Finding mental health care for your child or teen

Start with the pediatrician

Your child's pediatrician or family doctor is usually the best first call. They can check for physical causes, screen for common concerns such as anxiety, depression and ADHD, and refer you to someone who specializes in children. Some insurance plans also require that referral.

Be specific when you book. "I am worried about my son's mood and want to talk about getting him seen by a mental health specialist" gets you a better appointment than a routine checkup.

Bring the school in

Teachers and school counselors see your child for hours a day in a setting you do not. Ask what they are noticing; it is often useful for whoever evaluates your child. School counselors also tend to know which local clinicians work with children, which can shorten your search.

Public schools can also evaluate a child for learning and attention needs. The CDC notes that school systems provide free evaluations for children 3 and older. Put the request in writing to the school. A school evaluation decides what support your child needs at school, which is separate from, and can happen alongside, medical care.

The kinds of care you may be offered

Care for children and teens is usually outpatient, and often a combination of the following. Whatever the mix, ask whether the clinician regularly works with your child's age group; working with a 7-year-old is quite different from working with a 16-year-old.

• Therapy with a clinician who works with children or teens. For younger children it often involves play and parents directly.
• Family therapy, when the patterns at home are part of the picture or part of the solution.
• A psychiatric evaluation, if a diagnosis is unclear or medication might be considered.
• Medication management, with regular follow-ups if medication is prescribed.
• Parent sessions, where you learn approaches to use at home.

Consent and confidentiality for minors

In general, a parent or legal guardian consents to treatment for a minor. The details, including when a teenager can consent for themselves and what parents can see, are set by each state and can differ for therapy, medication and other care. Ask the practice to explain the rules that apply to your child.

In Tennessee, the state Department of Children's Services policy on consent states that youths 16 and older may provide their own consent for mental health treatment, and that parental consent is then not needed. The same policy notes that some providers may still choose not to treat a 16-year-old without parental involvement. If you live in Alabama, South Carolina or Kentucky, ask the practice how your state handles this.

Even when you have consented, most therapists keep the details of a teen's sessions private, while telling parents about anything that affects safety. That privacy is often what lets a teenager speak honestly. Ask the therapist to explain their approach to you and your teen together at the start.

What to ask when you call

Not every practice sees children, and those that do often have age limits. A few questions sort that out quickly. Keep a short note of each answer so you can compare practices afterwards.

• "Do you see children or teens of [age]? Which clinicians work with that age?"
• "Do you treat [the concern: anxiety, ADHD, mood, behavior]?"
• "How involved are parents in sessions, and what will you share with me?"
• "Are you in network with [plan name]? Do I need a referral?"
• "Do you offer telehealth for any visits, and after-school times?"
• "What is the wait, and is there a cancellation list?"

What to bring and how to talk about it

Bring the insurance card, a list of any medications, recent report cards or school notes, and your own notes on what you have seen and since when. A short written timeline is worth more than a long verbal one.

Tell your child what is happening in plain, age-appropriate words before the visit: "We are going to talk to someone whose job is helping kids with worries." Teens usually do better with a real say in the choice of clinician and time.

If parents are separated or someone other than a parent has legal custody, tell the practice when you book. Practices need to know who can consent for the child, and some will ask to see custody or guardianship papers before the first visit. Sorting this out in advance avoids a cancelled appointment on the day.

If it is urgent

If your child talks about suicide, is hurting themselves, or is in danger, do not wait for an appointment. Call or text 988 for the Suicide and Crisis Lifeline at any hour, or call 911 or go to the nearest emergency department.

Afterwards, tell your child's pediatrician and any regular clinician what happened, so they can follow up and adjust the plan. If your child was seen in an emergency department, ask for the discharge paperwork and bring it to the next appointment.