Let’s start our discussion about mental health with a story about Depression – what it looks like
and what parents can do.
I met a new 15-year-old patient for the first time. My nurse gives me a heads up about John –
he barely answers questions and avoids eye contact.
I get to talk with John alone at first. When questioning him he says he has no hobbies and does
not enjoy any school subject or being at school. John feels indifferent about his relationship
with his father, which is strained currently because his dad has removed his access to cell
phone or internet. He denies that he used the content inappropriately and states he has not
been in trouble at school or with law enforcement. He and dad live alone. Mom is living
abroad since John was 4 years old. He does not have much contact with her. He states he has
friends in the neighborhood, though not at school. When I asked him about suicide, he said he
often thinks the world would be ok without him. He has no plans on how to end his life and
there are no guns at home.
His medical history is mostly described as being healthy, his physical exam is normal.
Following his complete physical, when he is dressed, I ask his father to join us. Dad states that
John’s behavior has become a concern to his teachers who have tried to reach out to him. He
sits in the classroom with his head hung down, does not participate in class, has stopped doing
his homework and sits alone in the lunch room. Dad says nothing new has happened in the
family other than he has had to take away his cell phone and internet privileges because of his
fear that John will use them inappropriately. I explain to dad how important cell phones are to
teens his age and encourage them to work out a plan that will be respectful to both of them.
Dad then asks to speak with me alone.
Dad states that he had been concerned about John for several years. Dad sought help from a
physician. He explained his concerns about John’s relationships with teachers and friends, as
well as the growing difficulty in their own relationship. The physician told him that John had an
artist’s personality and that everything would be ok if John were left alone more often.
Fortunately, dad did not accept that assessment and sought further help. He was encouraged
by school personnel who continued to express to dad their concerns.
This story reminds me of strategies for careful parents to keep in mind:
Parental concern is real. You know your child and when you see something unusual, consult
with experts around you. If they do not make sense to you, find more experts who do make
sense.
Is it just a phase? Look at the duration of concerning symptoms: if they occur more than a few
days or weeks, or have continued despite showing your concern and trying different things, it is
probably not a phase.
Look at the severity: Seek immediate help if a child is engaging in unsafe behaviors, talks about
plans to hurt himself or someone else.

Look at changing events: A traumatic event in a child’s life can change the child’s health
dramatically. Try to be as open as you can about discussing how the event has affected you
also. If there is any discord in your positions, seek help.
Mental health treatment works! Many families have discovered that addressing problems as
early as possible allows the child to feel heard and cared about and may prevent more serious
problems in the future.