Talking to a child about their emotional wellbeing and mental health

Children may struggle to understand and find the words to describe their emotional wellbeing. It is parents, family, community other adults and practitioners who help children to understand their emotional world, both in a health and wellbeing sense and in terms of a mental health issue or illness.

Listen deeply to a child when talking with them about their mental health. Give them the space to say whatever they want. Resist the temptation to immediately cheer them up as the child may interpret this as not being ready to hear about, or dismissing, their experiences and feelings.

The information below provides some examples of ways to start a conversation with a child about their mental health.

Before having these conversations, think about:

how the ideas should be adapted to the age, developmental stage, capacity or situation of the child
the purpose of the conversation with the child and what you are hoping to achieve - for example, are you trying to find the best way of supporting the child?
who the best person is to have this conversation with the child — Child Safety, their parent, a carer, or their counsellor or mental health worker
how you will provide responsive support if the child says something that raises concerns about their immediate safety
how to make sure the child is supported after speaking with them, especially if it is distressing.

Be aware of your non-verbal responses to disclosures of self-harm. Ensure that you are not inadvertently labelling behaviours that are described by the child. Instead, remain curious about what is being described.

Practice considerations	Conversation ideas
Understand the persistence and intensity of the child’s feelings. Use tools such as scaling questions or The Bears App to explore the intensity of the child’s feelings. Use a scaling question to explore the intensity of a child’s feelings.	Have a look at these bear cards. Can you pick a bear that is most like you? Is there a bear that you would like to be? Have a look at the scale from 1 to 10. If 1 is the worst you have ever felt, and 10 is the best you have ever felt, how are you feeling today? How did you feel yesterday? Do you think this might change tomorrow or next week? Tell me what words we can use to describe when you are at a 10. What words can we use to describe when you’re at a 3?
Be curious if the child says something to make you worried about their safety.	I noticed you looked (uncomfortable, sad or worried) … when you mentioned John. Can you tell me more about this? Are there things that you are worried or sad about? Is there something I can do or help you to figure out?
Be responsive if the child talks about hurting themselves or dying. If you are worried, call the local Child and Youth Mental Health Service (CYMHS) for advice. 1300 MH CALL (1300 642255) is available 24 hours a day, 7 days a week and will link to your nearest Queensland Public Mental Health service. If you have immediate safety concerns for a child, call 000 for an ambulance.	Thanks for telling me about [use the child’s words]. That must have been really hard to say. It’s important you've spoken up. I want you to know that me, Aunty Janice and Troy really care about you and want you to be OK. Let’s talk about a plan to keep you safe tonight. We can also talk about what we can do to help you. What do you think you need from me to keep safe? From others? Refer to procedure 5 Respond to suicidal behaviour.
Support the child to get help.	Sometimes children just like you need help to talk about their sadness and worry so they can find a way to feel better. I work with lots of children and young people who see counsellors to talk about their sad and worried feelings. It seems to help, and I happen to know a really nice one. I think she can help you too. Counsellors are good listeners and can help you with things that are troubling you. How would you feel about me introducing you to her?

Conversation tips when talking to young people

Conversations with young people about their mental health can be challenging, especially if you do not know where to start. Consider the advice below.

Invest the time to talk. It is unlikely a young person is willing to talk on a first visit. Build a relationship of trust with them. Do not rush the young person.

Find the right time and place to talk. Avoid visiting the young person at school or interrupting their lesson times. Think about where they will be most comfortable. Try not to meet at the office, especially if this represents a sad or traumatic time for them. Some young people find it easier to talk with minimal eye contact, so consider going for a walk with them, or sitting next to them instead of opposite them. Lots of parents of teens will say that the car is the best place to have a deep conversation with their child!

Be aware of body language. Some young people might be hypersensitive or reactive to anything they perceive as threatening. Be aware of personal space. If the young person reacts to something you do, notice this and be aware of how this may relate to their experiences.

Just start the conversation. If you are worried about a young person, ask them about it. Be clear about Child Safety’s role and what the worries are.

Validate feelings and experiences. Validate their experiences, do not minimise them and help them to name their feelings. It can be very powerful for a teen to be listened to by an adult, without us trying to ‘fix’ or ‘minimise’ or to cheer them up.

Sit calmly and breathe. If a young person is upset, angry or disconnected by the conversation, be patient and take time.

Be aware of reactions. If practitioners respond with shock, judgement and anger, a young person is unlikely to keep talking or talk again in the future. Think about what can be done that is the most helpful for the young person at that moment.

Listen more, talk less. Use open-ended questions instead of questions that will give a yes or no answer. Try to sit with silence also, and avoid the temptation to fill the space with words and more questions. Allow time and space for the young person to think and respond.

Avoid the temptation to give advice or lecture. Do not jump in immediately with advice. Ask questions and try not to overwhelm the young person.

Talk openly about mental health. Talk about how other young people might experience the same issues. Tell them about ways they can feel better, such as getting support, diet, exercise, sleep, and connecting with peers, family and the community, and taking medications (if they have been recommended this by a doctor). Bring hope and optimism to these conversations.

Talk about ways to get help. Ask the young person what they think. Give suggestions and listen to what they need to get help. For example, ‘One place to start would be to go and see your doctor and let them know how you are feeling. Can I help to make you an appointment? Is there someone you would like to go with you to an appointment?’

Explain what might happen. Give them as much information as they need to know, depending on their developmental stage or worries about what will happen. For example, ‘Your doctor may help you make a mental health plan. This is written down and lists all the things you think might help, such as going to see a counsellor. It includes numbers you can call if you feel you’re having a really bad time. The doctor may also suggest prescribing medication to help you.’

Notice and build on strengths. Most young people will want to maintain connection to important people in their lives, and to their hobbies and interests. These play a protective role for young people. Help draw up a plan for the week so they can remain connected to who and what is important to them.

Tell the young person they are not alone. Let them know support is available for whatever they need.

Get more advice about talking to young people from Beyond Blue.

Talking to an Aboriginal and Torres Strait Islander child about their social and emotional wellbeing

It’s important to plan how to work with an Aboriginal and Torres Strait Islander child. Seek advice and consultation from the young person's family, cultural practice advisors or practice leaders. Ask them what they think you need to know to best work with the child.

Remember that most Aboriginal and Torres Strait Islander communities prefer to define mental health as social and emotional wellbeing. This lens will help to put the child’s experience in the context of loss of land, family and identity as a result of colonisation and oppression. It will also help to harness the strengths of the community, and the role they can play in the healing.

Engaging an Aboriginal or Torres Strait Islander Young Person