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“An estimated one in 20 children has a significant mental health problem,” says Eileen M. Ouellette, M.D., immediate past president of the American Academy of Pediatrics (AAP).

Facing these challenges, and helping our children face them, is as important to protecting children’s health as regular checkups and immunization schedules. As Dr. Ouellette points out, “There are only approximately 6,500 child psychiatrists in the country.”

To confront this challenge, AAP is actively developing and deploying mental health clinical toolkits to provide pediatricians with resources for recognizing and addressing adolescent (and younger) mental health problems and issues. Parents are, of course, the front-line, essential elements in fostering sound, effective mental health habits in their adolescents. To that end, here are a few key resources for you:

Communication That’s Constant, Open, and Honest

Your children should not only know that they can talk to you about anything, you have to be committed to broaching topics of concern and do so openly. Talk about your own experiences and fears when you were an adolescent. Let them know that they are not alone; nor are their anxieties unique.

Understand That Mental Health Disorders Are Treatable

Arm yourself with information about the most common mental health disorders among adolescents; speak with your child’s pediatrician, your local health department, your religious leader, and your child’s school representatives about what sorts of information are available from them. Investigate reputable online resources, such as www.aap.org.

Be Attentive To Your Adolescent Child’s Behavior

Adolescence is, indeed, a time of transition and change, but severe, dramatic, or abrupt changes in behavior can be strong indicators of serious mental health issues. Among the mental health “red flags” you should be alert for are:

• Excessive sleeping, beyond usual teenage fatigue, which could indicate depression or substance abuse; difficulty in sleeping, insomnia, and other sleep disorders
• Loss of self-esteem
• Abandonment or loss of interest in favorite pastimes
• Unexpected and dramatic decline in academic performance
• Weight loss and loss of appetite, which could indicate an eating disorder
• Personality shifts and changes, such as aggressiveness and excess anger that are sharply out of character and could indicate psychological, drug, or sexual problems Some of the key mental health issues to be aware of are:

Depression

While all of us are subject to “the blues,” clinical depression is a serious medical condition requiring immediate treatment. Watch for:

• Changes in sleep patterns
• Unexpected weeping or excessive moodiness
• Eating habits that result in noticeable weight loss or gain
• Expressions of hopelessness or worthlessness
• Paranoia and excessive secrecy
• Self-mutilation, or mention of hurting himself or herself
• Obsessive body-image concerns
• Excessive isolation
• Abandonment of friends and social groups

Eating Disorders

Body image concerns can become obsessions, resulting in startling weight loss, severely affecting the adolescent’s health:

• Anorexia: Avoidance of food and noticeable changes in eating habits should trigger concern.
• Bulimia: Purging (forced vomiting) after eating — be alert for both dramatic weight loss without changes in eating habits (which could, of course, indicate other health issues that require a doctor’s attention) and also for immediate trips to the bathroom or other private spot after a meal.

Drug Abuse

In addition to peer pressure, mental health issues can lead adolescents not just to experiment with alcohol and drugs, but also to use substances for “self-medication.” And in addition to being aware of the behavioral and physical signs of alcohol and drug abuse — drug and alcohol paraphernalia or evidence, hangovers, slurred speech, etc. — parents should also:

• Be alert for prescription drug misuse and abuse: According to the AAP, prescription drug misuse by adolescents is second only to marijuana and alcohol misuse. The most commonly abused prescription drugs include Vicodin and Xanax.
• Know that over-the-counter-medications can be abused as well: Teenagers also frequently abuse OTC cough and cold medications.

Concern about your adolescent’s mental health should first be addressed with your child — fostering open communication goes a long way toward fostering sound adolescent mental health habits.

If your concerns are serious, discuss them with your pediatrician. Because so many mental health issues display physical manifestations — weight loss being the most dramatic but not the only one — your pediatrician can offer both initial medical assessment and also refer you to appropriate mental health organizations and professionals for counseling and treatment if called for.

Pediatricians are increasingly aware of mental health issues and, as Dr. Ouellette says, “The Academy will continue to provide resources to support pediatricians as they enhance their skills in caring for children and youth with mental health conditions. Our goal, after all, is for pediatricians to feel as confident in treating mental health problems as they are when it comes to any other child health issue.”