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When Do Adolescents Need Mental Health Treatment?

Adolescents face multiple challenges as they move toward adulthood, starting with balancing schoolwork, extracurricular activities, and time with friends. There’s also resisting drugs and alcohol, trying to look good on social media, and processing news about the latest school shootings. With so much to deal with, it’s important that parents identify when their child may need mental health treatment. 

“Whether they’re able to voice it in that moment or not, I hear from my adolescent clients that they want their parents to notice and ask about their mental health struggles,” said Alysa Romano, a licensed professional counselor and clinical director of Embark Virtual IOP, a virtual intensive outpatient program at Embark Behavioral Health, a leading network of mental health treatment programs focused on preteens, teens, and young adults. “It shows them that you care. I’ve sat with a lot of clients who are angry and hurt because they think their parents waited too long to take them seriously.”

The Youth Mental Health Crisis

Today’s adolescents are facing a youth mental health crisis. According to the World Health Organization (WHO), 14% of youths ages 10-19 experience mental health conditions that are largely unrecognized and untreated. Those conditions include anxiety and depression, which can significantly affect youths and can start at a young age. 

  • According to the Centers for Disease Control and Prevention (CDC), approximately 4.4 million children and teens ages 3-17 have been diagnosed with anxiety, and 1 in 3 of those children also have depression.
  • CDC data for 2020 show suicide* was the second-leading cause of death for ages 10-14 and the third-leading cause for ages 15-24.
  • A 2022 report from Mental Health America shared that 15.1% of youths ages 12-17 experienced a major depressive episode in the past year, a 1.2% increase over the previous year.
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Eating disorders are also a significant issue. According to the American Psychiatric Association, they usually develop during adolescence and young adulthood and most often affect females ages 12-35.

Romano said the youth mental health crisis has multiple contributing factors, including the pressure to be high achievers, comparing themselves to peers, and easy access to information and news through digital and social media. 

Warning Signs an Adolescent Needs Help

Multiple warning signs can indicate youths may need mental health treatment. Romano said if adolescents have symptoms for longer than two weeks or the symptoms keep reoccurring, it’s time to connect them with a trained professional who can determine if they need support. She also advised that once a parent starts wondering if their child needs help, the answer is likely yes.

“I’m an advocate for reaching out as soon as you’ve been thinking that maybe you should,” Romano said. 

Overall warning signs

Overall warning signs parents should watch for in adolescents include:

  • Anger, hostility, or irritability. 
  • Family conflict or acting out in a destructive manner.
  • Feelings of stress or anxiety, including social anxiety.
  • Impulsive behaviors (e.g., spending a lot of money, stealing, gambling, or running away).
  • Lack of motivation, lack of concentration, or low energy levels.
  • Loss of interest in activities, depression, or crying spells.
  • Low self-esteem, guilt, shame, loneliness, or grief.
  • Medical concerns such as dizziness, nausea, poor bowel movements, poor vitals, cavities, or irregular menstrual cycles, which could indicate the presence of an eating disorder, depression, anxiety, or trauma.
  • Poor sleep habits (e.g., too much or too little sleep). 
  • Recent stressful life events (e.g., the end of a close friendship or romantic relationship, death of someone close to them, loss of a beloved pet, move to a new school or place, or exposure to violence).
  • Restricting food intake, binge eating, not eating in front of others, going to the bathroom quickly after meals, or exercising obsessively.
  • Signs of self-harm (e.g., a series of similar marks on the skin or wearing long sleeves consistently, even in warm weather).
  • Substance abuse or substance dependence.
  • Unusually high energy, inability to sit still, racing thoughts, or difficulty tracking a train of thought.
  • Withdrawal from friends, family, or social circles. 

If parents are concerned their child may have anxiety, depression, or an eating disorder given how significantly and often these conditions can affect adolescents, they can watch for several symptoms specific to these issues.

Symptoms of depression

Symptoms of depression include:

  • Anger, hostility, or irritability.
  • Lack of appetite.
  • Changes in sleep habits (e.g., difficulty sleeping or sleeping too much).
  • Fatigue no matter how much sleep they get.
  • Frequent crying.
  • Hopelessness or sadness.
  • Lack of motivation.
  • Loss of interest in favorite activities.
  • Low self-esteem.
  • Poor school performance.
  • Self-harm or thoughts of self-harm.
  • Suicidal thoughts.
  • Withdrawal from friends, family, and social circles.

