What are the Warning Signs of a Children's Mental Health Crisis?

Sometimes families or caregivers see changes in a child’s behavior that may indicate a crisis may be developing; while other times the crisis occurs suddenly and without warning.

You may be able to de-escalate or prevent a crisis from happening by identifying early changes in your child’s behavior, such as an unusual reaction to daily tasks or an increase in their stress level.

Families may want to keep a journal or calendar documenting what happened right before the behaviors that are of concern. A sample journal is included in the back of this booklet.

Here are some warning signs of a mental health crisis:

Unable to cope with daily tasks

• Doesn’t bathe, brush teeth, comb or brush hair
• Refuses to eat or eats too much
• Sleeps all day, refuses to get out of bed
• Doesn’t sleep or sleeps for very short periods of time

Rapid mood swings

• Increase in energy
• Unable to stay still, pacing
• Suddenly depressed, withdrawn
• Suddenly happy or calm after period of depression

Increased agitation

• Makes verbal threats, hostile toward others
• Violent, out-of-control behavior
• Destroys/Damages property
• Cruel to animals
• Culturally inappropriate language or behavior

Displays abusive behavior

• Hurts others
• Cutting, burning or other self-injurious behaviors
• Uses or abuses alcohol or drugs
• Promiscuity—random dangerous sexual behavior

Loses touch with reality (psychosis)

• Unable to recognize family or friends
• Is confused, has strange ideas
• Thinks they are someone they are not
• Does not understand what people are saying
• Hears voices
• Sees things that are not there
• Paranoia—suspicious or distrustful

Isolation from school, work, family, friends

• Little or no interest in outside activities
• Changes in friendships
• Stops attending school, stops doing homework; declining grades
• Will not leave bedroom, isolates
• Runs away from home

Unexplained physical symptoms 

• Facial expressions and/or eyes look different
• Increase in headaches, stomachaches
• Feels like they are outside of their body
• Complains they don’t feel well

What are the Warning Signs of Suicide?

Any of the following may be warning signs for suicide:

• Talking about or making plans for suicide
• Expressing hopelessness about the future
• Displaying severe/overwhelming emotional pain or distress
• Showing worrisome behaviors or observable changes in behavior, particularly in the presence of the warning signs above. Specifically, this includes significant:
  • Withdrawal from or changes in social connections/situations
  • Changes in sleep (increased or decreased)
  • Anger or hostility that seems out of character or out of context
  • Recent increased agitation or irritability
  • Writing about or drawing pictures about suicide or death

How to respond:

• Ask if they are ok, if they are having thoughts of killing themselves, if they have a plan
• Express your concern about what you are observing in their behavior
• Listen attentively and non-judgmentally
• Take all thoughts of suicide seriously
• Do not leave the person alone
• If they have expressed thoughts of suicide, they have a plan to hurt themself or if you/they are concerned, you need to get them professional help, such as a doctor or therapist
• Tell them they are not alone, offer hope in any form

If you think your child or another youth may need help right now, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) OR TEXT “MN” TO 741741 OR CALL **CRISIS or *274747. Your call is free and confidential. Trained crisis workers in your area can assist you and the child in deciding what they need right now.

Research by: Suicide Awareness Voices of Education (SAVE); American Association for Suicidology (AAS); Substance Abuse and Mental Health Services Administration (SAMSHA) and National Center for the Prevention of Youth Suicide 2015. 

Learn more by reading NAMI Minnesota's "Mental Health Crisis Planning for Children" booklet.

NAMI Minnesota

This content was taken from NAMI Minnesota's Mental Health Crisis Planning for Children booklet.