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1. Keep in Touch With Your Mental Health Service Provider

Ask to be put on a cancellation list (if your provider has one). This gives you the possibility of being seen more quickly. If another family cancels an appointment, your service provider calls you to see if your child or teen can make the appointment time. If not, you can wait for the next availabale appointment. Make sure your provider has up to date contact information for you, including a number where you can be reached during the day. 

Let your mental health service provider (or family doctor) know if your child or teen is getting worse. Your child’s place on the wait list depends on many things, including your child’s needs. Let your service provider know if your child or teen: 

• Is feeling more depressed or anxious; 
• Has more trouble at home or school; 
• Expresses thoughts that life is no longer worth living. 

Check out support services. Many organizations have ‘wait-list supports’, like: 

• Mental health information; 
• Information about support and advocacy groups. 

Keep your family doctor or pediatrician in the loop. If your child or teen gets worse, he or she may be able to advocate on your behalf. Your doctor may also know about other available services. 

Keep a journal. Write about events, situations, behaviours and worries that you want to share with your service provider. This is a good way to prepare for your first appointment. 

Be ready for the first appointment. Make notes of what you want to discuss with the service provider. If you have kept a journal, this will be much easier. It’s important that your service provider see a progression of how things have been going. It’s easy to forget things or only focus on what’s happened recently if you don’t write them down. 

2. Explore Other Mental Health Services

Even though you might be waiting for services at one agency, you can still contact other services and ask to be placed on their wait-list as well. Let them know that you are doing this. Many agencies will encourage you to do this to make sure you aren’t ‘putting all your eggs in one basket’. 

School services. Many high schools have mental health resources available including psychologists, mental health nurses and addictions counsellors. Contact your child’s principal or vice-principal to access these services. Schools may also be able to help refer you to other services. 

Employee Assistance Programs. Your employer may have an Employee Assistance Program (EAP) that can usually provide at least a few meetings with a mental health professional. These services are confidential, and your employer will not know if or why you contacted EAP. 

Private services. Wait lists are more common for public services like hospital clinics or a children’s mental health agency (this care is covered with your health card). You can make an appointment with a psychologist or social worker in private practice if you can pay the fee yourself (or if you have work benefits that will cover the cost). You may not have to wait at all to see a professional in private practice. 

Professionals in private practice:  (Please see the resource section at the end of this fact sheet to learn how to find a mental health professional)

Psychologists and psychological associates. Clinical psychologists have earned a PhD at university. They are qualified to assess, diagnose and treat mental health conditions, and focus on talk therapy  (psychological treatments), but do not prescribe medications. Some universities provide mental health services to their community at a reduced cost, often based on income. To find a psychologist anywhere in Canada, visit the Canadian Register of Health Service Psychologists at http://www.crhspp.ca

Social workers: Social workers have a university degree in social work. They do not diagnose mental health conditions, but they can provide counseling and therapy to help you and your family cope with mental health concerns. 

Certified counsellors. In many places, anyone can call themselves a therapist or counsellor without formal training. To make sure your counsellor or therapist is truly qualified, check out the Counselling and  Psychotherapy Association (CACP). To find a certified counsellor/therapist in your area, visit the CACP website at http://www.ccacc.ca. 

Psychiatrists. Psychiatrists are medical doctors who have taken several years of extra training in  psychiatry. They are able to assess, diagnosis and treat mental health conditions (with medications or without). Ask your family doctor or pediatrician if they can refer you to a psychiatrist in private practice.  Psychiatrists are covered by your provincial health plan, and just like seeing any other medical doctor, you do not have to pay ‘out of pocket’ for their services.  

3. How to Support Your Child or Teen

Warmth and support from parents makes all the difference in the world to children and youth, though they may not always show it. Strong family support leads to better outcomes for youth,  whether they have a mental health problem or not. 

Spend quality, one-on-one time with your child or teen, at least a few times each week.  Quality time can mean just talking or doing an activity together, for at least 15-30 minutes.  Time with just the 2 of you will give your child or teen the chance to share experiences, feelings  or worries. It will be easier for your teen to open up when it’s just the two of you. Focus on  making this a positive experience for both of you. Increasing positive interactions may help to decrease  negative things, like arguing. 

Interactive activities are best for creating a strong bond. Watching TV together can be a good place to start if you’re rebuilding your relationship with your child or teen. And it while it can be a positive experience, it doesn’t give many chances for talking and listening. You can work up to other activities that will give better chances for conversation. 

Try things like: 

• Cooking or baking together 
• Walking, hiking, going for a bike ride or throwing a ball around 
• Board or card games (video games don’t really offer good chances for talking) 
• Teaching your child or teen how to do something (knitting, a sport, car repairs, fishing or building) 
• Activities where you have more skill than your children, to help them appreciate that parents are capable, worth looking up to, and a source of help when needed. 

