Boy depressed with a tear in the eyes

Childrens’ Essential Need

A child at risk can easily go unrecognized!

Sam was lagging in his school work and was falling asleep on his school desk. His grades were failing. He was getting into fights, according to his principal. Other kids were bullying and picking on him. At home and school, he was often moody and irritable. He avoided social activities and liked to play by himself or watch TV. The school called his mother to make an appointment. What happened next totally caught everyone off guard. Help had come too late. [i]

Mental health is the critical factor for a child’s healthy development.

Children at risk—their families, community, and educational programs—need information and education about early recognition of problems, finding support services, and qualified evidence-based mental health services. The Substance Abuse and Mental Health Services Administration (SAMSHA) started the National Awareness Day to call everyone’s attention to the critical nature of a child’s mental health—the essential element for the development into a well-adjusted and stable functioning adult. The awareness day is a call for everyone to recognize and get the service and care for any child’s mental or emotional health issues or difficulties that become apparent. [ii]

Childhood difficulties may show up as changes in moods, behavior, irritability, or as described in my new book COVID-19/MENTAL HEALTH CRISES: Holistic Understanding & Solutions, in the chapter Pandemic, Fear, and Anxiety. [iii]

During times of significant turmoil or crises, the difficulties observed in children are often different and sometimes more difficult to recognize than those observed in an adult.

Children are at increased risk for fear, anxiety, mood, or worsening of existing problems during distressing times, as now during the COVID-19 pandemic. Signs and symptoms of impending problems are often more subtle for children than adults. Such behavior or emotional changes in children might appear as:

  • Temper tantrums, acting-out behaviors as being destructive, getting into fights or arguments
  • Sleep difficulties and nightmares
  • Showing decreased interests in things they usually enjoyed
  • Being more sullen or apathetic or becoming more hyperactive
  • Not wanting to take part in playful or recreational activities with themselves or with others
  • Not eating well, gaining or losing weight
  • Loss of concentration, attention, and becoming more distractible

Some of these children’s changes may be a warning sign of the need to seek support or help. Early recognition, getting support, and seeking help is critical for preventing and reducing the risk of chronic emotional and mental impairments and related physical illnesses. Focusing on inappropriate labels for a child’s difficulty is a distraction from an appropriate focus on a child’s actual needs and beneficial therapeutic interventions.

During my earlier psychiatry work, I assessed children, the family, and classroom situations when difficulties arose. Often, the child got labeled as a troublemaker, bully, withdrawn, opposition defiant child, attention-deficit hyperactivity disorder (ADHD), or depressed. The child often had failing grades, couldn’t stay awake in school, got into fights, or became a target of bullying. Parents or teachers usually demanded to put the child on a drug as an antidepressant or stimulant medication for ADHD. I would make everyone involved take a pause, including the child, and get everyone on board to look at the larger picture. Guess what? It often turned out that there much more significant issues that needed attention. Drugs, more often than not, were avoided, though used, and appropriate in some situations

Sometimes the child had depression from disruptive issues in the family or prior history of significant trauma. Triggers or conditioners for mood problems could be:

  • A parent losing a job
  • The family moving
  • Death of a family member or friend
  • Parents divorcing
  • Prior significant history of trauma as being in an accident, hospitalized for any reason, sexual or physical abuse, and even rape
  • A history of genetic uniqueness, as being on the autism spectrum with a different way and style of processing information and learning

Teachers and parents frequently do not recognize critical mental health issues that need attention. A child can end up feeling inadequate, defective, dumb, undeserving, or responsible for their painful and unhappy situation. Their peers and parents repeatedly reject and bully them. The child feels like a misfit that doesn’t fit in, and extreme behavior and mood problems can ensue, sometimes leading to tragedy.

A child with differences and needs can regain a positive sense of self and self-esteem with evaluation and testing to determine their needs. Skills training, trauma-focused therapy, family help, and correction in their living situation can support better adaptation in their current life and interaction with peers, family, classroom, and other social interactions. Skill training in the area that the child needs will help bring better adaptation to occurring life circumstances. Adaptation is easier for children with trauma-free upbringings and typical genetic make-ups. A positive outcome will be the acceptance and respect for those with unique life experiences as:

  • Trauma history with over-reactivity and moodiness
  • Physical limitations or disabilities
  • Unique ways of learning, processing information, and doing tasks

Other circumstances could be a child living in a very disruptive living situation with neglectful parents who leave the child to their own devices without routines, including poor diets and sleep habits. Some children who were falling asleep in the classroom stayed up late to watch tv, play their video games, etc.

The vital point goes back to the designated day, noted above, for child mental health awareness—which should be every day.

If a child has difficulty or struggles, get help from mental healthcare providers that can look at the family situations, a child’s individual needs, and any testing and assessment needed. Find the services that are required, which can help to prevent future severe consequences. Do not ignore and just put a label on a child that is having difficulties. The same holds for any adult when any struggles or problems appear—to be aware and seek help.

For questions or to schedule a consultation with Dr. Parks, fill in the contact form at

Lead-in photo for the article: ©Nadezda Ledyaeva/

Endnotes and References:

[i] Sam’s story is not that of an actual person, but a composite story from my clinical experience. The ending of this story is not necessarily a bad one. The hope is for adults to learn, be aware, and act to prevent a downward spiral in the mental and emotional health of a child.

[ii] The Substance Abuse and Mental Health Services Administration (SAMSHA),

[iii] Ronald R. Parks, MPH, MD. (2021). REMEMBER THE CHILDREN! In the book, COVID-19/Mental Health Crises: Holistic Understanding & Solutions (p. 14). Asheville, NC, USA: ParksPress 2021

Dr. Parks’ new book is a treasure chest of valuable insight into the stress and challenges to physical, emotional, and mental health, when under duress or in stressful times as with significant loss, trauma, climate disaster, the current pandemic, or the wake of emotional or mental illness. There is much helpful information, personal and composite stories from Dr. Parks’ years of clinical experiences, and educative information about early recognition of difficulties, what to do, and prevention tips, getting through the problems, recovery, and transformation to wellness and wellbeing. A holistic road map opens a path to not only survive but to thrive. The book offers holistic health essentials: As a safety net in times of crises and mental health challenges. For more information, click here.


ADHD, Anxiety and Panic, Bullying, Children's Mental Health, difficulties in school, Mental Health Crises, Mood disorders, Substance Abuse


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