Treatment of 

Children with 

Mental Illness 

Frequently asked questions 

about the treatment of mental 

illness in children 

NATIONAL INSTITUTE OF MENTAL HEALTH 

U.S. Department of Health 

and Human Services 

National Institutes of Health 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1
 

Introduction 

Research shows that half of all lifetime cases of mental illness begin by age 14.1 Scientists are discovering that 

changes in the body leading to mental illness may start much earlier, before any symptoms appear. 

Through greater understanding of when and how fast specific areas 

of children’s brains develop, we are learning more about the early 

stages of a wide range of mental illnesses that appear later in life. 

Helping young children and their parents manage difficulties early in 

life may prevent the development of disorders. Once mental illness 

develops, it becomes a regular part of your child’s behavior and more 

difficult to treat. Even though we know how to treat (though not yet 

cure) many disorders, many children with mental illnesses are not 

getting treatment. 

This fact sheet addresses common questions about diagnosis and 

treatment options for children with mental illnesses. Disorders 

affecting children may include anxiety disorders, attention deficit 

hyperactivity disorder (ADHD), autism spectrum disorders, bipolar 

disorder, depression, eating disorders, and schizophrenia. 

Q.	 What should I do if I am 

concerned about mental, 

behavioral, or emotional 

symptoms in my child? 

A.	 Talk to your child’s doctor or health 

care provider. Ask questions and learn 

everything you can about the behavior 

or symptoms that worry you. If your 

child is in school ask the teacher if your 

child has been showing worrisome 

changes in behavior. Share this with 

your child’s doctor or health care provider. Keep in mind that every child is 

different. Even normal development, 

such as when children develop language, motor, and social skills, varies 

from child to child. Ask if your child 

needs further evaluation by a specialist 

with experience in child behavioral 

problems. Specialists may include psychiatrists, psychologists, social workers, psychiatric nurses, and behavioral 

therapists. Educators may also help 

evaluate your child. 

If you take your child to a specialist, 

ask, “Do you have experience treating 

the problems I see in my child?” Don’t 

be afraid to interview more than one 

specialist to find the right fit. Continue 

to learn everything you can about the 

problem or diagnosis. The more you 

learn, the better you can work with your 

child’s doctor and make decisions that 

feel right for you, your child, and your 

family. 

Q.	 How do I know if my child’s 

problems are serious? 

A.	 Not every problem is serious. In fact, 

many everyday stresses can cause 

changes in your child’s behavior. For 

example, the birth of a sibling may 

cause a child to temporarily act much 

younger than he or she is. It is important to be able to tell the difference 

between typical behavior changes and 

those associated with more serious 

problems. Pay special attention to 

behaviors that include: 

Problems across a variety of settings, 

such as at school, at home, or with 

peers 

Changes in appetite or sleep 

Social withdrawal, or fearful behavior 

toward things your child normally is not 

afraid of 

Returning to behaviors more common 

in younger children, such as bedwetting, for a long time 

Signs of being upset, such as sadness 

or tearfulness 

Signs of self-destructive behavior, such 

as head-banging, or a tendency to get 

hurt often 

Repeated thoughts of death. 

Q.	 Can symptoms be caused by a 

death in the family, illness in 

a parent, family financial problems, divorce, or other events? 

A.	 Yes. Every member of a family is 

affected by tragedy or extreme stress, 

even the youngest child. It’s normal for 

stress to cause a child to be upset. 

Remember this if you see mental, emotional, or behavioral symptoms in your 

child. If it takes more than one month 

for your child to get used to a situation, 

or if your child has severe reactions, 

talk to your child’s doctor. 

Check your child’s response to stress. 

Take note if he or she gets better with 

time or if professional care is needed. 

Stressful events are challenging, but 

they give you a chance to teach your 

child important ways to cope. 

Q.	 How are mental illnesses 

diagnosed in young children? 

A.	 Just like adults, children with mental 

illness are diagnosed after a doctor or 

mental health specialist carefully 

observes signs and symptoms. Some 

primary care physicians can diagnose 

your child themselves, but many will 

send you to a specialist who can diagnose and treat children. 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2 

Before diagnosing a mental illness, the 

doctor or specialist tries to rule out 

other possible causes for your child’s 

behavior. The doctor will: 

Take a history of any important medical 

problems 

Take a history of the problem – how 

long you have seen the problem – as 

well as a history of your child’s 

development 

Take a family history of mental disorders 

Ask if the child has experienced physical or psychological traumas, such as a 

natural disaster, or situations that may 

cause stress, such as a death in the 

family 

Consider reports from parents and 

other caretakers or teachers. 

