If you’re a parent who suspects your teen is depressed, anxious or otherwise struggling, it’s a scary, helpless and overwhelming feeling. On the one hand, you know your child needs help. On the other, you may not know where to begin.
“If you suspect your teen is experiencing symptoms of mental health distress, such as changes in sleeping and eating, decreased concentration, decreased participation in daily activities or changes in academic performance, it’s important to address,” says Dr. Fatima Watt, vice president and director of behavioral health services at Franciscan Children’s in Boston. “There are a number of steps you can take, including checking in with your child directly and connecting with their pediatrician, who can provide an initial mental health screening or help coordinate care.”
The most important thing is that symptoms aren’t overlooked. From starting the process to not getting lost in a sea of paperwork, experts offer advice for connecting your child with the teen mental health services and treatment they need.
1. Start with a conversation
Across the board, experts agree: When you’re considering teen mental health treatment, the best place to start is a conversation. Dr. Ami Bax, chief of developmental and behavioral pediatrics at the University of Oklahoma Health Sciences Center, recommends picking a time when the conversation can be private (no interruptions from siblings) and when your teen isn’t “preoccupied or especially stressed from school and other activities.”
“Parents should aim to help normalize feelings their teens may be having, particularly in light of the significant stress of the last few years related to the pandemic,” notes Bax. “These can be tough conversations, but it is really important for teens to understand that their parents and caregivers are a strong source of support if they are potentially having depression or anxiety.”
“Parents should aim to help normalize feelings their teens may be having.”
— DR. AMI BAX, CHIEF OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
Instead of using interrogation tactics, Watt advises using any behavior changes you’ve noted as an opener. Think along the lines: “I noticed that you are not spending as much time with friends as you used to, so I wanted to check in and see how you are doing.”
“These conversations can feel challenging, but parents often find that teenagers want to be asked about how they are doing,” Watt says. “To this end, it’s important for parents to talk with their teen about what they’re noticing.”
And regardless of what your teen says, maintain a judgment-free zone during the conversation. “Teens can be afraid to share their feelings or experiences with parents, worried about their reaction,” explains Dr. Doug Nemecek, chief medical officer for Behavioral Health at Cigna. “Parents should focus on listening to their teen, understanding where they’re coming from and then finding help to address their concerns.
“Teens can be afraid to share their feelings or experiences with parents, worried about their reaction.”
— DR. DOUG NEMECEK, CHIEF MEDICAL OFFICER
2. Speak to their pediatrician
If a conversation indicates an increased risk for depression or anxiety in your teen, it’s important to enlist a professional. “Many parents try to address their concerns without the help of a behavioral health provider, and it can be a very frustrating experience for both the child and the parent,” Nemecek says.
While going through your pediatrician isn’t always a requirement when seeking therapy for teens, your child’s primary care doctor can be a great resource and help streamline the process (while making it feel less confusing).
“Many parents try to address their concerns without the help of a behavioral health provider, and it can be a very frustrating experience for both the child and the parent.”
— DR. DOUG NEMECEK, CHIEF MEDICAL OFFICER
“Pediatricians and family physicians are an excellent resource for parents who are concerned their teen may be experiencing depression or anxiety,” Bax says. “They receive training in pediatric behavioral and mental health conditions and are often helpful in screening and diagnosing depression and anxiety. In many cases, they can initiate referrals for behavior therapy and counseling or begin medications when warranted. They also can help determine if teens may need urgent help or hospitalization.”
Bax also notes that it’s important parents include their child in the process (don’t bamboozle them) “so you can be prepared together for seeking help.”
Lena Suarez-Angelino, a licensed clinical social worker and empowerment coach in Woodbridge, New Jersey recommends giving your teen a say in who they speak to. “This can mean providing your teen with a list of three to five profiles of therapists that you, as the parent, feel comfortable with them seeing,” she says.
If your child doesn’t have a pediatrician
If your teen does not have an established pediatrician or other primary care medical provider, Bax encourages parents to reach out to their school’s counselor. “If you have an urgent concern that your teen may be suicidal, call 1-800-273-TALK (8255),” she says. “Many states also have suicide and mental health crisis intervention hotlines.”
3. Find out what therapy for teens is covered by insurance
“A law passed in 2008, known as the mental health parity law, requires insurance companies to treat mental and behavioral health and substance use disorder coverage equal to, or better than, medical coverage,” Watt explains. “However, this does not guarantee that an insurance provider offers mental health coverage, and the covered services may vary from plan to plan, but nearly all insurers cover outpatient therapy and medication management.”
