to attend school? Have their sleeping or eating patterns changed significantly? Are they becoming increasingly angry or emotionally volatile? Have they become unusually secretive? Do they appear hopeless, overwhelmed, frightened, or disconnected? Has something changed in their online life?

None of these observations automatically means a young person is experiencing a serious mental health issue. However, significant changes should create curiosity rather than assumptions. Sometimes the most important thing a parent can say is simply, “I’ve noticed you haven’t seemed like yourself lately. What’s going on?”

Any meaningful conversation about youth mental health today also needs to recognize that young people’s emotional lives do not stop when they pick up their phones. Their friendships, relationships, identities, conflicts, embarrassment, rejection, popularity, sexuality, creativity, entertainment, and sense of belonging increasingly move between offline and online spaces.

A disagreement that begins at school can continue through a group chat throughout the evening. A romantic breakup can become public through screenshots and social media. A humiliating photograph can circulate while a teenager is sitting alone in their bedroom. Social exclusion can become painfully visible when a young person watches photographs and videos of friends gathering without them. Bullying can follow a child home. Sextortion, grooming, harassment, impersonation, deepfakes, and other forms of online victimization can create emotional consequences that parents may never see unless their child tells them.

At the same time, technology can also provide young people with friendship, support, creativity, education, entertainment, identity exploration, and communities where they experience genuine belonging. This is why blaming “the phone” or “social media” whenever a young person experiences a mental health challenge oversimplifies what is often a far more complicated and nuanced situation.

Rather than only asking, “How much time are you spending on your phone?”, sometimes parents and caregivers should also be asking, “What’s happening on your phone?” Those are two very different questions. One measures time, while the other attempts to understand experience.

There is another uncomfortable part of the prevention conversation that we cannot ignore. We frequently tell parents and caregivers that early intervention is important and that they should seek professional help when they are concerned about their child’s mental health. That sounds straightforward until a family actually attempts to find that help.

A parent or caregiver may recognize that something has changed, speak with their child, contact the school, visit their family doctor, seek counselling, contact community services, and discover that meaningful ongoing mental health care is not immediately available. There may be lengthy waitlists, shortages of professionals who specialize in children and adolescents, geographic barriers, financial barriers, or thresholds that a young person must meet before qualifying for certain services.

This can leave families trapped in an incredibly frustrating position. They are told not to wait for a crisis, while simultaneously discovering that some parts of the system become easier to access once a crisis actually occurs, and that contradiction deserves much greater public attention.

If we genuinely believe prevention is preferable to crisis intervention, then families need meaningful access to support while problems are still manageable. A parent or caregiver who says, “My child is changing and I am worried,” should not have to wait until that statement becomes, “My child is in immediate danger,” before the system responds with urgency. Prevention and treatment cannot simply be something we tell parents to practise, it has to be something our systems are designed to support.

Parents and caregivers cannot guarantee that their children will never experience depression, anxiety, trauma, bullying, heartbreak, loneliness, rejection, exploitation, or other significant challenges. No parenting strategy can eliminate every mental health difficulty or prevent every crisis. What parents and caregivers can help build is a relationship where their child believes difficult things can be brought to them.

That relationship is rarely created during the crisis itself, it’s built through thousands of seemingly insignificant interactions throughout childhood and adolescence. It grows when we listen to small problems rather than dismissing them. It grows when mistakes do not automatically result in humiliation. It grows when our children learn that telling us something uncomfortable will not necessarily cause us to explode, panic, confiscate everything they own, or immediately take control of the situation without first listening to them.

This does not mean becoming permissive. Parents still need boundaries, expectations, consequences, and accountability. However, accountability should exist alongside connection.

We want our children to know that when something goes seriously wrong, their instinct can be to move toward us rather than away from us. Sometimes one of the most protective messages a parent can repeatedly communicate is, “Whatever happens, bring it to me. We will figure out what to do next together.” That doesn’t turn a parent into a therapist, it makes the parent or caregiver a bridge between their child and whatever support may be needed next.