Very young children often cannot 

express their thoughts and feelings, so 

making a diagnosis can be challenging. 

The signs of a mental illness in a young 

child may be quite different from those 

in an older child or adult. 

As parents and caregivers know, children are constantly changing and growing. Diagnosis and treatment must be 

viewed with these changes in mind. 

While some problems are short-lived 

and don’t need treatment, others are 

ongoing and may be very serious. In 

either case, more information will help 

you understand treatment choices and 

manage the disorder or problem most 

effectively. 

While diagnosing mental health problems in young children can be challenging, it is important. A diagnosis can be 

used to guide treatment and link your 

child’s care to research on children with 

similar problems. 

Q.	 Will my child get better with 

time? 

A.	 Some children get better with time. But 

other children need ongoing professional help. Talk to your child’s doctor 

or specialist about problems that are 

severe, continuous, and affect daily 

activities. Also, don’t delay seeking 

help. Treatment may produce better 

results if started early. 

Q.	 Are there treatment options 

for children? 

A.	 Yes. Once a diagnosis is made, your 

child’s specialist will recommend a specific treatment. It is important to understand the various treatment choices, 

which often include psychotherapy or 

medication. Talk about the options with 

a health care professional who has 

experience treating the illness observed 

in your child. Some treatment choices 

have been studied experimentally, and 

other treatments are a part of health 

care practice. In addition, not every 

community has every type of service or 

program. 

Q.	 What are psychotropic 

medications? 

A.	 Psychotropic medications are substances that affect brain chemicals 

related to mood and behavior. In recent 

years, research has been conducted to 

understand the benefits and risks of 

using psychotropics in children. Still, 

more needs to be learned about the 

effects of psychotropics, especially in 

children under six years of age. While 

researchers are trying to clarify how 

early treatment affects a growing body, 

families and doctors should weigh the 

benefits and risks of medication. Each 

child has individual needs, and each 

child needs to be monitored closely 

while taking medications. 

Q.	 Are there treatments other than 

medications? 

A.	 Yes. Psychosocial therapies can be very 

effective alone and in combination with 

medications. Psychosocial therapies 

are also called “talk therapies” or 

“behavioral therapy,” and they help 

people with mental illness change 

behavior. Therapies that teach parents 

and children coping strategies can also 

be effective.2 

Cognitive behavioral therapy (CBT) is a 

type of psychotherapy that can be used 

with children. It has been widely studied and is an effective treatment for a 

number of conditions, such as depression, obsessive-compulsive disorder, 

and social anxiety. A person in CBT 

learns to change distorted thinking patterns and unhealthy behavior. Children 

can receive CBT with or without their 

parents, as well as in a group setting. 

CBT can be adapted to fit the needs of 

each child. It is especially useful when 

treating anxiety disorders.3 

Additionally, therapies for ADHD are 

numerous and include behavioral parent training and behavioral classroom 

management. Visit the NIMH Web site 

for more information about therapies 

for ADHD. 

Some children benefit from a combination of different psychosocial approaches. 

An example is behavioral parent management training in combination with 

CBT for the child. In other cases, a 

combination of medication and psychosocial therapies may be most effective. 

Psychosocial therapies often take time, 

effort, and patience. However, sometimes children learn new skills that may 

have positive long-term benefits. 

More information about treatment 

choices can be found in the psychotherapies and medications sections of 

the NIMH Web site. 

Q.	 When is it a good idea to use 

psychotropic medications in 

young children? 

A.	 When the benefits of treatment outweigh the risks, psychotropic medications may be prescribed. Some children 

need medication to manage severe and 

difficult problems. Without treatment, 

these children would suffer serious or 

dangerous consequences. In addition, 

psychosocial treatments may not 

always be effective by themselves. In 

some instances, however, they can be 

quite effective when combined with 

medication. 

Ask your doctor questions about the 

risks of starting and continuing your 

child on these medications. Learn 

everything you can about the medications prescribed for your child. Learn 

about possible side effects, some of 

which may be harmful. Know what a 

particular treatment is supposed to do. 

For example, will it change a specific 

behavior? If you do not see these 

changes while your child is taking the 

medication, talk to his or her doctor. 

Also, discuss the risks of stopping your 

child’s medication with your doctor. 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3 

Q.	 Does medication affect young 

children differently than older 

children or adults? 

A.	 Yes. Young children handle medications 

differently than older children and 

adults. The brains of young children 

change and develop rapidly. Studies 

have found that developing brains can 

be very sensitive to medications. There 

are also developmental differences in 

how children metabolize – how their 

bodies process – medications. Therefore, doctors should carefully consider 

the dosage or how much medication to 

give each child. Much more research is 

needed to determine the effects and 

benefits of medications in children of 

all ages. But keep in mind that serious 

untreated mental disorders themselves 

can harm brain development. 

