Understanding children's mental health & emotional wellbeing

Common Mental Health Concerns

  • Emotional disorders, e.g. phobias, anxiety, depression
  • Conduct disorders, e.g. stealing, defiance, aggression, fire-setting
  • Hyperactivity & attention difficulties e.g. Attention Deficit Hyperactivity Disorder [ADHD]
  • Developmental disorders, e.g. delay in acquiring speech, social or other skills; more pervasive developmental disorders, like autism
  • Attachment disorders, e.g. distress or social impairment associated with abnormal and often distressing patterns of relationships to parents or primary carers

Other possible areas of mental health needs include:-

  • Eating disorders, e.g. anorexia / bulimia
  • Habit disorders, e.g. tics, sleeping problems, soiling
  • Post-traumatic stress syndromes i.e. from a traumatic experience; abuse
  • Somatic disorders, e.g. chronic fatigue syndrome, headaches, body pain, nausea with no diagnosable physical cause
  • Psychotic disorders, e.g. schizophrenia, mania, delusional depression, drug-induced states

N.B. It is not uncommon for a child or young person to have more than one disorder or to have disorders from more than one of these groups. For example children with pervasive developmental disorders often suffer from ADHD. Children with a conduct disorder are often depressed, and the various anxiety disorders may also be paired with mood disorders, such as aggression.

Learning disorders can also be linked with these conditions, as are alcohol and other substance use disorders.  It is also useful to bear in mind that children who have experienced trauma can exhibit many of the behaviours commonly attributed to a disorder e.g. ADHD. In other words assessment of trauma related issues is crucial.


Childhood behaviour and expression of psychological distress varies, but some of the general symptoms include:

  • Changes in school performance [this may be despite continued efforts rather than just a lack of seeming interest or attention]
  • A lack of curiosity, interest or enjoyment in life and usual activities [this may also include an active avoidance of new situations, experiences and people]
  • Significant increase in time spent alone plus a “closing down” and withdrawing from people; reduced emotional expression
  • Inability to cope with daily problems, activities or changes to usual routines
  • Excessive worrying or anxiety e.g. this might involve both people, usual routines and general activities
  • Changes in sleeping and/or eating habits [toileting habits may also be affected]
  • Excessive complaints of physical ailments, and/or a lack of response to usual pain treatments e.g. headaches; stomach aches; nausea
  • Frequent outbursts of anger, disobedience and defiance [which may be to both adults and peers]
  • Defying authority, playing truant, stealing, or damaging property
  • Frequent temper tantrums i.e. above what might be reasonably expected for the child’s age and stage of development
  • Hyperactivity – increasing problems in paying attention [this might also include risk taking behaviour e.g. climbing furniture; running off]
  • Frequent tearfulness [and possible inability to be easily comforted – the child may be experienced as being over clingy; whining and generally exhausting for all concerned]
  • Heightened, ongoing fear of rejection or being left
  • Persistent [and pervasive] feelings of low self-esteem and self-worth
  • Abuse of drugs and/or alcohol; risk-taking [including sexual behaviours]
  • Self-harming behaviours e.g. excessive nail-biting; self hair-pulling [including eyebrows/lashes]; over-picking of scabs; head-banging; cutting [with blunt or sharp instruments]
  • Intense fear of gaining weight e.g. refusing certain foods; preoccupation with calories etc; repeated excuses being made about ‘not being hungry’ or ‘feeling sick’
  • Long-lasting negative moods, often accompanied by poor appetite and thoughts of death
  • Persistent bad dreams or night terrors e.g. chronic fatigue/lethargy; unable to concentrate or think/follow instructions at an appropriate level for their age and stage of development
  • Intrusive thoughts and stress reactions e.g. themes in perhaps play and artwork are possibly disturbing; play behaviours may become very rigid, narrow and repetitive in nature; an over-responsiveness to sensory stimuli e.g. sound and light in class
  • Hearing voices or seeing things that are not there [hallucinations]; difficulties in telling fact from fantasy i.e. inappropriate to age and stage of development