Help Children With Mental Health Issues Before They Escalate

6 min read

Sept. 13, 2024 – The shooting at Apalachee High School in Winder, GA, this past week marked a somber occasion: the first school shooting of the new school year in a country that has already seen almost 400 mass shootings in 2024 alone. The shooting at Apalachee High School near Winder, GA, is also unique in that it’s only the second time that a parent is also being charged with a crime. 

In the Georgia shooting, the alleged shooter, 14-year-old Colt Gray, “had been begging” his family for help with his mental health, according to the account his aunt shared with The Washington Post. While that help never came, law enforcement officials said Colin Gray bought his son an AR-15, a semiautomatic assault rifle, for Christmas. It is that rifle that Colt Gray is accused of using when he allegedly killed two students and two teachers, while wounding nine others, at his high school. 

Now Colin Gray, 54, faces four counts of involuntary manslaughter, two counts of second-degree murder, and eight counts of cruelty to children. In a separate incident earlier this year, James and Jennifer Crumbley were convicted of involuntary manslaughter for the deaths of four students shot by their son at Oxford High School in Michigan. 

These cases bring to light a larger question: Why do some parents find it so difficult to take action when their child is going through a mental health crisis, including those that do not result in a highly publicized shooting? And how can parents and family recognize when a child’s emotional struggles are crossing the line into a more serious stage that may result in actions harm themselves or others? 

The Roots of Parental Denial

Suicidal and homicidal behaviors rarely develop overnight. But parents aren’t given an instruction manual for how to treat their child’s mental health issues, and many of them are left in the dark, said Jessica L. Schleider, PhD, an associate professor in the departments of Medical Social Sciences, Pediatrics, and Psychology at Northwestern University in Evanston, IL.

Unfortunately, denial of a child’s mental health challenges is a natural response that in some ways parents have to fight against, Schleider said. Parents are prone to blame themselves for anything that’s going wrong with their child. It’s a painful experience even when it’s not accurate because mental health troubles can happen regardless of what a parent is doing or how supportive they are of their child. 

Still, parents need to understand that acknowledging mental health challenges doesn’t mean you’ve failed. It simply means you’re opening up a line of communication. 

“The desire to think that everything is OK in part comes from the desire to think that parents haven’t done anything wrong,” said Schleider.

This country also has a bad history when it comes to how we treat mentally ill people, placing them in asylums, locking them up and throwing away the key. We’ve long had an out-of-sight, out-of-mind mentality when it comes to mental illness. Mental health needs are still looked at as a personal failure in many parts of our society, which keeps parents from taking the steps they need to take, said Schleider.

“Stigma is different from community to community, but it persists all over,” said Cindy Huang, PhD, an assistant professor of counseling psychology at Teachers College at Columbia University in New York City.

Parents need to be aware of self-stigma and that a child’s mental health is not a reflection of them or their character.

Barriers to Mental Health Care

But even for parents who do seek out mental health care for their child, the U.S. has long had a hard time meeting these needs. An estimated 70% to 80% of children with mental health concerns go without care. 

It’s a statistic that was true even before the COVID-19 pandemic. There aren’t enough mental health providers, and many of them don’t use evidenced-based treatments. And for those who are taking new patients, weekly outpatient visits, which are the traditional treatment, aren’t always covered by insurance, making them off-limits to many families in need. 

Also, parents often have to be the ones to refer teens to mental health services. Teens are only allowed to self-refer to counseling in about a third of U.S. states. If parents aren’t open to their child seeking care, theyre often left without it, even if the teen perceives a problem.

Dealing with Mental Health Challenges Early On 

According to experts, the best course of action is not to let mental health issues become so severe. It starts with knowing your child well enough to see when something is off and acting on any signs you might notice, Huang said. 

“From a young age, parents need to position themselves as someone their child feels comfortable coming to with their problems,” she said.

Being a good listener and trying not to be judgmental are keys to keeping those lines of communication open, said Huang. If kids don’t think their parents will listen or care about their mental health concerns, they’re less likely to disclose them. Having direct and honest conversations about difficult topics like anxiety, depression, and thoughts of harming oneself or others makes them less taboo if a child runs into difficulty later. 

If kids do show changes in behavior – like an increased need for isolation, sleeping more or less, increasing or beginning the use of drugs or alcohol, and stopping the activities that they normally enjoy – these can be signs of mental health concerns. The child might also be eating less because they have less appetite or because the food no longer tastes good to them. These changes are all caused by anhedonia, a symptom of depression that results in a person no longer getting joy from life’s experiences, said Paul Nestadt, MD a psychiatrist at Johns Hopkins University in Baltimore who studies how and why suicide happens in different groups of people.

In this case, parents can start by talking to their child’s pediatrician and their school to seek out mental health services. They may also find care from community or religious leaders if it’s more comfortable for them.

Making the Environment Safe

“Still, the signs can be difficult to read because teenagers exhibit these symptoms sometimes at baseline. They have famously irregular sleep patterns, strong emotions, and their behavior changes as their identity changes,” Nestadt said.

And even when serious signs arise, it’s difficult to know who is actually suicidal or homicidal, said David A. Jobes, PhD, director of the Suicide Prevention Lab at the Catholic University of America in Washington, DC. “Many kids have severe mental health challenges, but few act on them,” he said.

What’s more, if a child is invested in hiding their symptoms, which they often are, it’s impossible for parents or even mental health professionals to know how they’re feeling, Nestadt said. So perhaps most importantly, the focus should always be on making the environment safe so that if these thoughts arise, it’s more difficult to act on them. 

The most important way to secure your home is through the safe and locked storage of all firearms. Nestadt’s soon-to-be-published research found in a small study that 77% of kids in Maryland who died by firearm used the family gun to do it. Parents should also ensure that kids are only allowed to have playdates or visits to homes that also use safe storage. And health care providers should also consult with parents about safe storage.

The bottom line for parents is that conversations about mental health need to start early before there’s any indication of a problem. 

“Kids need to know that you’re available to listen, and even if you’re not personally able to help them, you can facilitate getting them the help they need,” said Schleider.