Also, it is important to avoid drug interactions. If your child takes medicine for 

asthma or cold symptoms, talk to your 

doctor or pharmacist. Drug interactions 

could cause medications to not work as 

intended or lead to serious side effects. 

Q.	 How should medication be 

included in an overall treatment 

plan? 

A.	 Medication should be used with other 

treatments. It should not be the only 

treatment. Consider other services, 

such as family therapy, family support 

services, educational classes, and 

behavior management techniques. If 

your child’s doctor prescribes medication, he or she should evaluate your 

child regularly to make sure the medication is working. Children need treatment plans tailored to their individual 

problems and needs. 

Q.	 What medications are used 

for which kinds of childhood 

mental disorders? 

A.	 Psychotropic medications include stimulants, antidepressants, anti-anxiety 

medications, antipsychotics, and mood 

stabilizers. Dosages approved by the 

U.S. Food and Drug Administration 

(FDA) for use in children depend on 

body weight and age. NIMH’s medications booklet describes the types of 

psychotropic medications and includes 

a chart that lists the ages for which 

each medication is FDA-approved. See 

the FDA Web site for the latest information on medication approvals, warnings, and patient information guides 

at www.fda.gov. 

Q.	 What does it mean if a 

medication is specifically 

approved for use in children? 

A.	 When the FDA approves a medication, 

it means the drug manufacturer provided the agency with information 

showing the medication is safe and 

effective in a particular group of people. 

Based on this information, the drug’s 

label lists proper dosage, potential side 

effects, and approved age. Medications 

approved for children follow these 

guidelines. 

Many psychotropic medications have 

not been studied in children, which 

means they have not been approved by 

the FDA for use in children. But doctors 

may prescribe medications as they feel 

appropriate, even if those uses are not 

included on the label. This is called 

“off-label” use. Research shows that 

off-label use of some medications 

works well in some children. Other 

medications need more study in children. In particular, the use of most psychotropic medications has not been 

adequately studied in preschoolers. 

More studies in children are needed 

before we can fully know the appropriate dosages, how a medication works 

in children, and what effects a medication might have on learning and 

development. 

Q.	 Why haven’t many medications 

been tested in children? 

A.	 In the past, medications were seldom 

studied in children because mental illness was not recognized in childhood. 

Also, there were ethical concerns about 

involving children in research. This led 

to a lack of knowledge about the best 

treatments for children. In clinical settings today, children with mental or 

behavioral disorders are being prescribed medications at increasingly 

early ages. The FDA has been urging 

that medications be appropriately studied in children, and Congress passed 

legislation in 1997 offering incentives 

to drug manufacturers to carry out 

such testing. These activities have 

helped increase research on the effects 

of medications in children. 

There still are ethical concerns about 

testing medications in children. However, strict rules protect participants in 

research studies. Each study must go 

through many types of review before, 

and after it begins. 

Q.	 How do I work with my child’s 

school? 

A.	 If your child is having problems in 

school, or if a teacher raises concerns, 

you can work with the school to find a 

solution. You may ask the school to 

conduct an evaluation to determine 

whether your child qualifies for special 

education services. However, not all 

children diagnosed with a mental 

illness qualify for these services. 

Start by speaking with your child’s 

teacher, school counselor, school 

nurse, or the school’s parent organization. These professionals can help you 

get an evaluation started. Also, each 

state has a Parent Training and Information Center and a Protection and 

Advocacy Agency that can help you 

request the evaluation. The evaluation 

must be conducted by a team of professionals who assess all areas related 

to the suspected disability using a 

variety of tools and measures. 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4 

Q.	 What resources are available 

from the school? 

A.	 Once your child has been evaluated, 

there are several options for him or her, 

depending on the specific needs. If special education services are needed, and 

if your child is eligible under the Individuals with Disabilities Education Act 

(IDEA), the school district must develop 

an “individualized education program” 

specifically for your child within 

30 days. 

If your child is not eligible for special 

education services, he or she is still 

entitled to “free appropriate public education,” available to all public school 

children with disabilities under Section 

504 of the Rehabilitation Act of 1973. 

Your child is entitled to this regardless 

of the nature or severity of his or her 

disability. 

The U.S. Department of Education’s 

Office for Civil Rights enforces Section 

504 in programs and activities that 

receive Federal education funds. For 

more information about Section 504, 

please see http://www.ed.gov/about/ 

offices/list/ocr/504faq.html. 