Connect before correcting. When your child or teen shares feelings, ‘validate’ these feelings by showing that you’ve heard and care. This helps to make children and youth feel loved and understood. Don’t criticize or minimize his feelings. And try not to jump in with advice-although this is sometimes hard, because we really want to help! Giving  advice when your child is just sharing feelings can make her feel that you really don’t understand. If she thinks she’s  going to get a lecture every time she shares her feelings, then she won’t confide in you. 

For example:

• Teen: “I’m freaking out-I’m so stressed about all the school work I have to do. I just can’t handle it!” 
• Parent: “Sounds like you're feeling a bit overwhelmed by everything you have to do right now... How can I help?” 

Less helpful responses: 

• Blame and advice: “Well, it’s your own fault. You should have done your homework instead of watching TV.”  
• Reassurance (without first connecting): “You’re worried for nothing! You don’t really have that much to do, you’ll be fine!”

What teens usually want most is to be empathy, to be heard and listened to. Reassurance, or advice giving, even though well intentioned, is no substitute for what most people really want, which is empathy.

If you’re worried about something, state your concerns with a gentle observation. For example:

Parent: 

• “I’ve noticed you seem a bit sad lately. I’m worried  about you, how are things going?”
• "I'm here for you... How do you want me to support you?” 
• “Do you want me to just listen? Or do you want my advice too?”

Don’t be discouraged if you feel that your child or teen is trying to detach from you. Many children and youth are very focused on their peers. It might even seem that they value their friends and peers more than parents. Children and youth struggling with mental health problems may also try to detach from parents. Try not to take this personally. Your child or teen still really needs you, even if he isn’t aware of it. While peers are very important, they just don’t have the same, long term commitment that a parent or caregiver has. Parents and caregivers, not peers, will always ‘be there’ in good times and bad, 24 hours a day, 7 days a week. This is just not possible for peers. Only parents and caregivers can truthfully say, “It’s OK if you’re feeling this way. I’m here for you and always will be. We’ll get through this together”. Very rarely can peers offer this kind of support, because they’re still just growing up themselves. 

4. Healthy Living Makes a Difference!

No matter what mental health issue your child is struggling with, caring for the body and mind can really help. Taking care of the basics can go a long way to helping your child or teen to feel better.

If you have a good enough connection with your team, try to model and encourage your teen to: 

• Get enough sleep. Most of us, children and youth included, don’t get enough sleep, and a lack of sleep can lower mood and energy levels. Better sleep can improve behaviour, attention and outlook. Try to work out a regular bedtime, and a calming bedtime ritual. Keep computers, TVs, cell phones and video games out of the bedroom. 
• Eat healthy meals and snacks, with plenty of fruits and vegetables. 
• Be physically active. Children and youth need about an hour each day of physical activity, and if this happens outside, even better. Studies also show that exercise can have antidepressant effects. 
• Have limits on ‘screen time’. Too much screen time doesn’t leave enough time for physical activity or ‘face time’ with family and friends. And it can interfere with sleep. Try to set a limit on the amount of time each day your child or teen spends watching TV, using social media or playing video games. Please don’t try to ‘ban’ anything-this could start a small war. Have a discussion with your child or teen about setting reasonable limits that everyone can live with. 
• Take care of yourself too. Waiting for mental health services can be stressful. Make sure you’re eating well, getting enough sleep and exercise too. The best way to get your children to take care of themselves, is for you to model healthy behaviours. 

5. Help Your Child or Teen Cope With Stress

Stress is part of our daily lives. Mental health problems like depression or anxiety can make it harder to handle these everyday stresses. Learning to cope with stress in a positive way is an important part of mental health.

Help your child or teen to: 

• Get support (especially from you!). Remind your child or teen that you are always there for support during rough times. Listen and validate your child’s feelings. Ask your child or teen how she’d like to be supported. 
   

• Identify sources of stress. Children and youth often feel stressed by: 

  • School (teachers, schoolwork); 
  • Friends and peers (sometimes bullying); 
  • Parents and siblings (family conflicts, financial troubles, separation, divorce, family illnesses). 
     

• Find ways to cope with those stresses. There are many ways to handle stress in a positive way such as: 

  • Distraction (moving attention away from the stress for a little while) 
  • Taking a walk, 
  • Exercising 
  • Listening to music 
  • Doing something enjoyable 
  • Relaxation and Mindfulness 
    Consciously relaxing muscles and focusing on breathing deeply. Calming the mind by trying to let go of thoughts and focusing on the moment. 
    Yoga practice-focusing on body postures and breathing.
     

