In this four-part series, we are going to dive into the experience of a mental health diagnosis for children: how to know if a child should be tested, what to look for, what questions to ask, how to explain a diagnosis to the child, and more. Dr. Méroudjie Denis, a Licensed Psychologist and our Director of Clinical Program Innovation will break it down.
In part one, we explored the stigma and fear that surround a mental health diagnosis.
In part two, we discussed how to know when to test for mental health concerns.
In part three, we looked at the process of testing.
In this post, we will talk about how to share the news with the child.
When a parent receives a mental health diagnosis for their child, what should they consider before explaining it to their child?
My biggest advice to parents and caregivers is to deal with your own emotions first. It is not helpful to put your own feelings about the diagnosis onto the child. In fact, they may have an entirely different reaction depending on their experiences, background knowledge and developmental age. So however parents need to work through their feelings – whether they’re feeling grief, anger, sadness, relief… I encourage them to do that.
What advice do you have for parents as they begin to explain the diagnosis to their child?
If children are not properly introduced to the diagnosis, they can often personalize it to become part of who they are. So when we talk to children, it is important to say “you have” versus “you are”. For example, “You have depression” versus “You are depressed” or, “You have autism” versus “You are autistic.” It seems small, but this distinction can make a big difference.
It feels more hopeful to hear something like, “You have autism” because it means it is something I can understand and manage, versus, “You are autistic” This can be the difference between the child feeling like the diagnosis is part of who they are, rather than their entire identity.
How, specifically, should parents talk about the diagnosis with their child?
Stick with the facts. This is important because it removes the parent’s feelings from the equation and allows the child’s reactions to come up. Parents can explain that the results indicate that the child has a certain diagnosis, some of the key elements of that diagnosis, and some of how they have seen it show up in their child.
I also encourage parents to look into the limitations but also the strengths of the diagnosis. A child can leave a conversation like this feeling defeated, or they can feel empowered. When an adult tells a child that they have a certain diagnosis that explains some of the challenges they have been experiencing, but that also gives them some really amazing strengths, that can feel really hopeful and affirming to a child.
What different reactions might a child have, and how can parents respond?
Children, like adults, can have very different reactions to a diagnosis. Some children will feel validated and hopeful. Some children may grieve or become angry. Some may be eager for interventions, others may be resistant. Some children feel stuck. They can start to cycle through feelings like, “I will never be able to…” or “I’m different from everyone else…” These differences can depend on the severity of the symptoms and how big the challenges are to the child’s well-being, or could be based on experiences, age, maturity or other factors. We can’t predict how a child will react.
My advice to parents is to validate their child’s reaction, whatever it is. Even if it is different from their own. When parents comfort a child and say things like, “It makes sense to feel this way”, or acknowledge that it is difficult news, it helps the child process through the feelings around the diagnosis. If a child does get stuck in a negative loop, parents can help them get unstuck by telling them stories that counter this narrative, such as examples of people they know or famous people who have had a similar diagnosis.
Any closing thoughts on this conversation?
Like with anything, accepting a child for who they are and not who a parent wants them to be or expected them to be will best help a child live a healthy and productive life. A mental health diagnosis can be scary, but it doesn’t have to be. Together with the child, parents can begin to get some comfort and answers and then work together to lean into all of the amazing strengths and talents of the child to lead to long-term success. Also, I want to remind parents they do not have to navigate this alone.