Mental health assessment: pre-teens and teenagers

What is a teenage mental health assessment?

A mental health assessment is an appointment or consultation – or a series of appointments – with a health professional like a GP, counsellor, psychologist or psychiatrist to talk about thoughts, feelings and behaviour.

A teenage mental health assessment aims to find out what issues are affecting your teenage child’s mental health and wellbeing.

Why teenagers might need a teenage mental health assessment

It’s not always easy to tell the difference between normal teenage moods and more serious mental health issues.

Most normal teenage irritability, arguing and moodiness comes and goes quickly. But when these feelings go on for 2-3 weeks or are very intense for shorter periods, it can be a sign that it’s more than just worry or feeling down.

If your child doesn’t want to see friends, or is spending most of their time alone, it’s a sign that you need to take action.

Also, if your child stops doing things they usually enjoy, doesn’t seem to be enjoying the things they’re doing, isn’t doing so well at school or is taking more risks than usual, this could be a sign that your child feeling very anxious, depressed or stressed. A mental health assessment might be a good idea in this situation.

The best place to start is your GP, who can either help you directly or refer your child to another professional.

What happens in a teenage mental health assessment?

You or your child might have a specific problem in mind when your child goes to see a counsellor, psychologist or psychiatrist. But the first interview will look generally at the issues that are affecting your child’s wellbeing.

What the professional will talk with your child about
The professional will talk with your child about their thoughts, feelings, moods, behaviour, relationships and other things like school, friendships, work and home. The aim is to find out how your child’s mental health is affecting their wellbeing.

The professional will start with the least sensitive issues – for example, home, school, interests and friendships. The professional will then move on to more sensitive areas like sexuality and drug use. The professional will also assess your child for mental health issues like anxiety, depression, self-harm and suicidal thoughts.

The professional might not always work through each area in order or spend equal time exploring every area. Your child will get the chance to tell their story too.

How long mental health assessment takes
A mental health assessment usually takes longer than other health appointments. It might take more than one appointment, so that the professional can really understand your child’s issues.

The length of assessment depends a bit on your child’s age and maturity too. If your child is older, they’ll probably be OK with longer appointments.

The advantage of things taking a bit longer is that your child gets a good chance to make sure they’re comfortable with the health professional. If your child has a good relationship with the mental health professional, it will have a big effect on how well mental health treatment is likely to work.

Seeing your child alone
The professional will usually want to speak with your child alone, for all or part of the mental health assessment.

Being alone with the professional can help your child talk openly about their worries. If you’re there, your child might feel embarrassed about speaking openly, or might not want to talk about sensitive or private issues.

Holistic approach to teenage mental health
The health professional will take a holistic approach. This means that the mental health assessment will look at your child’s unique characteristics and qualities in relation to their social and cultural world.

For example, the professional will talk with your child about their thoughts and personal beliefs and how these might affect health. The professional will also talk about physical and mental health symptoms, emotions and behaviour.

A teenage mental health assessment probably won’t be all talk. The professional might use art, music, photos, play therapy, drama therapy, electronic assessment tools or storytelling to understand your child’s perspective on things. The professional might also use formal tests to check anxiety, depression, learning ability or substance use.

Talking to you about your child’s mental health
The health professional will want to talk to you and possibly other members of your child’s family, kinship group or community to get an overall impression of your child’s issues.

Depending on your child’s age and maturity, the professional will ask your child first. For example, the professional might say, ‘I usually like to speak with people’s families – is that OK with you?’ If your child objects, the health professional will follow this up with you and your child.

Your support can have a direct and positive effect on your child’s mental health. In fact, there’s a strong link between the quality of parent-teenager relationships and positive outcomes for teenagers’ mental health.

Preparing pre-teens and teenagers for a mental health assessment

How you prepare your child for a teenage mental health assessment will depend on your child’s development. But being honest and talking with your child about the concerns you have for their wellbeing can help your child get the most from mental health consultations and treatment.