Sound confusing? That’s because it is. So ultimately, the best way to find out exactly what’s covered — and by how much — is by calling your insurance provider directly via the number on the back of your card. “When you call your insurance, you can ask for a list of in-network mental health providers to choose from,” says Robert Hinojosa, a licensed clinical social worker in Little Rock, Arkansas. “And many times, they can help narrow down that list to those that have current openings.”
“When you call your insurance, you can ask for a list of in-network mental health providers to choose from.”
— ROBERT HINOJOSA, LICENSE CLINICAL SOCIAL WORKER
“Your child’s pediatrician can help navigate the healthcare system, and recommend providers too, but it’s important to connect with your insurance provider to understand what your out-of-pocket costs will be,” Nemecek adds. “For individuals with employer-sponsored health care, they might also have access to an employee assistance program (EAP) that includes free counseling sessions.”
If you don’t have insurance
“If you don’t have insurance or your insurance does not cover mental health treatment, many clinics offer services on a sliding scale based on income and other factors,” notes Watt. “It’s best to contact any provider or facility to see specifically if they offer the low-cost or free mental health service that you need.”
Other options for free or low-cost counseling for teens are:
- Your teen’s school.
- Churches.
- State-funded agencies, which can be found via the Substance Abuse and Mental Health Services Administration (SAMHSA).
- Open Path Collective, which is a directory of sliding-scale therapists.
4. See who has availability
Once you’ve narrowed down providers in your network, call (a lot of them, not just one) to see who has availability and when. “The pandemic has lengthened the waiting time for receiving mental health treatment, so don’t be afraid to place your teen on several lists in an effort to expedite access,” Watt says.
“The pandemic has certainly lengthened the waiting time for receiving mental health treatment, so don’t be afraid to place your teen on several lists in an effort to expedite access.”
— DR. FATIMA WATT, DIRECTOR OF BEHAVIORAL HEALTH SERVICES
And if you don’t hear back, don’t give up. “I always encourage parents to be a squeaky wheel!” says Bax. “This is a very challenging time. Pediatric mental healthcare providers and agencies are passionate about helping youth and families, but their systems are being overtaxed right now. If you’ve made a call and you haven’t heard back, regularly check with your pediatrician or the agency you were referred to. Sometimes, key paperwork or information is missing that is holding up the referral, and this can greatly expedite the process.”
Another option, according to Suarez-Angelino, is to “reach out to your insurance and ask if they have a patient advocate or care coordinator to assist you in the process.”
5. Consider virtual appointments
While the pandemic has shone a light on how woefully understocked the U.S. is when it comes to mental health providers, it did open up the floodgates for virtual care, which means families have more options than what’s in their 20-mile radius.
“For many, a positive impact of the pandemic on mental health care has been the accelerated implementation of telemedicine and teletherapy,” Bax notes. “These modalities are often particularly effective for a variety of mental health treatments, and they have increased access for many families to these needed services. This is particularly true for families in rural areas and those with transportation challenges.”
That being said, Suarez-Angelino notes that, while not having to rely on parents for rides is a plus for teens when it comes to telehealth appointments, privacy can be a caveat. “Some teens may not feel they have adequate privacy in their household to talk about stressors which may pose a barrier in engaging in virtual therapy,” she says. “So parents should always make an effort to ensure their teen has privacy if they’re meeting with their therapist virtually from home.”
“Parents should always make an effort to ensure their teen has privacy if they’re meeting with their therapist virtually from home.”
— LENA SUAREZ-ANGELINO, LICENSED CLINICAL SOCIAL WORKER
6. Consider the following mental health resources for teens
Whether you haven’t had the conversation yet or are in the midst of your journey, the following resources can be helpful for teens and their families, according to Watt, Bax, Hinojosa and Suarez-Angelino. That said, they’re not a replacement for professional help.
- American Academy of Pediatrics (AAP) list of anxiety, depression and suicide resources.
- Mental Health Literacy.
- National Alliance on Mental Illness (NAMI).
- Substance Abuse and Mental Health Services Administration (SAMHSA).
- Teen Line.
- The Jed Foundation.
- The Trevor Project or 866-488-7386 (suicide prevention and crisis intervention for LGBTQ youth).
- The Youth Mental Health Project.
Finally, if a teen is making statements related to self-harm or wanting to die, it is important to reach out for help immediately. You (or they) can call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741) or dial 911 in an emergency.
Read more:
Mental health issues in teenage girls: What to look for and how to help
Mental health issues in teen boys: What to look for and how to help
