Children (0-12yrs) - Mental Health

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This section of the Mental Health Media Guide offers insight and recommendations surrounding the portrayal of kids’ mental health in entertainment media geared toward adult audiences. The tips in this section can inform storylines depicting young characters or cast members, their families, and others in the community who may play a role in influencing a child’s mental health. 

For consultation on resources to support the well-being of kids on set, visit the expert directory.

  1. Model healthy adult-child relationships
    1. Research consistently shows that a positive, supportive relationship with at least one trusted adult—be it a parent, teacher, mentor, or other caregiver—can significantly contribute to protective factors that support a child’s mental health.
  2. Highlight that mental health issues in kids can show up as physical symptoms
    1. Symptoms of mental health challenges like anxiety or depression can present as physical symptoms in kids (like bellyaches, headaches, or changes in eating and sleeping habits), but adults can easily miss the underlying cause. Depicting characters whose symptoms are connected to underlying emotional or psychological distress can help increase understanding.
  3. Focus on positive outcomes with professionals
    1. For a variety of reasons, including shame, skepticism, or hard-to-understand symptoms, adults may be unlikely to seek mental health support for kids. On average, it takes 10-11 years from a child’s first symptom of a mental health disorder until they receive treatment. Showing families with young children positively engaging with mental health professionals can help increase understanding and decrease fear of treatment.
This section was written in partnership with Kids Mental Health Foundation

Storytelling Tips

Diversify Representation
  • Demonstrate how experiences with mental health challenges, warning signs, help-seeking, and access to care can show up differently across communities and identities. 
    • Kids are unlikely to receive mental health support unless the adults in their lives can spot warning signs and seek help. Showing this process in underrepresented communities can have a powerful impact. 
    • It’s helpful to show stories that have caregivers teaching children about their cultural or racial background to build their confidence and identity, while also preparing them for possible barriers and discrimination or racism they may encounter. 
    • BIPOC kids with mental health challenges are more likely than white kids to be punished for their behaviors. Demonstrating this systemic pattern can help families and communities learn to advocate for better services for their kids.
    • Find opportunities to show kids from marginalized communities experiencing moments of joy and community. These communities often have higher rates of mental health concerns and lower access to care due to a variety of systemic barriers. Depicting these barriers authentically can help call attention to them, but depicting the strength and joy in these communities in the face of barriers can be equally humanizing and powerful.
Portray a Range of Mental Health Experiences
  • Show children dealing with experiences across the mental health continuum, from day-to-day emotional struggles to diagnosed conditions.
    • Children do not need to have a mental health diagnosis to have discussions about big emotions, how they feel in their body and how to cope. These are skills everyone can learn about from the moment they are born.
  • Highlight the range of symptoms that can indicate underlying mental health challenges in children.
    • A child struggling with mental health challenges may show unexpected symptoms, like behavioral issues or physical health symptoms. For example, a child who is struggling with academics in school could have a difficult home environment including trauma, a sick caregiver or other concerns.
    • Don’t sensationalize the symptoms that children and families face in the depths of their disorders. Try to avoid focusing on the extremes of an individual’s experience, glorifying their pain or exaggerating an individual’s experience as normal baseline behavior for everyone with that issue. Show the real challenges children face on a daily basis and the steps that children or families take to build resilience on a regular basis.
Model Age-Appropriate Conversations 
  • Model the importance of adults listening to–and connecting with–children by showing adult characters checking in with kids about a variety of topics.
    • In the same way we talk to infants and teach colors, numbers, and letters, adults can teach emotional words to infants. You can show adults labeling emotions for young characters or reading to children and discussing the emotions in a book.
    • Research suggests that showing adults and children having realistic, supportive conversations about tough topics like bullying, racism, school violence, or self-harm can encourage young people to seek out trusted adults in their own lives when these issues occur.
  • Ensure discussions of suicide are developmentally appropriate, especially in children under the age of 12, and avoid details that may lead to contagion. 
    • Consult an expert in kids’ mental health when portraying children navigating complex topics. The Expert Directory has contact information for individuals and organizations with a variety of areas of expertise. 
    • Help viewers understand signs that a child is at risk for self-harm or suicidal behaviors by showing a child displaying major changes in their mood or activity level, no longer doing the things they used to enjoy, or significant changes in in eating or sleeping.
    • Provide examples of adult characters directly addressing suicide by asking children if they have ever had thoughts of suicide, talking about what they can find purpose or meaning in life, asking open-ended questions and giving children space to talk about all of their feelings.
Depict Effective, Realistic Help-Seeking and Treatment
  • Depict adults seeking mental health support for kids the same way they do for physical health issues, which can encourage audiences to do the same. 
    • Families often don’t have a starting point for how to begin their mental health treatment journey or what to expect. Decrease the fear of mental health treatment by showing characters finding a therapist, asking the right questions and setting up an appointment.
    • Provide and model appropriate portrayals of what effective therapy looks like. For example, have a therapist teach a skill from an evidence-based treatment (teaching a patient to challenge negative thoughts, creating an exposure plan for a child with anxiety, etc.) to the main character. Show a child character, entire family or caregiver making progress based on therapy or talking about how their therapist has been key to their growth and positive change.
    • Avoid showing harmful or unethical behaviors by therapists and providers that make people even more reluctant to seek treatment (i.e. therapists taking advantage of patients or engaging in unethical relationships).  If that is part of the storyline, show realistic consequences like the therapist losing their license.
Highlight the Power of Coping Skills and Self-Care
  • Model the skills communities can use to support kids’ mental health and wellness on a day to day basis.
    • Just like physical health, mental health care happens every day. Stories often  focus on the difficulties and challenges of serious mental health concerns, but modeling the skills families and communities can use to take care of their mental health and wellness every day can have an even greater positive impact.
    • Parents, coaches, teachers, extended family members and mentors can all play a role in helping kids develop positive mental health skills that may prevent some mental health concerns from developing. Showing those kinds of positive relationships, conversations and skills on screen could help millions of families think about mental health differently.
    • Adult characters can model healthy ways that adults can validate children for how they feel and encourage healthy emotional expression and coping. You can show how to help children initiate, manage and/or stop actions and behaviors sparked by emotions.  For example, a child is angry and is able to pause, notice their feelings and take a break to calm down instead of hitting a peer or sibling.
    • Adult characters can also model healthy expressions of emotion, i.e. sharing about how they had a hard day and what mental health coping skills they’re using (deep breathing, taking a walk, etc.).
  • One of the best ways to increase positive behaviors and healthy connections is to promote consistent habits, routines and traditions through your storylines.
    • Have adult characters show intentional child focused time as a way to connect with a child to support their development. Building daily or nighttime routines as well as holiday celebrations helps kids create habits that support their mental health. 
    • Just like emotional awareness and coping starts from infancy, so does building healthy relationships with children. The way adults respond to developmentally normal tantrums and unwanted behaviors is important for keeping the relationship on a healthy track. Having adult characters set expectations, use praise or use consequences appropriately can increase positive behaviors and decrease unwanted behaviors.