You know your child best so you can judge what and how much to explain. Your mental health professional can also give you advice.

Here are some guidelines that can get you started.

Children 9-11 years
In the pre-teen years, children still think in fairly concrete terms and about things related to themselves. They can be concerned about whether they’re normal and the same as their friends. At this age, children follow the rules of their social group and values friendships highly.

This means that your child needs accurate information, but not too much of it. When you talk about the appointment, you could:

explain that the aim of the mental health assessment is to help both you and your child understand how and why their feelings and/or behaviour have changed lately
reassure your child that there’s nothing wrong with visiting a mental health professional – it’s like visiting a GP
tell your child that you’ll go into the appointment with them if they want
reassure your child that what they tell the professional will be private and confidential
let your child know that you’re not going to trick them into going to appointments.

Children 12 years and older
From the age of 12 years, children think more deeply about things and begin to question authority. They make up their own minds about issues.

At 12-15 years, children understand consequences better, think about right and wrong, starts to develop their own identity, and think about what they want from life. They think about other people’s points of view, but they’re still strongly influenced by peers.

So when you talk about the appointment, you could:

reassure your child that there’s nothing wrong with visiting a mental health professional
talk about what they can expect to get out of going
talk about confidentiality and privacy
visit websites together to read other young people’s stories – try Reach Out, headspace and Kids Helpline.
give your child information about different professionals and services – like counsellors, psychologists and GPs
tell your child you’re happy to go with them and that you’ll respect their privacy.

If you approach teenage mental health issues with kindness, openness, hopefulness, tolerance, confidentiality and encouragement, it helps your child to accept help.

Getting ready for a mental health assessment: practical tips

Before the first appointment, find out:

what the meeting will cover
how long it will last
whether you need to take anything with you – for example, school reports, test results or medication
whether the professional will want to see the whole family or only your child
what approaches the health professional will use when working with your child
whether there’s a cost for the mental health assessment.

You could also:

make a list of questions so you get all the information you want
let your child know if you want time alone with the health professional
take some paper or a tablet to write notes
let the service know in advance if you need an interpreter.

After a teenage mental health assessment

At the end of a teenage mental health assessment, the professional will give you an opinion about what the issues and problems are and suggest a treatment plan. The professional will also say if your child has an emergency that needs immediate action.

It’s a good idea to make sure your child’s treatment plan has clear goals that your child and your family can achieve. For example, a goal might be getting up at the same time each morning, going for a walk each day, or keeping a brief diary of thoughts and feelings. It’ll also help if you’re positive about the outcomes of your child’s treatment plan.

Although you might want to know what has happened and what was said at the mental health assessment, your child might need some time before they talk about things with you. Your child might decide not to share what happens at their mental health appointments. This can be hard, but it’s your child’s right.

When your child won’t go to the mental health assessment

If your child is reluctant to see a mental health professional, it might help if a trusted family member or friend talks with your child about it – but avoid tricking your child into going. For example, it’s not good for trust if you tell your child you’re taking them shopping when you’re actually taking your child to see a mental health professional.

Here are some ways you can encourage your child to see a mental health professional:

Speak to your child about changes you’ve noticed – for example, changes in their mood, behaviour, relationships or schoolwork. Say you’re worried.
Explain why you think seeing someone might be a good idea. For example, you think it might help your child to talk with someone outside the family who’s good at helping young people.
Give your child information about services and how they can help – for example, counselling and psychology.
Explain that the health professional won’t tell your child what to do but will suggest things and help them find solutions to problems.
Explain that going to a mental health assessment isn’t a punishment and that you’re not suggesting counselling or psychology because you’re angry. You just want to help.
Explain that you’ll help your child to make an appointment, or will make one for them, but that you expect them to go to it.

It can also help if you talk to the GP or your child’s school counsellor about your concerns. It might be that your concerns are unfounded and don’t need following up, or the school counsellor or GP might be able to help you with what to do next.