As the back-to-school excitement fades and homework assignments begin to pile up, now is the time to check in on your kids and their mental health. After two chaotic school years, things have somewhat returned to normal this year, but the kids are still in transition and so are the parents.
We spoke with Dr. Nicole Stelter, director of behavioral health at Blue Shield California, about what to keep in mind. She shared some tips on how to talk to kids about mental health, what to look out for and how to help them.
Q: When and how should parents start talking to their children about mental health?
A: Conversation isn’t easy, but it doesn’t have to be difficult either. Sometimes it’s just wishful thinking that you won’t get it right the first time. You won’t be perfect, but you just have to be a good enough parent, you don’t have to be perfect.
Many times parents and guardians, adults in general, worry that we can “infect” our children with mental health problems or anxiety because we ask questions or talk to them about what is fortunately not true.
Part of reducing stigma is related to health. When we start telling our kids “don’t ride your skateboard without a helmet because it’s not safe”, “don’t climb the bookcase or jump off the top”, when we talk to them about taking care of their bodies, it’s a great time to talk about what it means to take care of your mind and brain.
What does this look like? Destigmatizing, normalizing as part of what you do to take care of yourself and take care of each other. These are conversations that many parents are already having in different ways. So it’s not something different per se, it’s just an addition.
Q: This is the second year that kids have been back to school since COVID, and we’ve heard a lot of discussion about how COVID has challenged the mental health of young people. What are the specific concerns that have arisen over the past few years?
A: Anything that disrupts the social fabric of what our children and communities do is a potential challenge to mental health and emotional well-being. There’s a similar kind of disorder, isn’t it, that’s where we find social support, where we find community. And for kids, they’re working out where they fit in the world, and they’re going to be curious if that’s OK, all those things that are really, really important developmentally.
There are simply many interruptions to this normal social development. Part of the other thing we’re starting to realize is how much learning has been affected in the last few years.
There is some catching up or reformulation and strengthening that needs to happen. This is a generation of children who will experience their academic pursuits and learning in a completely different way than any of us have ever had to. And I think we’re still trying to figure some of that out.
Q: What are the specific mental health issues that are most common that parents should watch out for?
A: I think our biggest concerns right now are not necessarily any different than before or will be any different going forward.
Parents should watch out for their children being anxious. Much more worry, isolation, withdrawal. These are all concerns that lead us to start thinking about anxiety, to start thinking about trauma response, depression, substance abuse concerns.
Substance abuse is to some extent an indicator that someone needs to give up something that is overwhelming. It could be substance abuse, it could be too much time playing video games. When a parent, teacher, community or guardian sees a child finding ways to get out, you have to worry about what overload is going on there.
And the overload may be related to pressure to perform because children know they are not the same students they were three years ago, so some feel their performance is deteriorating.
It can also be about social skills. Many of us are frankly out of practice. And if you’re a kid, you’re new to doing a lot of these things. So that can be quite stressful. And they may want to withdraw or avoid.
Q: If a parent notices that a child is becoming more withdrawn or is concerned about substance abuse, what should they do to help or support their child?
A: Perhaps the most important thing is to ask them. Parents and guardians will avoid asking directly because we expect them to push us away or we think we can infect them with the idea of something that isn’t actually happening and make it worse.
But these are the most important things to pay attention to, not avoid. Don’t wait for it to go away. Find a way to ask questions about how they are doing.
The kind of questions I’m talking about are really open-ended. Asking a question in a way that says “I’m interested in the answer, but it doesn’t have to be a specific answer.”
I would say that parents can absolutely contact their insurance provider to find out what is available for help. We [Blue Shield] they have our BlueSky programwhich is focused on teenagers and kids, but it can also be for parents, teachers, guardians, so people can find free resources really quickly.
You don’t have to wait until there’s a problem before you start taking care of yourself. It’s like going to the gym. We don’t go because we have back pain, we go to prevent back pain.
Question: How can parents model good mental health habits for their children?
A: I think we forget that this is part of how we teach our children.
We can be open about our own health. If you think about your physical health, you’d talk about something that’s going on with you, a medical concern, so it’s very, very similar.
What gets a little tricky is that there is a limit as a parent. If I’m stressed because I’m worried about my kids, what can happen is that our kids can pick up on that. And we don’t want that, they are working on their own stuff.
You can say “work has been really hard lately” or “I’ve been under a lot of stress” and “here’s what I’m doing about it.”
The most important thing you want your child to hear is “and this is how I take care of myself” and that it’s okay to do so. I put myself and my health first, the same way I want you to.
Q: Are there specific habits that parents should either encourage or discourage for their school-aged children that make a big difference in their mental health?
A: It’s the simple stuff really. That’s the basics.
Do they go to bed and get up at relatively the same time and do they get enough sleep? Sleep hygiene is really important. It’s just as helpful for older children as it is for younger children to have a bedtime routine or ritual that involves reducing screen time, giving your brain a chance to wind down before you need your body to too. calm down and sleep.
For older children, disconnecting from content that is stimulating, things like social media, news. Make sure they get regular exercise and don’t drink caffeine too late in the day.
The other parts are really about proper nutrition. I know that sounds overly simplistic. Are they drinking enough water? Are they eating as regularly as they should? Is it balanced?
These are the things that can make them able to take on what they need from a mental health perspective. So pretty basic, but it’s a very important foundation to be able to be resilient and take care of yourself.
Dr. NICOLE STELTER
Title: Director of Behavioral Health for Blue Shield of California
Residence: South Orange County – Just moved from Long Beach where she lived for almost 30 years. “So I still kind of ‘want’ The LBC.”
education: La Mirada High School, BA in Psychology, MA in Marriage and Family Counseling, PhD in Industrial/Organizational Psychology
family: 2 teenage boys, 2 stepsons, fiance, 2 stepkittens, 1 dog
FIVE THINGS YOU NEED TO KNOW ABOUT DR. STELTER
- Lifelong Green Bay Packers fan whose father was from Wisconsin
- Served from 2010 to 2015 as a Behavioral Health Officer with the California State Guard/Army National Guard
- Worked as a family and marriage therapist for almost 30 years and in organizational mental health for almost 20 of those years.
- Played interscholastic softball at California State University, Dominguez Hills
- To learn to play the bass guitar.