Symptoms of anxiety

Symptoms of anxiety include:

  • Avoiding or quitting extracurricular activities.
  • Avoiding social interactions.
  • Changes in eating habits.
  • Difficulty concentrating or finding their mind “goes blank.”
  • Difficulty falling or staying asleep.
  • Fatigue.
  • Feeling overwhelmed by schoolwork.
  • Feeling restless or on edge.
  • Having panic attacks.
  • Worrying excessively.

Symptoms of an eating disorder

Symptoms of eating disorders include:

  • Constant worry about being overweight.  
  • Dental cavities.  
  • Eating in secret.  
  • Eating large amounts of high-fat foods and sweets.  
  • Eating more food at a meal than is considered normal.  
  • Excessively exercising.  
  • Insomnia.  
  • Irregular menstrual cycles.  
  • Obsession with celebrities’ body shapes and wanting to look like them.  
  • Obsession with losing weight.  
  • Showing disgust at their eating habits.  
  • Skipping meals.  
  • Using laxatives.  
  • Visiting the bathroom soon after each meal.

When There Aren’t Warning Signs

One challenge for parents is some adolescents who are doing well on the surface don’t exhibit warning signs. Romano said a lot of teens are good at hiding their struggles.

“On the outside, it may appear like there’s nothing wrong,” she said. “They’re getting straight A’s. They’re on the volleyball team. They have friends. They have a loving family. All of that can be very true while they could also be struggling internally, feeling very anxious or depressed.”

Romano said with the quieter, more put-together adolescents, their mental health struggles may not be identified until the situation becomes serious.

“You see this a lot with clients with eating disorders, for example,” she said. “The family may not know about the disorder until suddenly the child is ill, and their heart rate is low. Then they go into the hospital, and this whole experience they’ve been having is revealed.”

So, even when adolescents seem to be thriving, Romano recommended checking in with them. She suggested asking, “How is your heart feeling?” to encourage a child to share how they feel internally.

Getting Help: Next Steps

Once parents have identified that their children may need mental health treatment, they can contact their pediatrician or general practitioner for assistance. The doctor should be able to recommend resources including therapists, psychologists, psychiatrists, and counselors. 

Parents can also go straight to a mental health professional such as a general psychology practitioner or therapist. This person can evaluate and, if needed, treat the adolescent — or recommend another provider who’d be a good fit for the child. 

If parents do decide to contact a mental health professional, they should find a practitioner who specializes in adolescents. They can locate these experts through their health insurance plan or Psychology Today.

If adolescents are having suicidal thoughts, parents should seek help right away. They can contact the 988 Suicide & Crisis Lifeline for immediate support by calling, texting, or chatting 988. 

Focusing on Outcomes and Supporting Adolescents

When it comes to exploring mental health support, Romano said it’s important that parents know how hopeful treatment outcomes can be. 

“I like to highlight that treatment really does work,” she said, “and that while we’re seeing anxiety, depression, and suicide at all-time highs, at the same time, the potential for well-being and for healing and recovery — a healthier society — is still strong.”

Romano said it’s also important that parents take the time to connect with adolescents on a regular basis to know when they’re struggling.

“Your child wants to love and be loved by you. Listen to them,” she said. “Even if you can’t solve their problems, you can be an endless source of support for them, and that will deeply matter.“

*This article is for informational purposes only and not to be considered medical advice. If an adolescent is having a mental health emergency, parents should contact the 988 Suicide & Crisis Lifeline for immediate support by calling, texting, or chatting 988. They can also text HOME to 741741 the Crisis Text Line from anywhere in the country to talk with a trained crisis counselor. 

Rob Gent is the chief clinical officer and one of the founding members of Embark Behavioral Health, a leading network of outpatient centers and residential programs for preteens, teens, and young adults. Rob has been with the company for 15 years and has led the Embark organization in clinical development and the growth of numerous programs. He is the lead developer of the proprietary CASA Developmental Framework, used throughout Embark’s locations to create therapeutic relationships.

Through his dedication to advancing clinical development, practice, and research, Rob has become a nationally recognized expert in the behavioral health field. He is passionate about neurological, psychological, and physiological development and focuses on advancing research and the effectiveness of therapeutic interventions. He has a doctorate in psychology with an emphasis on development and attachment. 

Rob resides in Tempe, Arizona, with his wife and two boys.

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