On the Pulse

How to Do “Mental Health Check-Ins” With Your Child

5.2.2024 | Rose Ibarra

Father and son chatting while sitting outside Each time I pick my kids up from school, I’m eager to learn every single detail about their day, including their thoughts and feelings. Yet, when I ask them, “How was your day?” my 8-year-old typically disappears into a book and my 5-year-old responds by asking for a snack or screen time.

Like many parents, there are few things I care about as much as my children’s mental health, but learning what they’re thinking and feeling can be difficult. One habit that can help is having regular mental health check-ins.

What exactly are mental health check-ins and how can they be done effectively? I asked Dr. Yolanda Evans, head of the Division of Adolescent Medicine at Seattle Children’s, and a parent herself, what she recommends. See her responses below.

What are mental health check-ins?

A mental health check-in with your child just means asking them about their mood and how things are going; learning what’s going on in their lives and how things are affecting them.

It’s about tracking the ups and downs in their lives, which can be hard when we’re constantly racing from one thing to the next.

How can parents start these conversations?

It can be challenging. I have three kids myself and when I ask, “How was school?” they just say, “Fine.”

So, I’ve switched tactics. Now I say, “Hey, what was interesting about today? Tell me something you really liked about today or tell me something that was hard about today.” I ask questions that are a little bit more specific, and I usually do it at a time where they can’t get away from me – like when we’re driving to an activity.

Sometimes I bring up music or TV shows. After we watch a cartoon I might say, “That character looks like they’re having a really hard time. What do you think about that?” If we’re listening to music in the car, I’ll ask, “What playlist do you want to hear?” And then I can follow up with, “Why that one?”

I also talk to my kids when we’re winding down for the evening. I ask them to “tell me two or three good things about the day or things that were tough.”

Try having these conversations at different times of day to see works best for you and your child.

During these conversations, listen more than you talk and validate their feelings. Encourage them to name their emotions and come up with ways to cope in the future when they start feeling sad, mad, scared or upset.

At what age should parents start checking in on their child’s mental health?

There’s no exact age, but as soon as your child is engaged in activities, start asking, “How did it go? What was hard? What did you learn?”

What should parents say if they have specific concerns?

If you get the sense your child is struggling with their mental health, be as honest as you can and start the conversation with curiosity.

Talking about serious concerns like self-injury behaviors can be scary, but you can start by saying, ‘Hey, I noticed some marks on your skin. Do you feel comfortable talking to me about it, or would you like to talk to somebody else about it?’”

Don’t try to hide your concerns or be sly about it. Just sit down with them in a kind and open way and let them know how you feel.

On the flip side, if they don’t feel comfortable sharing with you, you may ask if they would like to talk to another trusted adult like a family member, teacher, or coach.

We don’t ever want to make our children feel self-conscious, but having up-front conversations about mental health is important.

How can parents tell the difference between typical mood or behavior changes and serious mental health concerns?

This can depend on the child’s age. For example, it’s typical for teens to pull away from their parents. They’re trying to figure themselves out, and pushing back against rules or boundaries is to be expected.

What worries me is when teens disengage from things that once brought them joy or when they socially isolate. If they don’t want to engage with peers or stop doing things they once enjoyed, that’s a warning sign to pay attention to.

There can be subtle signs too, like if a teen is always tired and never feels well rested. Or, they might be sleeping more than usual.

Also, pay attention if your child is searching online for content about self-injury, suicide, or other harmful behaviors.

Above all, if your child tells you they’re struggling, listen and don’t brush it off.

How should parents respond if they see concerning signs?

Step one is to schedule a visit with your child’s primary care provider. Medical providers can be a great resource for families and give kids the opportunity to talk about their mental health to someone other than their parent. Let your child’s doctor know what behaviors are concerning you so they can help you find the right treatment if needed.

During their appointment, give teens and adolescents the chance to meet with the provider alone in case there’s something they don’t want to talk about in front of you.

You may also reach out to other trusted adults in your child’s life. Check in with their teachers, band instructor or coach to see if they’re noticing anything concerning.

At what age should parents ask their kids about suicide?

Suicide is the second leading cause of death for youth ages 10 to 24. At Seattle Children’s locations, we ask patients age 10 and older questions about suicide so we can provide preventative care for kids at risk. Parents should definitely ask their child during the tween and teen years, too. That’s when things start ramping up, like the pressure of societal norms, while adolescents are trying to figure themselves out.

And at the same time, we see younger kids struggling with mental health too, especially when there’s been trauma or other things happening.

What other mental health habits can families adopt?

It can be helpful to create mental health toolboxes that each member of your family can use to calm down when their emotions escalate. Select tools when you’re in a calm state and keep them somewhere accessible like on a desk or next to a bed.

The tools themselves can vary. Some kids really like music or coloring. Others need to go for a walk, use fidget toys or hold a stuffy. Revisit the toolboxes every six months or so to update them.

Remember, basic habits like getting enough sleep and exercise, eating consistently and choosing foods from different food groups, and reducing and managing stress are important for physical and mental health.

As parents and caregivers, we must check in with ourselves, too. We put a lot of energy into caring for our loved ones and that is really challenging to do when we’re depleted ourselves.