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Answering your questions on young people’s mental health
Dr Naveen Puri discusses the link between the mental health of a parent and their child and how to support both.
Transcript
Who are you?
Hello, I'm Naveen Puri.
I'm a GP by background.
I work for Bupa as a medical director
for the insurance business.
Previously, I've worked for Bupa in their health clinics
business as a GP.
How can being a parent affect your mental health?
I think it's important to recognise
that when you are a parent, your mental health can go
through ups and downs because there's a concern not just
for your own mental health and wellbeing,
but also the mental health and wellbeing of your child
as well.
What can I do if my child’s mental health is affecting my own mental health?_
I think it's really important that you recognise
that your mental health takes precedent,
and obviously you'll have a concern
for your child's mental health too, but
unless you're looking after yourself,
you're not in a position to look
after your child's mental health as well.
So what I would say is be sure to tend
to your own mental health needs
and seek the appropriate support, be that reaching out
to your spouse, reaching out to your GP or a friend
or a colleague, and then you're in a much better position
to help your child with any challenges they may be facing
with their mental health as well.
As a man, how can I take care of my own mental health while supporting my child?
I think it's important that we recognise as men,
often conversations around mental health are not very easy
for us to have, and we're not commonly having
them are we, in honesty.
So then to sort of have the conversation with your child
or somebody at home who you're concerned about
can be even more challenging.
What I'd say is use this
as an opportunity to upskill yourself.
Maybe this is the time
that you learn about your own mental health and wellbeing,
and use that as an opportunity then
to help your child as well.
So things like informing yourself by reading online,
looking at resources that Bupa might offer, for example,
can be a really good way to upskill yourself
around your own mental health,
and then have an understanding
and insight into what you might want to tackle with a child
or young person at home as well.
How can I balance my work responsibilities with my child’s mental health needs?
I think you'll often find that it's always the case
that things at work get really busy just
as things at home get really busy and fraught as well.
And these things never time themselves well do they?
So be really kind to yourself
and recognise that there'll be two kinds of stresses
that I think you might find at work, those
that you can anticipate.
So things like deadlines, things that you need
to work towards, and those that are unexpected.
And the same probably happens at home as well.
There might be things that you know are going to happen at home, such
as your child, having appointments with a doctor
or with a counsellor or a therapist,
but also other things that you can't anticipate,
like being called by the school,
even having a call from your child in distress.
And so give yourself the flexibility
to accommodate the things you can plan for,
but also give yourself the flexibility in your diary
to be able to manage the things that come up unexpectedly,
either at work or in the home as well.
What can affect a young person’s mental health?
There are a whole host of things
that can affect a young person's mental health in modern
life from the kind of things
that would've affected our mental health, like pressures
around school, friendships, relationships, growing up,
and going through puberty
to more modern things like social media, body image
pressures that children may be under
because of what they see on Instagram
or other social platforms as well.
It's important that we recognise that there are a whole host
of things that can affect an individual
and really inquiring about them
with your child gives you much more
of an insight into what's affecting them rather than second
guessing what things out there might be causing their mental
health not to be as optimal as it could be.
What are some common signs that my child might be struggling with their mental health?
I think what's really important to recognise is that you
as a parent will have a sense of what's normal
for your child, and so maybe use that as a baseline
to consider what might be different
or significant from that perspective.
Sometimes when children have mental health issues,
they can change in their mood,
so they may become more withdrawn, less talkative,
more quieter than normal.
They may become easy to snap,
perhaps becoming more argumentative
or more angry at smaller things
that previously would not have affected them.
Things like changes in diet can also be a factor as well.
Some children may eat less than normal, some may take
to food for comfort and therefore eat more.
You might find their sleep
is interrupted or affected as well.
They may be sleeping a lot later at night
or having more issue waking up in the morning as well.
So what I'd say is consider what's normal for your child
and then if there's a change from that, use that as a basis
to consider whether something might
not be quite as it should be.
I'd also say alongside that though, just
to complicate the picture, is that your child is going
through quite a lot as is, such as going through puberty,
going through exams at school, relationship issues,
all those sorts of things as well,
and they themselves can cause a change in their mood
and how they present as well.