Imagine youth mental health as a long continuum. At one end is a young person beginning to struggle, and at the other is an emergency requiring immediate intervention. Between those two points can exist dozens, sometimes hundreds, of opportunities to change the trajectory. There can be a conversation with a parent or caregiver. A teacher can notice a change, a coach can ask a second question, a friend can tell a trusted adult that they are worried, a school counsellor can become involved, a family doctor can assess what is happening, and a young person can learn coping strategies. Professional counselling can begin, family conflict can be addressed, bullying can be interrupted, sleep can improve, academic pressure can be reduced, online victimization can be discovered, relationships can be repaired, and community resources can become involved.

The problem occurs when our greatest urgency, attention, and resources become concentrated primarily at the far end of that continuum. When the young person finally reaches crisis, everyone responds, but what if we became just as interested earlier?

What if we listened earlier, asked questions earlier, provided counselling earlier, supported parents earlier, taught emotional literacy earlier, addressed bullying earlier, investigated behavioural changes earlier, and created accessible mental health services earlier? Prevention doesn’t mean believing every crisis can be avoided, it means recognizing that waiting for crisis should never become our default pathway to care. 

Unfortunately, effective early intervention requires both adequate funding and timely access to appropriate supports. In our experience, both are often in short supply. Programs and services can be difficult to access, waitlists can be lengthy, and in some communities funding for preventative mental health supports is being reduced or eliminated altogether as governments, school districts, and service providers struggle with increasingly strained budgets.

There is an important conversation taking place about improving police responses to mental health crises. Crisis intervention training, partnerships with mental health professionals, mobile crisis teams, de-escalation training, and alternative response models can all be valuable parts of improving what happens when someone reaches crisis and police now become involved.

However, we should be careful not to allow improving crisis response to distract us from preventing crisis whenever possible. Success should not simply be measured by how effectively police respond after a young person’s mental health has deteriorated to the point where someone feels compelled to call 911. We should also measure success by how often that call never needed to happen.

How many young people received help before their anger became violence? How many families received support before conflict became unmanageable? How many children were connected with counselling before hopelessness became suicidal thinking? How many schools noticed the quiet child as quickly as they noticed the disruptive one? How many parents and caregivers felt comfortable saying, “Something has changed in my child,” and discovered that someone was available to listen? Those are prevention questions.

When a young person’s emotional distress finally emerges through aggression, violence, self-harm, suicidal behaviour, substance use, or another emergency, we understandably focus on what needs to happen immediately. However, once everyone is safe, there is another question worth asking, “What opportunities existed to help this young person earlier?”

That question should not be about blaming parents, teachers, schools, healthcare providers, police officers, or the young person themselves. Sometimes there were no obvious warning signs, sometimes families did everything they reasonably could, sometimes mental health conditions emerge rapidly, and sometimes extraordinary support is already in place and a crisis still occurs. Prevention is not a guarantee, it's a philosophy. It means believing that a young person’s emotional wellbeing deserves attention before their pain becomes dangerous enough to demand ours.

Youth mental health should matter when a child becomes unusually quiet. It should matter when their behaviour begins changing, it should matter when they suddenly stop seeing their friends, it should matter when they no longer want to attend school, it should matter when a parent says, “Something just doesn’t feel right”, and it should matter when a teenager says they are overwhelmed, lonely, frightened, angry, or exhausted. 

Most importantly, it should matter before the police are standing at the front door. Police will always have an important role when immediate safety is at risk, but they should never become our substitute for accessible youth mental health care, strong family relationships, supportive schools, early intervention, and community-based prevention.

When it comes to youth mental health, perhaps one of the most important shifts we can make is moving from asking, “How do we respond when something goes wrong?”, to also asking, “What can we do earlier so that, whenever possible, it never reaches that point?”

The measure of a healthy approach to youth mental health should not simply be how effectively we respond to young people in crisis. It should also be how hard we work to reach them before they get there.

Digital Food For Thought

The White Hatter

Facts Not Fear, Facts Not Emotions, Enlighten Not Frighten, Know Tech Not No Tech

Reference:

1/ https://www.thewhitehatter.ca/post/we-never-saw-it-coming-understanding-teen-self-harm-and-suicide-some-thoughts-for-parents-and-c