Snapshot

Developmental psychologists categorize the experiences of children (birth to age 12) and the experiences of young adults (ages 13-25) differently due to variations in the physical capabilities, cognitive processing, and emotional maturation of the two demographics. Ninety percent of a person’s brain develops from birth to age 5.1 Attachment to caregivers, close relationships with others, and mutually rewarding interactions during this stage all influence a child’s brain development. Children who face greater stress and adversity, such as living in poverty or experiencing abuse, are at far greater risk for delays in their cognitive, language, and emotional development.2 

Mental health disorders and distress have worsened in kids over the past decade for a variety of reasons. 93% of parents of kids under 18 say it is important for parents and caregivers to talk to their children about mental health, but only 43% say their family talked about mental health openly when they were growing up. Today’s parents need tools and models of effective communication to meet the mental health needs of today’s kids. Sharing mental health stories that include practical prevention and early intervention tools can help us tackle the current children’s mental health crisis. 

1. Center on the Developing Child, The Foundations of Lifelong Health Are Built in Early Childhood, Harvard University, July 2010. Available at: https://46y5eh11fhgw3ve3ytpwxt9r-wpengine.netdna-ssl.com/wp-content/ uploads/2010/05/Foundations-of-Lifelong-Health.pdf. 

2. Center on the Developing Child, “Brain Architecture,” Harvard University, July 2, 2019. Available at: https://developingchild.harvard.edu/science/key-concepts/brainarchitecture/.

Facts and Stats

  • 1 in 6 U.S. children aged 2–8 years (17.4%) had a diagnosed mental, behavioral, or developmental disorder in 2016. 1
  • Among children aged 2-8 years, boys were more likely than girls to have a mental, behavioral, or developmental disorder. 1
  • Among children living below 100% of the federal poverty level, more than 1 in 5 (22%) had a mental, behavioral, or developmental disorder. 1
  • Behavior problems are more common among children aged 6–11 years than younger or older children. 2
  • Children who were discriminated against based on race or ethnicity had higher percentages of one or more physical health conditions (37.8% versus 27.1%), and one or more mental health conditions (28.9% versus 17.8%). 3

1. Cree RA, Bitsko RH, Robinson LR, Holbrook JR, Danielson ML, Smith DS, Kaminski JW, Kenney MK, Peacock G. Health care, family, and community factors associated with mental, behavioral, and developmental disorders and poverty among children aged 2–8 years — United States, 2016. MMWR, 2018;67(5):1377-1383.

2. Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, Blumberg SJ. Prevalence and treatment of depression, anxiety, and conduct problems in U.S. children. The Journal of Pediatrics, 2018. Published online before print  October 12, 2018

3. Hutchins HJ, Barry CM, Valentine V, Bacon S, Njai R, Claussen AH, Ghandour RM, Lebrun-Harris LA, Perkins K, Robinson LR (submitted). Perceived racial/ethnic discrimination, physical and mental health conditions in childhood, and the relative role of other adverse experiences. Adversity and Resilience Science published online May 23, 2022.

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