We’re facing a pediatric mental health crisis that’s worsening by the day. Amid a national provider shortage, increased rates of anxiety, depression, and other behavioral health challenges are overwhelming under-resourced health systems and understaffed clinics. But even with urgent calls for more funding for therapists and increased access to care, the mental well-being of caregivers is often overlooked.
Mental health conditions among children are on the rise, medical spending for families with children with mental health conditions is increasing, and adults caring for these children are carrying the weight of this crisis, often without any support of their own. Caregiver strain includes the mental, physical, emotional, and financial impact of caregiving. It’s responsible for a $44 billion impact through the loss of more than 650,000 jobs and nearly 800,000 caregivers experiencing absenteeism at work, according to a Blue Cross Blue Shield report.
A recent study published in JMIR Pediatrics and Parenting found a strong correlation between the severity of a child’s behavioral health issues and caregiver strain. This indicates that as a child’s symptoms become more severe, the caregiver experiences higher levels of strain, which impacts workplace productivity, absenteeism, and overall stress.
Identify and support
We must support both caregivers and children. This begins with empowering parents and caregivers to support and identify mental health issues in their children. Parents and caregivers are often the first line of defense, providing their children with a safe and nurturing environment. Their actions—or their lack thereof—can significantly impact a child’s physical and mental well-being. Caregiver stress and strain can also potentially contribute to or even exacerbate the risk for mental health conditions in the child.
To identify and help offer mental health support for their children, parents, and caregivers should do the following:
- Create a safe and nurturing environment, which includes a loving and predictable lifestyle.
- Foster open and frequent communication using open-ended questions. Plan ample and appropriate time for these conversations.
- Validate feelings and emotions, even if you do not agree with or understand them. Be empathetic to their child’s concerns.
- Teach children coping mechanisms. Caregivers don’t need to fix every problem for their child, but we do need to help them navigate them. This could involve offering praise when they succeed and providing support when things aren’t quite right.
- Be a good role model. Children hear and repeat what you say, and see what you do. This includes how you cope with stress or challenges.
Children thrive when they have a strong sense of self-worth and positive self-esteem. One way to help instill these is through positive reinforcement and being in environments where they are respected and worthy of compliments and positive feedback.
Help identify early mental health concerns
The safest, most secure, and loving environments are not immune to mental health challenges, of course. But attentive parents and caregivers can help identify early mental health concerns in their children. They just need to be empowered to know what it is they’re looking for.
Parents and caregivers are often the first to notice changes in their child, no matter how small they may seem. Be aware of any changes in behavior, sleeping, eating, and participating in day-to-day activities. Performance issues or unwelcome behaviors at school can be an early sign that a child may be struggling.
This is where good and open communication with your children’s teachers and coaches comes in. They can offer valuable insight into how your child is doing physically and emotionally when you’re not around, as well as how they respond to peers or when they’re in challenging situations. More severe signs can include increasing irritability, changes in stress levels, including the inability to deal with “simple” things, withdrawal from social or family activities, disrupted sleep, or prolonged grief after a traumatic event.
Children don’t have the cognitive development to analyze these sorts of things that may seem easy to an adult. Caregivers should also consider a physical ailment and seek medical advice, as certain medical conditions often present with mood swings.
For many caregivers, it can be difficult to know when to seek professional help or if their child is in “a phase.” It is never too soon to check in with your pediatrician or ask for a mental health referral for your child’s well-being. If you cannot manage your feelings or see that your child is consistently struggling, it’s important to find support.
The connection betweencaregiver and child mental health
Mental health is not isolated: Stress, burnout, and anxiety among caregivers can impact their ability to model emotional regulation and stability, and children are more likely to receive timely care and show improvement when caregivers are engaged and supported. So, how can parents and caregivers recognize their stress?
- Recognize your stressors and address them as soon as possible.
- Prioritize your self-care. It’s incredibly valuable for both you and your family. Even small things like some alone time provide outlets for resolution and self-worth.
- Connect with family or other parents and caregivers who are likely facing similar struggles to find common solutions.
- Sometimes parents and caregivers have their mental health issues, and it is important to seek assessment and guidance, as often these conditions can contribute to your child’s well-being.
- Identify local community resources on parenting to provide parents and caregivers with insight, skills, and tools for more effective and positive parenting.
Examples of common stressors facing caregivers include navigating the ever-complex mental health system. Lack of time, resources, and support for managing one’s own needs can often amplify the problem. Balancing work responsibilities with caregiving responsibilities can often
compound stress, often leading to feelings of guilt, isolation, or failure when a child struggles.
The JMIR Pediatrics and Parenting study cited above found that over 70% of caregivers reported moderate to severe stress. Family-based therapy helped both children and caregivers, and these gains were most significant when both the child and the caregiver received support.
Supporting caregivers
We know that sustainable improvements in children’s mental well-being are increased when caregivers receive support, so we have to take a more holistic approach to family mental well-being. We should integrate caregiver-focused sessions into pediatric mental health services and provide access to therapy, coaching, and stress-reduction tools for parents and caregivers.
With the overburdened and under-resourced mental health system, there’s more need than ever for scalable, accessible interventions that help both the children and the caregivers across diverse communities. Supporting caregivers is not just a compassionate move; it’s a clinical imperative. Sustainable improvements in children’s mental health depend on systems that nurture the nurturers and offer holistic family-based care.
Research shows what common sense already tells us: When caregivers are mentally and emotionally supported, children are far more likely to stabilize, heal, and thrive. Addressing caregiver strain isn’t a parallel issue; rather, it’s a central strategy for solving the pediatric mental health emergency.
About Jeanne Marconi, MD
Jeanne Marconi, MD, is a Senior Vice President for business development and strategic partnerships at Brightline, the leading pediatric mental health solution supporting kids, teens, and their parents. Dr. Marconi is a nationally recognized physician and transformational leader in pediatric and young adult physical and mental health and wellness. Committed to driving systemic change to improve mental health access and improved outcomes for young people, Dr. Marconi serves as a board and committee member for organizations that support youth aging out of foster care and youth who are residents of long-term care facilities. Dr. Marconi is a graduate of New York Medical College, and completed her pediatric training at Northshore-Cornell University, Long island, NY.
