Mental Health in Children | Parenting Support with Dr. Christine Crawford

“Our kids are really struggling.”

Dr. Christine Crawford sees the struggle of mental health challenges among youth and feels its urgency, every day — first-hand — as a child and adult psychiatrist.

“They’re also struggling to gain access to the supports they need,” she told Lianne Castelino during an interview for WhereParentTalk.com. “There are significant delays in kids being able to get treatment, such as therapy or medications, and there’s a shortage of youth mental health providers.”

As the global epidemic of mental health challenges among children and adolescents continue to rise, Dr. Crawford who is Associate Medical Director for the National Alliance on Mental Illness (NAMI), the largest grassroots mental health organization in the United States, Assistant Professor of Psychiatry at the Boston University School of Medicine and a mother of two, offers new insight and a resource for parents that tackles the topic in a different way.

“A lot of books focus on specific diagnoses,” Dr. Crawford explains, referring to You Are Not Alone: For Parents and Caregivers. “This book is about better understanding your child—how they express emotions, how they behave, and how you can connect with them.”

The Importance of Early Intervention

The urgency of addressing mental health concerns early in a child’s life is a key focus of You Are Not Alone. It is meant to provide parents with a single, comprehensive guide that can be used throughout their child’s development—from as young as three years old through adolescence and young adulthood.

Unlike many mental health books that focus solely on diagnosis, Dr. Crawford’s approach emphasizes understanding a child’s emotions and behaviours, fostering connection, and improving communication between parents and children.

“Kids notice and learn from the adults in their lives,” she says. “Modelling how to talk about emotions and cope with challenges can be incredibly impactful.”

The Language of Emotions

Dr. Crawford underscores the importance of equipping children with language and tools to express their emotions, starting at an early age.

For parents who may be accustomed to dictating how their children feel, Dr. Crawford encourages a shift toward active listening and curiosity. “Rather than assuming what’s going on with your child, ask them. For example, ‘I notice you don’t want to go to gymnastics anymore, even though you used to love it. What’s changed?’” she suggests. This approach can uncover underlying issues such as anxiety, bullying, or other stressors that might otherwise go unnoticed.

Research for the book involved interviews with over 80 individuals that Dr. Crawford conducted with parents, caregivers, teachers, coaches, young adults, and children experiencing mental health challenges. The goal was to validate the experiences of those navigating the often-overwhelming mental health system and to provide a resource that offers practical guidance and shared experiences.

“What I learned was that people were obviously concerned about what was going on, but they weren’t all that focused on what exactly is wrong with my kid or what exactly is wrong with me, but it was more about understanding — how do I continue to live and to function and to interact with people, connect with my family — given all of these challenges that I’m experiencing with my mental health. What do I do outside of my appointments with my mental health providers, where you are spending the majority of your time, in school and other places,” she says.

Understanding the Mental Health Landscape

One of the most alarming insights Dr. Crawford uncovered is the increasing prevalence of severe mental health symptoms in young children.

Research indicates that children as young as five years old can develop suicidal thoughts, with Black children between the ages of five and twelve being twice as likely as their white peers to experience such thoughts or behaviours.

Dr. Crawford emphasizes the urgency of early detection, urging parents to be vigilant about signs of distress in their children and to seek professional support without delay.

Recognizing mental health struggles in children is particularly challenging, as symptoms often resemble typical developmental changes.

However, Dr. Crawford suggests that parents trust their instincts and pay attention to shifts in their child’s behaviour.

Significant changes, such as social withdrawal, declining academic performance, disrupted sleep patterns, and loss of interest in previously enjoyed activities, should be treated as red flags warranting deeper conversations and possible intervention.

The Importance of Open Conversations

Rather than immediately jumping into problem-solving mode, Dr. Crawford encourages parents to start by having open, empathetic conversations with their children.

She advises parents to approach these discussions with curiosity rather than assumption, asking questions like, “I’ve noticed some changes in your behaviour—what do you think might be behind that?” Listening to children and validating their experiences can provide valuable insight into their struggles and potential solutions, sometimes even without the immediate need for professional intervention.

“If we see a problem, we call it out as a problem, we’ll label it as a problem, and then we want to problem solve, but we really need to take the time to kind of allow our children to engage and participate in this experience of understanding themselves, understanding why there may be some changes in their mood state, understand why there may be some changes in how they’re behaving, and to take the time to lean into those conversations. They may not go as quickly as you like, but you might actually be surprised by what it is that your child shares with you,” she says.

For parents who determine that professional help is necessary, Dr. Crawford underscores the importance of reaching out to primary care doctors or mental health professionals as early as possible. In cases where a child expresses suicidal thoughts or other urgent concerns, she advises immediate action, including contacting emergency services or resources like the 988 crisis hotline in the U.S.

Proactive Mental Health Education

Dr. Crawford strongly advocates for a proactive approach to mental health education, comparing it to other essential safety conversations parents have with their children. Just as families discuss seatbelt use and the dangers of drugs, mental health should be part of regular discussions.

Teaching children to recognize the signs of depression and anxiety not only helps them better understand their own emotions but also encourages them to seek help when needed.

She also highlights the importance of modelling healthy coping mechanisms.

Children learn by example, and parents who prioritize self-care, openly express their emotions, and demonstrate stress management techniques provide a crucial foundation for their children’s mental resilience.

A Personal Shift in Parenting Perspective

As a parent of two young children, Dr. Crawford shares that her research has deeply influenced her own parenting style.

Initially focused on ensuring she did everything “right,” she has shifted her priority to simply being present and emotionally connected with her children.

The most valuable lesson she has taken from her interviews is that children don’t necessarily need all the right toys, activities, or solutions—they need to feel heard, understood, and supported by a caring adult.

“We make this assumption that kids can just learn how to navigate and manage really intense emotions or how to cope with challenging situations,” she says. “We just figure they’ll figure it out, they’ll pick up things along the way. No. We have to be very intentional about talking about mental health, about modelling how to take care of your mental health, so that they can develop those tools, put them away in their toolbox, so if something were to bubble up to the surface, they can quickly intervene, instead of letting things drag out to a point in which they evolve into a crisis.”

Hope for the Future

Despite the daunting challenges surrounding youth mental health, Dr. Crawford remains optimistic.

The growing awareness and openness surrounding mental health conversations provide hope for a future where children feel empowered to prioritize their well-being.

She is encouraged by the increasing normalization of therapy and the willingness of young people to advocate for their own mental health needs.

The fact that children are looking out for one another and engaging in meaningful discussions about emotional well-being is a significant step forward.

Key Factors in Navigating Your Child’s Mental Health with Dr. Christine Crawford