This child might be experiencing mental health difficulties … now what?

Originally posted in 2015, this post was updated in August 2020. 

Good mental health is vital for learning and life. Just like physical health, it changes over time and according to different contexts. Research shows we can identify mental health issues in early childhood and being aware of and responding to early signs that may indicate a potential difficulty can make a difference. It can help ensure children receive the help they need before problems get worse.

Identifying mental health issues

A child’s behaviour is often what first triggers our concerns about their mental health and well-being. We can categorise behaviours that give us cause for concern in two ways:

  • Externalising or ‘acting out’ behaviours are usually observable and relatively easy to detect e.g. disruptive, impulsive, angry or hyperactive behaviours
  • Internalising or ‘holding in’ behaviours primarily affect the individual child and not others around the child e.g. Inhibited or over-controlled behaviours, including withdrawal, worry, and emotional responses.

The Early Support Domain in the Be You framework provides information and guidance on how to notice behaviours which might indicate early signs of mental health issues, how to inquire and talk to children and families about these issues, and how to provide appropriate and timely support.

Deciding to seek help

The decision to seek professional help for a child and their family, or educators, can be arrived at  by considering and documenting what we know about concerning behaviours in terms of their:

  • Frequency – How often does the behaviour happen?
  • Severity – How does the child’s behaviour compare to other children’s behaviours within the same age group? Does it interfere with everyday functioning?
  • Persistence – When did the behaviour start and how long has it been going on? Does the behaviour only occur in certain situations, or across multiple situations?
  • Pervasiveness – Where does the behaviour occur? Home, child care service, when visiting family/friends.

Considering the frequency, severity, persistence and pervasiveness of behaviours in conjunction with the Be You BETLS observation tool can assist educators who are observing and documenting what they know and notice about a child.

Over time, documenting observations using the BETLS model will provide a comprehensive overview of the child’s behaviour and educators’ reflections. Remember to share your concerns with colleagues, who spend time with the child, and a leader in your setting. They could provide valuable information and support too.

Sharing information with families

After gathering your observations, it’s time to think about sharing these with the child’s family. Sometimes talking with parents or carers can be daunting, but sharing information is important. Discover tips and strategies on understanding your role and maintaining professional boundaries when collaborating with families in the Family Partnerships Professional Learning domain.

This preparing for difficult conversation with families news item provides useful guidelines for talking with parents and carers about a concern. Essentially, you will need to consider:

  • Getting support from your team
  • Explore the family partnerships professional learning Assist module to review how to start a difficult conversation
  • Use the BETLS observation tool to shift the focus
  • Give families time to reflect utilising the Stop, Reflect and Act process
  • Check in.

Seeking professional advice and support

Accessing support can be overwhelming at times for families. Early childhood settings can support families by:

  • Displaying brochures, flyers, parenting information and a list of high quality websites
  • Partner with families through purposeful and positive relationships explore how in the Partner module in the Be You Partnerships with families Domain
  • Gathering a list of local support services and having the information readily available to families when they need it. Resources and professional services available vary from state to state, so find out what is available in your area
  • Making connections with local external service providers and utilising the Be You STEPS decision Making tool to become aware of what and how they do what they do and sharing this with families can reduce barriers to accessing support
  • Working to address stigma related to mental health literacy by having open, easy conversations about mental health related topics. You could create opportunities for these in your planning The, Be You Early Learning, Be You Primary and Be You Secondary Facebook pages offer great links to information and resources for all families and educators. Explore how to introduce Be You to families. 

Be You provides educators with knowledge, resources and strategies for helping children and young people achieve their best possible mental health. This article was first published on KidsMatter (now known as Be You) Early Childhood’s blog in 2015.

Be You

Early Childhood Australia’s Be You team is a highly qualified and experienced multidisciplinary team of professionals committed to promoting and supporting positive mental health and wellbeing in the early years. Together, with Be You partners, Beyond Blue and headspace, the ECA team support educators in implementing the Be You Professional Learning and continuous improvement processes across early learning services and schools.

3 thoughts on “This child might be experiencing mental health difficulties … now what?”

    Wendy Sullivan says:

    I would like a copy of the observation and reflection chart as well as the discussing concerns flow chart please.

    Thank you so very much

    Anju Dahal says:

    Kids need love n secure environment to develop their selfsteem.so first know them well n create the environment as per their needs.Meeds eans not choice but in case of their own developmental issue..

    Melea Lafferty says:

    Over the years as an educator, I can recall a handful of children as described here, with distinct internalised/ externalised behaviours. The child who is internalised, in too many instances, from my own observations, is deemed ‘too clingy’ or so withdrawn as to not draw attention to themselves, being interpreted as a shy disposition and left to their own devices, unlike the externalised behaviours, which sadly, some of these children end up being deemed ‘unsuitable’ for mainstream settings when early intervention and skill might have affected these outcomes. Early childhood mental health as well as trauma informed practice should for part of formal education and training for all educators, I feel. I’m glad ECA is having this conversation.

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