5.3 Identify the signs of possible mental health concerns in children and young people

This guide will help you answer 5.3 Identify the signs of possible mental health concerns in children and young people.

Spotting possible mental health concerns early in children and young people can make a big difference to the help and support they receive. These signs are not always obvious and they can be different for each individual. Recognising them can help you take early action and share your concerns through the proper channels.

This guide cover some of the things to look out for, why signs might appear and how to understand them in the context of a child or young person’s stage of development.

Mental Health in Children and Young People

Mental health means a person’s emotional, psychological and social wellbeing. For children and young people, it affects how they think, feel and behave. It can also influence how they cope with school, friendships, home life and changes.

Mental health concerns may affect a child’s ability to learn, form relationships or feel safe. These concerns can include anxiety disorders, depression, eating disorders, behavioural problems or trauma-related difficulties.

General Signs of Mental Health Concerns

Signs can be physical, emotional or behavioural. You might see only one sign or several together.

Common signs include:

• Sudden changes in mood
• Withdrawal from friends, family or activities they enjoyed
• Unexplained physical symptoms like stomach aches or headaches
• Speaking negatively about themselves or feeling worthless
• Difficulty concentrating in class or at home
• Noticeable drop in school performance
• Becoming easily upset, angry or irritable

You should see these in the context of what is normal for that child. A behaviour that is unusual for one child might be normal for another.

Emotional and Behavioural Signs

Some signs appear in how a child acts or expresses feelings.

Look out for:

• Persistent sadness or tearfulness
• Extreme mood swings without clear reason
• Strong fear or worry that affects daily activities
• Loss of interest in hobbies or play
• Over-reacting to small problems
• Aggression or disruptive behaviour that is more frequent or intense than before
• Talking about death or self-harm

If a young person talks about wanting to harm themselves, this should be treated seriously and reported immediately through your safeguarding procedures.

Physical Signs

Mental health concerns can show through physical changes.

You might notice:

• Change in eating habits or extreme dieting
• Weight loss or gain without medical cause
• Frequent tiredness or trouble sleeping
• Unexplained injuries or marks on the body
• Neglect of personal hygiene

It can be useful to keep notes if you see repeated physical signs, so patterns can be built and shared with the appropriate safeguarding lead.

Social Signs

A child’s interaction with others can give clear clues.

Watch for:

• Avoiding social situations they previously enjoyed
• Trouble making or keeping friends
• Isolating themselves
• Conflict with peers or family increasing
• Appearing detached or disconnected from surroundings

If a child pulls away from usual social contact, it might show they feel unsafe, anxious or unable to cope.

Signs in Younger Children

Younger children may show mental health concerns differently compared to teenagers.

Possible signs in younger children include:

• Frequent tantrums that seem extreme for their age
• Difficulty separating from parents or carers at a stage where this is usually easier
• Play that repeatedly shows themes of danger, violence or loss
• Regressing to earlier behaviours like bedwetting after being dry for some time
• Speaking of monsters or fears that cause distress

Children often communicate feelings through play and behaviour, so observing this can be useful.

Signs in Teenagers and Young Adults

Older children and teenagers may hide feelings more or express them through risky behaviour.

Signs include:

• Extreme concern with body image or weight loss
• Use of drugs or alcohol to cope
• Secretive behaviour
• Talk of hopelessness or feeling there is no future
• Decline in school attendance
• Spending long periods alone in their bedroom with little interaction

Teenagers may also become argumentative or withdrawn as a normal part of development, so patterns and severity are important to monitor.

How Development Affects Signs

A child’s stage of development shapes how mental health concerns appear. For example, a four year old might express anxiety through clinginess, while a fifteen year old might express it through silence or irritability.

Thinking about what is typical for the age and personality of the child can help you spot when something feels different.

Triggers That Can Lead to Signs

Understanding what might be affecting a child can help make sense of changes. Common triggers can include:

• Family breakdown or conflict
• Bereavement
• Bullying at school or online
• Physical illness or injury
• Moving home or school
• Trauma or abuse

You are not expected to diagnose, but knowing the impact of major events can help you recognise a need for support.

Cultural and Social Factors

Cultural expectations can influence how children express feelings. In some cultures, expressing sadness openly might be discouraged. Social factors such as poverty or community violence can also add stress. Be sensitive to differences, but stay alert to signs that a child is struggling.

Importance of Listening

Sometimes the clearest sign is what a child tells you directly. They may not use words like anxiety or depression. They might say things like “I feel weird inside” or “I don’t want to wake up in the morning”.

Pay attention and avoid dismissing their words as attention seeking. Often children hint at problems before openly stating them.

Keeping Records

When you notice possible signs, make careful notes. Record:

• The behaviour you saw or words you heard
• The date and time
• Any patterns or repeated incidents
• How the child’s presentation differs from usual

Records help show patterns and make it easier for the safeguarding lead, teachers or health professionals to take correct next steps.

Reporting Concerns

Follow your school or setting’s safeguarding policy. Concerns about mental health should be passed to the nominated safeguarding lead or designated person. You are not diagnosing, but providing information so the right help can be given.

Prompt reporting can mean quicker access to support services such as school counsellors, Child and Adolescent Mental Health Services (CAMHS) or family support teams.

Working with Parents and Carers

Often, parents or carers will have seen changes at home too. They might share information about triggers, medical history or other factors. Conversations should be handled with care and privacy, ideally led by trained staff.

Be mindful that parents may feel worried or defensive. Focus discussions on shared care for the child rather than blame.

Signs That Need Urgent Action

Some signs need an immediate safeguarding response:

• Mention of self-harm or suicide
• Severe withdrawal from normal life
• Signs of abuse or neglect
• Dangerous risk-taking that could cause harm

In these cases, follow safeguarding steps straight away. Do not promise the child you will keep serious concerns a secret.

Supporting the Child in the Moment

While waiting for specialist help, small actions can make a difference.

You can:

• Listen without judgement
• Acknowledge their feelings
• Offer time and space to talk
• Keep routines predictable where possible
• Give reassurance without making unrealistic promises

Your role is to notice, record, report and offer a safe presence.

Common Misunderstandings

Some behaviours can be misread. A quiet child is not always unhappy. A lively child is not always well. Look for changes from their own usual patterns and consider the context.

Avoid assuming behaviour is simply “bad” without considering emotional needs. Mental health concerns may be behind disruptive behaviour.

Looking After Yourself

Supporting children with mental health concerns can be emotionally draining. Talk to colleagues, supervisors or your own support networks. Follow your setting’s wellbeing policies and do not take the role of a mental health professional unless qualified to do so.

Final Thoughts

Spotting the signs of possible mental health concerns in children and young people takes patience, good observation skills and awareness of what is usual for each child. It is about piecing together small clues from changes in mood, behaviour, physical health and relationships.

Your job is not to treat or diagnose. Your responsibility is to notice, record and pass on concerns according to procedure. This helps children get the right help at the right time. Early notice can prevent a small worry from becoming a bigger problem. By staying observant and approachable, you make it more likely that children will feel able to share how they feel.