Child Mental Health

Diversity hug

Children need to have a good mental health status if they are going to live up to their full potential and truly live a life that is filled with positive experiences and the willingness to do what is best for themselves and the people around them.

There are many factors that can impact a child’s mental health status, both positively and negatively. Providing children with an environment that demonstrates love, compassion, trust, and understanding will greatly impact a child so that they can build on these stepping stones to have a productive lifestyle. It is a difficult process for any person, let alone a child, to overcome such adversity but being proactive and doing all that you can for the child will at least help their mental health in some positive fashion.

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How to encourage a child’s positive body image

  • Do not talk about being too fat, weighing too much or needing to diet. This can contribute to a child’s negative body image.
  • Talk with your child about the media’s distortion of body shape. Super-thin actors and models are not “normal.” Help children understand that being thin does not mean being happy.
  • Reinforce that there is no “ideal” body. Everyone is an individual.
  • Emphasize the functions of the body rather than appearance — strength, the ability to perform tasks, maintaining energy for activities your child enjoys.

Strategies for helping your child cope with tragedy

  • Give reassurance and physical comfort that send these messages: “You are safe” and “I will be here for you.”
  • Provide structure and routine for your child. Keep children on eating, sleeping and napping schedules. Keeping routines the same for your child provides consistency and stability that will make dealing with things easier.
  • Provide many activities and opportunities for children to release stress. Activities where children use their hands are good for this: playdough, sand, mud, water and clay. Games and activities involving physical exertion are also good outlets. Provide children the chance to work out what they have seen through dramatic play by being firefighters, doctors or police officers.
  • Help children steer away from generalizations and stereotypes. Don’t label label people based on race, ethnicity or religion.
  • For children who can express themselves, invite discussion about what they know and how they feel. Share information in bits and pieces as it relates to what the child understands. You want to clarify, not terrify.
  • For children who can talk, focus on different resolutions that will bring peace to the situation. Talk about ways a child can resolve conflict without hurting others.
  • Be aware of any behavioral changes with your child. If you have concerns, consult your primary health care provider, or call 211 The Children’s Trust Helpline.

— , “Helping Children Cope With Disaster”

What is practice telling us about early childhood mental health?

Early childhood mental health is the term used to deal with the emotional, social and behavioral needs of young children from birth to 6 or even 8 years, through both developmental and clinical perspectives. Little attention has been paid to the mental health (social and emotional problems) of young children. The trends from practice-based perspectives are these:

  • Increasing numbers of children are less prepared to cope with the demands of the child care and school environments than in the past.
  • More children are entering early childhood settings with fewer intellectual, social and emotional school readiness skills than in the past.
  • The levels of provocative, inappropriate and challenging behaviors frequently overwhelm staffs in early childhood care settings.
  • Higher levels of parent depression are reported. So, too, is parental involvement in substance abuse and family or community violence.
  • Children are being “expelled” from child care programs because they are unprepared to cope with demands of these environments.
  • Data from early efforts to provide mental health services to infants and toddlers confirm the picture of family stress and disorder, and increasing numbers of children with serious emotional disturbance.

What is research telling us about early childhood mental health?

Multiple streams of research support the rationale for paying attention to the emotional development of all young children — those with clinically significant problems and those at high risk of developing such problems. The critical need for early childhood mental health services and systems development are these:

  • Lack of warm, nurturing relationships. Research suggests that early disruptions in emotional development and caregiving relationships can have long-term negative consequences.
  • Brain development in young children suggests not only the importance of early experiences for cognitive development but also, significantly, for emotional development. Children deprived of early warm and nurturing relationships may experience such life-long adverse consequences as impaired school performance and difficulties in establishing warm and nurturing relationships.
  • Evidence suggests that high levels of stress in the earliest years can undermine brain development. Depression has been linked to punitive parenting behaviors to anxiety and aggression in children.
  • A child’s biological system in conjunction with early stressful experiences associated with poverty, parental substance abuse and mental illness can undermine brain development that set the stage for early-onset conduct disorder and later involvement in delinquency, emotional and behavioral disability and other high-cost social outcomes.
  • The additive effect of increasing numbers and combinations of risk factors such as marital discord, very low income, large family size, parental criminality, maternal psychiatric disorder and child welfare involvement place children with multiple risk factors at very high risk of problem behaviors.
  • Children experiencing two risk factors were four times as likely to have a psychiatric impairment compared to children not exposed to any risk factor or were exposed to one. Children with four risk factors were 10 times as likely to have a psychiatric impairment as those with one or none.
  • There is evidence of the concurrence of communications problems and emotional and behavioral difficulties in young children.
  • There is a lag between when problems are first identified and when appropriate services begin for children.
  • The impact of risk factors is lessened for children who experience “buffers” such as a warm, caring relationship with an adult.