So maybe try and unpick over a period
of time rather than making a snap judgement around
what is normal for them and not, and if you have got a concern,
maybe that's the basis to have a conversation.
What are the long-term implications of unmet childhood mental health needs?
We know increasingly as a medical community,
that actually when we don't deal with things early on,
they can have an impact long-term.
And that's true for both physical health issues as well
as mental health ones as well.
I also want to say that as a parent,
please don't burden yourself with having
to manage everything when a child is young,
because actually you are doing the best you possibly can.
And even by watching content like this,
you are already seeking to educate yourself
what could be a problem further down the line.
We do recognise that when we don't deal
with things early on, they can have
an impact further down the line.
So things like not talking about your mental health
as a child mean that when you're an adult,
it can be even more difficult to start those conversations
and lean into being vulnerable.
So if you can encourage those conversations,
or indeed role model those for your child,
it just gives them the vocabulary
and the ability to see what that looks like.
So when they're older, it becomes a skill
they're much more attuned to.
How can I support my child’s mental health on a day to day basis?
I think it's important to remember
that actually day-to-day, you can role model
what good attention to your mental health looks like.
So if it's the kind
of thing which is openly spoken about in the household
and done so responsibly,
but also in a calm manner without judgement ,
that really sets a tone
that I think your child would respond to.
I often find that when parents create a safe space
to have a conversation with their children, let's say it's
during a task like washing up the dishes where one
of you is doing the washing, the other's doing the drying,
or maybe some gardening,
or having a walk in the park, that can be a really good way
to have those kinds of conversations.
Sometimes direct eye contact can be quite intimidating
for children, so standing side by side with them
or being in different parts of the room,
doing something menial, like washing the dishes
or drying the dishes can be a really good way
and a safe space to then sort of lean into conversations
that are more casual and more kind
of spontaneous rather than formalise where you sit down
and have this very serious dialogue
around something which the child might feel quite
uncomfortable talking about.
How can I approach my child about their mental health?
The useful framework we have
that we often encourage parents to use
with their children is an acronym, which is heard, H-E-A-R-D.
The H stands for how are you?
That's a nice open question
to get a conversation going with your child.
The E stands for empathise.
We want you to be able to show your child
that you are listening to what they're saying,
but also sympathetic to it
and not judging what they're saying as well.
A is an extension of that which is acknowledged.
So you want to acknowledge what your child is saying,
and sometimes the R, which is reflect can be a good way
to acknowledge what they're saying to you.
So listen to what they're saying to you
and maybe play it back to them in their own language
or in your own sort of tone of phrase,
so they you've truly received it.
I think this is also a good opportunity
to demonstrate you aren't judging them either.
So if you're sitting there listening
and playing back to them what they've said without putting
your own spin on it or judgement on it,
that can be really powerful for your child as well.
And then the D, final part of it is direction.
And this is not where you tell them what to do
or jump in with the solution, which I think is quite natural
for us as older people,
but actually asking them where they want to go
with the conversation and what's next.
Is it a follow-up conversation?
Is it to go away
and look something up and come back with them?
Is it to have a conversation again, whatever they want next.
And whatever you feel could be helpful
is what the direction will be.
So hopefully that provides you with a useful framework
for those conversations.
How do I explain the importance of mental health to a child?
I think it's really important that we educate our children
that mental health can affect them just like a physical
health condition can as well.
So just like you might have a sore knee
or a heart issue, you can also have an issue with your brain
and some of the chemicals that swirl around that
and can in affect your mood, your anxiety levels,
those kinds of things as well.
Children should be aware that when their brain isn't working
as it should, it can also cause physical symptoms too.
So if you are feeling low
or depressed for example, you might be more
sleepy or want to eat more.
You might feel like your tummy's a bit more sort
of slower than normal as well, which can lead
to abdominal pains and things of that nature.
If you've got anxiety, it can cause you
to be a bit more sweaty, your heart racing a bit more,
you palm's feeling a bit more clammy.