More information about programs for 

children with disabilities is available at 

http://www.ed.gov/parents/needs/ 

speced/edpicks.jhtml?src=ln. 

Q.	 What special challenges can 

school present? 

A.	 Each school year brings a new teacher 

and new schoolwork. This change can 

be difficult for some children. Inform 

the teachers that your child has a mental illness when he or she starts school 

or moves to a new class. Additional 

support will help your child adjust to 

the change. 

Q.	 What else can I do to help my 

child? 

A.	 Children with mental illness need guidance and understanding from their parents and teachers. This support can 

help your child achieve his or her full 

potential and succeed in school. Before 

a child is diagnosed, frustration, blame, 

and anger may have built up within a 

family. Parents and children may need 

special help to undo these unhealthy 

interaction patterns. Mental health professionals can counsel the child and 

family to help everyone develop new 

skills, attitudes, and ways of relating to 

each other. 

Parents can also help by taking part 

in parenting skills training. This helps 

parents learn how to handle difficult 

situations and behaviors. Training 

encourages parents to share a pleasant 

or relaxing activity with their child, to 

notice and point out what their child 

does well, and to praise their child’s 

strengths and abilities. Parents may 

also learn to arrange family situations 

in more positive ways. Also, parents 

may benefit from learning stressmanagement techniques to help them 

deal with frustration and respond 

calmly to their child’s behavior. 

Sometimes, the whole family may need 

counseling. Therapists can help family 

members find better ways to handle 

disruptive behaviors and encourage 

behavior changes. Finally, support 

groups help parents and families connect with others who have similar problems and concerns. Groups often meet 

regularly to share frustrations and successes, to exchange information about 

recommended specialists and strategies, and to talk with experts. 

Q.	 How can families of children 

with mental illness get support? 

A.	 Like other serious illnesses, taking care 

of a child with mental illness is hard on 

the parents, family, and other caregivers. Caregivers often must tend to the 

medical needs of their loved ones, and 

also deal with how it affects their own 

health. The stress that caregivers are 

under may lead to missed work or lost 

free time. It can strain relationships 

with people who may not understand 

the situation and lead to physical and 

mental exhaustion. 

Stress from caregiving can make it hard 

to cope with your child’s symptoms. 

One study shows that if a caregiver 

is under enormous stress, his or her 

loved one has more difficulty sticking to 

the treatment plan.4 It is important to 

look after your own physical and mental 

health. You may also find it helpful to 

join a local support group. 

Q. Where can I go for help? 

A.	 If you are unsure where to go for help, 

ask your family doctor. Others who can 

help are listed below. 

Mental health specialists, such as psychiatrists, psychologists, social workers, or mental health counselors 

Health maintenance organizations 

Community mental health centers 

Hospital psychiatry departments and 

outpatient clinics 

Mental health programs at universities 

or medical schools 

State hospital outpatient clinics 

Family services, social agencies, 

or clergy 

Peer support groups 

Private clinics and facilities 

Employee assistance programs 

Local medical and/or psychiatric 

societies. 

You can also check the phone book 

under “mental health,” “health,” “social 

services,” “hotlines,” or “physicians” 

for phone numbers and addresses. An 

emergency room doctor can also provide temporary help and can tell you 

where and how to get further help. 

More information on mental health is at 

the NIMH Web site at www.nimh.nih.gov. 

For the latest information on medications, see the U.S. Food and Drug 

Administration Web site at www.fda.gov. 
Citations 

1. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. 

Prevalence, severity, and comorbidity of 12-month DSM-IV 

disorders in the National Comorbidity Survey Replication. 

Arch Gen Psychiatry. 2005 Jun;62(6):617–27. 

2. Silverman WK, Hinshaw SP. The Second Special Issue on 

Evidence-Based Psychosocial Treatments for Children and 

Adolescents: A Ten-Year Update. J Clin Child Adolesc Psychol. 

2008 Jan–Mar;37(1). 

3. Silverman WK, Hinshaw SP. The Second Special Issue on 

Evidence-Based Psychosocial Treatments for Children and 

Adolescents: A Ten-Year Update. J Clin Child Adolesc Psychol. 

2008 Jan–Mar;37(1). 

4. Perlick DA, Rosenheck RA, Clarkin JF, Maciejewski PK, Sirey J, 

Struening E, Link BG. Impact of family burden and affective 

response on clinical outcome among patients with bipolar 

disorder. Psychiatr Serv. 2004 Sep;55(9):1029–35. 

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

National Institutes of Health 

National Institute of Mental Health 

NIH Publication No. 09-4702 

Revised 2009 

U.S. Department of Health 

and Human Services 

National Institutes of Health