What is the aim of early childhood mental health strategies?

Father and son reading

The evidence that negative patterns can be transformed has direct implications for the design of general early childhood and family support programs that incorporate an intensive preventive intervention perspective. Family-centered services to young children with challenging behaviors, emotional or behavioral disabilities or those at high risk of developing them are critical to the prevention of later difficulties. Early childhood mental health initiatives can be defined as a set of strategies and perspectives that:

  • Promote the emotional and behavioral well-being of young children, particularly those whose emotional development is compromised because of poverty or other environmental or biological risks.
  • Help families of young children address barriers to ensure that their children’s emotional development is not compromised.
  • Expand the competencies of non-family caregivers to help promote the emotional well-being of young children and families, particularly those at risk for environmental or biological factors.
  • Ensure that young children experiencing clearly atypical emotional and behavioral development and their families can access services and support.
  • Federal policy mandating that all children shall enter school ready to learn has largely been interpreted as a mathematical and reading literacy, or community issue. Positive emotional and behavioral patterns are essential to learning and social achievement.
  • Federal policy mandating that all low-income women work as a condition for receiving public benefits has attempted to reduce barriers to employability in vulnerable populations such as adults affected by substance abuse, mental illness and domestic violence. But adults with these barriers to employability and also with young children may need extra attention to promote good mental health and development in their children.

What should the primary support system for childhood mental health strategies look like?

Incorporate mental health principles, particularly those focused on relationship building, into the core approach of primary support programs such as home visiting and early care and education programs. Effective programs have three critical factors:

  • Child development knowledge and relationship-building to promote positive parent-child relationships and interactions.
  • A focus on relationship building to foster social interaction and communication between the mother and child, as well as to decrease social isolation of the mother. A sense of competence as person and parent is necessary. Education, information and resources alone are insufficient.
  • Parent involvement or parent support approaches must be integrated into early care settings focusing on child development knowledge and relationship-building. Promote positive parent-child relationships among groups of parents by using guided group discussion. Parents solve problems together sharing reactions, strategies and frustrations.

What are the core principles of an early childhood mental health system?

  • A family-centered early childhood mental health service strategy includes mental health and related services designed to support parents of young children to nurture and build caring relationships.
  • A family-centered early childhood mental health service strategy includes mental health and related services designed to support non-parental caregivers of young children to nurture and build caring relationships.
  • A family-centered early childhood mental health service strategy includes mental health and related services delivered, to the greatest extent possible, in natural settings, including homes, child care, health care and family support settings.
  • A family-centered early childhood mental health service strategy should be sensitive to cultural, community and ethnic values of families.
  • Caregivers, home visitors and administrators working with infants, toddlers and pre-schoolers should have access to clinical services, case consultation and clinical supervision to strengthen their competencies in promoting emotional development in all young children at high risk for developing diagnosable problems, and in young children with already diagnosed problems.

Family service workers, home visitors, and others working with families of infants, toddlers and pre-schoolers and their families (including kinship and other foster parents, grandparents, and non-custodial fathers) should have access to mental health program consultation, case consultation and back-up support for families requiring more intensive interventions, particularly when there are issues of substance abuse, domestic violence, child maltreatment, depression or other mental illness.

Caregivers, home visitors, family workers and administrators working with families of infants,

toddlers and pre-schoolers should have access to clinical supervision and support in dealing with such staff issues as burnout, cultural and workplace conflict. Young children, families, and programs experiencing crises related to violence, community disasters or family-specific upheavals should have immediate and as-necessary access to crisis intervention and support.

Developing a family- and caregiver-centered early childhood mental health service system requires building partnerships between both primary and secondary support services in the community and state.

Develop state-specific incentives to encourage local collaboration among mental health, substance abuse, early intervention and early childhood programs.

Strengthen systems of training for child care and early education providers to include a focus on dealing with the most psychologically vulnerable young children and families and to increase attention to early childhood mental health issues in training programs for social work, psychology and allied disciplines.

Pay attention to what home visitors do, the kind of clinical supervision they have, and the intensity of the intervention.


Knitzer, Jane (2000). Early childhood mental health services: A policy and systems development perspective.

In Jack P. Shonkoff & Samuel J. Meisels (Eds.), Handbook of Early Childhood Intervention (2nd ed., pp. 416-438). New York: Cambridge University Press.