And so I think an understanding
that when the brain isn't working, it can have impacts
around the whole body, can be a useful way to start
that conversation with your children.
How can I talk to my child about their mental wellbeing?
I think for some men it's really difficult
to speak about mental health and you know what, use that
as an opportunity to be honest with your child
because actually if they're finding it difficult, seeing
how hard it is for you gives them
permission to find it hard.
But you can also both find
a solution for it together as well.
So maybe leaning into the
conversation and saying, you know what,
I'm really concerned about you,
but I'm finding this really difficult to talk about.
Or, this is the kind of thing I really struggle with,
but I'd really be interested to hear how you are doing
can be really good ways, I think, to start
that conversation with a child.
You might also find that you want to try
and fix things quickly and have a conversation
and get to the bottom of what's going on,
and that'd be the end of it, but actually
sometimes it's a long game.
So maybe just planting seeds regularly, having
that conversation every weekend
or every time you watch football together,
or go for a walk together or wash the dishes together.
There might be any number of ways that you are interacting
with them and to normalise conversations
around mental health in those things you do day to day
and looking at it as a long-term thing you want
to invest in rather than a quick fix can be the way forward
sometimes.
What should I do if my child won’t open up about their mental health?
If your child isn't opening up about their mental health,
I can only imagine how stressful that must be for you,
because the last thing you want is for your child
to be getting more and more distressed
and not having an outlet for that.
So let's think about a couple of things
that might be useful for you.
The first is be really kind to yourself
and recognise you may not be able
to fix a problem in one conversation alone.
It may be the case you have
to have the conversation on many occasions,
and by planting the seed
and at least making them aware that you are open
to the conversation means that when they want to speak
to you, they know you are available for that.
You might also want to signpost them to resources
that maybe they could look at on their own basis.
Things on the internet, for example, JAAQ,
Bupa resources, things of that nature.
There are also charities out there
who produce content specifically for young people.
So it's written in a language
and in a manner that's really accessible to them.
Short videos, that kind of a thing, which might be more
to their liking than having a conversation with mum or dad.
I'd also say that sometimes children find it easy
to communicate with parents in a way
that we don't necessarily consider natural for us.
So text message or leaving a
note for them or things like that.
Sometimes just leaving a note
to say something quite routine like that's where
the cornflakes is, or whatever, alongside how are you doing,
by the way, can be a nice way to start that conversation
or a text message where you're messaging about something
quite routine, but also insert in there a
comment around their wellbeing.
So think about it as a multi-pronged approach.
You might want to take several approaches rather than a one
size fits all,
and hopefully you'll find one way that breaks through.
What should I do in a crisis situation?
In a crisis, it's really important you remember there is
lots of support out there for you.
So let me talk you through what that support looks like.
The first thing to say is that if you're registered
with a GP practice, you can reach out to them at any time.
And if it's out of hours, which is often the case,
when these things crop up,
then remember your practice does have an out
of hour service it's connected to as well.
If you call your usual practice number, you'll be connected
to that automatically if you call them
outside of surgery hours.
The other option, if you aren't able
to call your own practice or aren't aware of their number,
is to call 111.
That's a non-emergency medical number where you're triaged
by somebody who will prioritise the urgency of your call.
If it's deemed to be urgent,
they'll either put you in a queue to be spoken to
by a doctor relatively quickly, or if they feel it's urgent
or an emergency and can't wait for a doctor
to call you back, they'll redirect you to 999.
And so that's my next bit of advice.
Remember, you can make use of 999
for an emergency situation
where an operator will talk you through what you need to do.
Sometimes that might be to wait at home while they send help
to you via an ambulance or a first responder.
Other times it might be to go to an accident and emergency
and be seen by someone there.
And then the last thing to say is you can make your way
straight to an A&E if you want to
and if you feel that your situation warrants that.
A&E again will take some details from you
and give you a level of priority based on your need.
And they'll always have mental health support available
should that be required as well.
As a parent how best can I cope with a mental health crisis?
I think as a man, it's really important you're kind
to yourself because there isn't a one size fits all approach
here at all, but rather, you'll have to really dictate
what you do depending on the situation you find yourself in.
Sometimes as men, we can find
that we have lots of things to contend with.
You might have some work responsibilities,
you might have other things to contend with in the home,
and so maybe making a list of priorities in your head
and maybe delegating things
elsewhere could be really useful.
So for example, if you've got things at work
that need tending to maybe handing them over to a colleague
or speaking to your boss to get them addressed
could be useful. If you've got other responsibilities in the
house, like other children to tend
to, maybe recruiting your partner, a relative
or a friendly neighbour to help you out could be helpful
and helping you prioritise the child
that you have to tend for, for
now. I'd also say that sometimes you have
to tend to your own needs as well.
You can't be a good dad and a good carer if
you can't recognise that
you have to look after yourself first.
So don't neglect to look
after your own wellbeing, your own sleep,
your own dietary needs, your own hydration,
those sorts of very simple things.
Thinking as clearly as you possibly can,
not making decisions in haste,
not driving when you are particularly stressed or wound up.
Those sorts of very simple small things can make a big
difference in the long term as well.
How can I support my children if their sibling suffers with mental health challenges?
I think it's very important that you recognise
that the impact of your child's mental health condition can
impact their siblings as well as you've rightly recognised.
And so what I'd say is a couple of things on this.
Your children need a space to be able to express themselves.
And so not just the child who's affected
by the mental health condition,
but also those that are not affected
and are possibly vicariously impacted by that.
Your child who has the mental health condition should be
able to express to you any concerns and needs they have
and any anxieties and worries
and fears they have around their condition,
but also your children that aren't
directly impacted should be able to as well.
And sometimes it is the case
that the responses your children give you
might be in conflict.
So the children that are otherwise well may almost resent
the child that has the mental health condition
because of the impact it has on them or
because the attention you are providing to that one child.
And it's okay for them to be able to express that.
Expressing that in front of the child
that has the condition though probably
isn't going to be the best way forward.
And so don't have these conversations together.
Maybe carve out time separately
to have those conversations on a one-to-one
basis, if that could be helpful.
There is also power in having collections, sorry,
conversations collectively.
So sitting around a dinner table
or sitting on the sofas together,
watching a film together can be a nice way
to bring the family together, but recognise there'll be
times where you have to have conversations separately
and other times where bringing them all together can also be
helpful as well.
Should I encourage my child to talk to other members of the family about their mental health?
The short answer is yes, absolutely.
The more people your child is speaking to, the better
for them because they'll get a range
of support from different people,
but also a range of different
perspectives and response as well.
The nice thing about a family unit is
that there are many people that the child could speak to,
from grandparents, to uncles and aunts, to a trusted cousin,
and even to their own siblings actually as well.
And the relation they have with them
and also the insights that they can get from each other can
be quite unique and quite
different to what you might provide.
So if they're able to have those
conversations, absolutely encourage them.
I think they'll be to your advantage as well as
to your child's as well.
How do I approach other members of my family for help?
It's often the case that other members in your family have
probably gone through their own struggles and trials
and tribulations, and actually there's a lot of sympathy
amongst people, for other people
that go through things as well.
It might not be the same kinds of things,
but actually if you reach out
to other family members to say, you know what?
We are really struggling with this aspect of this child.
There could be a whole outpouring of sympathy
and support that comes your way without you even having
to invite it. Sometimes
also, just being really direct about
what challenges you're facing gives people the
opportunity to step into that.
So they might offer you a lift or offer to cook a meal,
or things of that nature, which can really just take away
some of the things you are concerned
about or worried about as well.
You might also have members of your family
who you can directly reach out to
for support and help as well.
You'll know who they are, and so if you've got a parent,
a sibling, somebody in the family who can be helpful
and is willing to help, then maybe consider
making use of them as well.
I wish you well with it, I know it's not easy to ask
for help, but remember you can always pay it forward in the
future as well, so by helping them out,
rather having them help you out on this occasion means
that you are then able to help them out
and be helpful to them in the future as well.
How can I balance the needs of my work whilst supporting my child and family?
While I recognise that work is really important,
remember your family and your child
certainly come before that.
Sometimes it takes things like this
to make us reassess our priorities
and recognise that that is the priority, and
therefore just giving yourself permission to make
that your number one focus means
that you can then put into place all the things
you have to make that happen.
Don't feel afraid to have the conversation at work.
I know it's an uncomfortable thing to discuss with a boss
or with colleagues, but actually sometimes you find that
by opening the conversation up, they open up
to you about some of the challenges
and issues they faced as well.
Your line manager or boss may well have come across
with other colleagues and
therefore may also already have
a template for how to manage this.
And so while you are thinking, gosh, how are they going
to respond to me making this request?
It may be something they've already been through themselves
as a line manager or boss, if not professionally,
maybe even personally, or possibly even both.
I'd also say that there is also scope to consider
how you might offer solutions to work.
You might say to them, can I work flexibly on this
or could I extend this deadline,
or things of that nature too.
Sometimes by being open
and transparent with the workplace means
that they can be much more helpful
to you in a timely manner rather than being forced to
make adjustments for you at the last minute,
which might impact what they're looking to achieve as well.
So working with your employer and being open
and as transparent as you can might be the way forward here.
Is it okay to speak openly to friends about my child's mental health condition and needs?
The short answer is yes,
but let me give that a bit more flavour
because I think it's important you think about some
other considerations as well.
Your child would also have a sense of who they want
to know about their mental health condition
and what needs they may be
contending with at this time as well.
So if you're going to speak to, let's say, their parents
of one of your child's friends, then maybe
that isn't the best person, or if they are the right person
to maybe make clear that actually what you're discussing
with them is confidential so that it doesn't get fed back
to your child's friend inadvertently.
So conversations are always a good thing.
I'd certainly encourage you to have them,
but maybe just think about your child's confidentiality
and their own wishes around who they might want
to know about their condition as well.
Should I speak openly to colleagues about my child's mental health condition?
You'll have a sense of which colleagues you can trust
and have open conversations with.
And so my simple answer would be absolutely feel free
to open up to them and have those conversations
if they could be helpful to you.
It's often the case that when you open about your own
problems, your colleagues are then
able to do the same with you as well.
And sometimes there's some really useful knowledge and tips
and advice around how to approach these situations
that can be shared in those scenarios as well.
Sometimes in workplaces, there are networks, parent
and carer networks, for example,
that can be really useful forums to this as well,
where people specifically want to come together
to discuss the challenges of parenthood.
In our own organisation,
we have a network which is thriving.
I will say that it's usually attended a lot by women,
but there's no reason why fathers and dads
and men can't be there as well.
So feel free to make use of these networks
because they can be really helpful.
My child's mental health condition is impacting my relationship. What can I do?
I think it's really important to recognise
that when a child is affected by a mental health condition,
it has an absolutely huge impact on the family
and especially on the child's parents as well,
or on you as a parent and your partner.
So be really kind to yourself
and first of all, give yourself permission to recognise that
that's a well-known phenomenon.
What I'd also say is that as a experience, this is something
that was you and your partner are uniquely experiencing
compared to everybody else around you.
You both have that same child's interest at heart.
You want the best for them,
and actually, while it can be a source of real conflict
and strife between you, it can also be a source
of bringing you together as well
because you've both got a common goal in this regard.
Make time to have a conversation around this
because actually if you are at loggerheads, that's not going
to help either of you and it
certainly isn't going to help your child.
Very easy for me to say I know,
but making time
with the conversation really will be very, very fruitful.
Maybe have a conversation on a five by five basis.
So give your partner five minutes to have a round
around whatever their concerns may be, and then
after listening to them without interruption,
you give yourself five minutes to have a rant around
what your concerns are.
That way you put into the open without any conflict
or challenge, what each other's perspectives are.
You're both made to listen to each other
and really understand what's going on,
and then you can start to forge a solution from
that point onwards.
So have an open dialogue.
Be kind to yourself and often recognise this is a very common phenomenon.
Whenever a child is impacted, actually their parents
or carers often are as well.
And by being open about it, you can then start
to chart a way forward and I wish you the very best of luck
with it as well.
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