• Try to deal with the problem that is causing the stress. This can mean facing the stress and making a plan to deal with it. If school work is a stress, this could mean getting tutoring, help to organize work or checking for learning disabilities. If the problem is conflict, listen carefully to your child or teen’s point of view. Your can then help your child develop a plan to resolve it. You can also help your child to communicate assertively. If the conflict is with you, set the example for listening and positive communication, and try to come up with a solution that works for everyone. If you’re having trouble with family conflict, family therapy may help. 

6. Take Care of Yourself 

As a parent, it’s hard to find time for yourself when you are busy looking after your children. But it’s also much harder to meet your child’s mental health needs, if your own mental or physical health needs are not met. 

Take care of yourself by: 

• Asking family and friends for help and support. It’s much easier to cope if you have support from others. Friends and family might be able to give you a break by helping with child care, errands or household tasks. Or they could just be there for you, listening when you need to talk. 
• Getting professional help. Speak with your family doctor, or see a mental health professional if you are having your own troubles with mood, anxiety, depression, or troubles coping. 
• Connecting with self-help and peer support groups. Support groups can help you learn about other community resources, as well as giving practical advice and support that professionals cannot provide. 

Please see the ‘Support and advocacy’ section below for more information. 

Support and Advocacy Groups

• Anywhere in Canada: Canadian Mental Health Association (CMHA) (www.cmha.ca)
• In British Columbia: BC FORCE (www.forcesociety.com) 
• In Ontario: Parents for Children’s Mental Health (www.pcmh.ca) 
• In Ottawa: PLEO, the Parents’ Lifeline of Eastern Ontario (www.pleo.on.ca)

Coping with Stress

• MindMasters and Mini-MindMasters, for children 4-10 years: Developed by the Child and Youth Health Network for Eastern Ontario, and tested at CHEO. A free audio program and workbook. Helps parents teach children simple ways to manage stress and frustration, relax fully and develop a positive outlook.
  
  MindMasters
  

  https://www.ottawapublichealth...
  

• Healthy TransitionsProgram: A school curriculum to teach skills for mental health to young teens, developed by CHEO and the Child and Youth Health Network for Eastern Ontario. While designed for use in schools, parents will find some of the activities helpful. The activities will help youth:
  • Understand how changing the way we think about things can change the way we feel and act;
  • Learn to express themselves more assertively; 
  • Learn ways to cope more positively with stress; 
  • Identify adults who can help them when needed. 

https://www.ottawapublichealth.ca/en/professionals-and-partners/curriculum-support.aspx#
 

• Anxiety BC: Complete Home Toolkit. The toolkit provides simple ways to help anxious children cope with specific issues, like school worries, nightmares or troubles making friends.
  www.anxietybc.com/parent/complete_home_tool_kit.php 
   
• Dealing with Depression, Anti Depressant Skillsfor Teens: A free self-guided 62 page handbook available for download from the BC provincial government.
  http://www.mcf.gov.bc.ca/mental_health/teen.htm. 
   
• eTherapy websites: A number of websites are designed to help people cope with common mental health problems. In general, these sites are work best for youth with mild to moderate symptoms, who are very motivated and independent. Youth with more severe symptoms will probably find the websites too overwhelming. Parents may find these free programs helpful for them too, as part of a coping strategy. 
  
  For example: 
  
  Mood Gym for anxiety/depression from the Australian National University.
  http://moodgym.anu.edu.au 

Other Helpful Websites

• Children's Hospital of Eastern Ontario (CHEO): Information under health topics A-Z and various mental health information topics.
  www.cheo.ca
   
• Offord Centre for Child Studies in Hamilton, ON
  www.offordcentre.com
   
• Children's Mental Health Ontario
  www.kidsmentalhealth.ca 
   
• Canadian Paediatric Society: Information on various topics such as helping your child with healthy sleep, exercise, eating, and media use. 
  http://www.caringforkids.cps.ca
   
• The Knowledge Network: Supported in part by the National Film Board of Canada has various free videos for teens and parents on mental health promotion. Videos include perspectives from teens, parents, and health professionals. 
  http://www.takingcare.knowledge.ca
   
• Mental health blog from Dr. Stan Kutcher at Dalhousie University, Halifax, Nova Scotia
  http://teenmentalhealth.org/

About this Document

Written by the Mental Health Information Committee at the Children’s Hospital of Eastern Ontario (CHEO).  Special thanks to Jeff McCrossin (social work trainee); Parent’s Lifeline of Eastern Ontario (PLEO); Joanne Curran (Hopewell Eating Disorder Support Centre); CHEO’s Mood and Anxiety Clinic. 

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Disclaimer

Information in this article is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance.