Mental health support

Mental health and emotional wellbeing

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Many children and young people will experience difficulties with their mental health at some point during childhood. This may show up as changes in thinking, feeling or behaving, which can cause distress and disrupt life at home, school or in other settings.

Mental health difficulties can present in different ways and it may not always be easy to notice when children are struggling. Children and young people may not want to talk about how they feel or may find it hard to explain. They may not fully understand their feelings themselves.

Some of the common difficulties we see in children’s mental health or emotional wellbeing include:

  • Anxiety
  • Emotional dysregulation and behaviour that challenges
  • Low mood, including risk and self-harm

Help in a mental health crisis or emergency

If you or someone else is in immediate danger, call 999. In an emergency, you can also go to your local A&E department.

  • Hammersmith & Fulham: NHS West London 24-hour helpline (freephone) 0800 328 4444
  • Westminster or Kensington & Chelsea: Central and North West London single point of access (SPA) 0800 023 4650

If you live in a borough that is not listed, you can call either number above for help or advice in a crisis. These services are available 24 hours a day, 7 days a week, 365 days a year.

Mental health and neurodivergence

Neurodivergent children and young people may be more at risk of experiencing difficulties with their mental health. Below are some examples.

Children with learning differences or Attention Deficit Hyperactivity Disorder (ADHD) may experience anxiety as a result of difficulties keeping up at school. If demands feel unmanageable, they may become anxious and frustrated. If they find it hard to communicate that frustration, it may show up through behaviour.

Autistic children may experience higher levels of anxiety in social situations, when things feel unpredictable or when there are changes to routine. Autistic adolescents may experience performance anxiety and school-related anxiety, which can contribute to difficulties attending school. Sensory processing differences can also cause anxiety, as children and young people may feel overwhelmed by sights, smells and sounds. Anxiety can sometimes show up as demand-avoidant behaviour, as a child tries to feel more in control by avoiding situations they feel unable to cope with.

Warning signs

Some common warning signs that your child may be struggling include:

  • Behavioural outbursts, moodiness or irritability
  • Out-of-control behaviour that may be harmful
  • Big changes in mood, behaviour or personality
  • Sadness that lasts two weeks or longer
  • Hurting themselves or talking about hurting themselves
  • Talking about death or suicide
  • Becoming more withdrawn from friends or family
  • Frequent reassurance seeking
  • Significant changes in eating habits
  • Noticeable weight loss or weight gain
  • Trouble sleeping
  • Frequent headaches or stomach aches
  • Trouble concentrating
  • Doing poorly in school
  • Not wanting to go to school

Anxiety

Understanding anxiety

Anxiety is a natural emotional response to stress, danger or uncertainty. Children can feel anxious about different things at different ages and many anxieties are a normal part of development. For example, young children aged 6 months to 3 years may experience separation anxiety and become upset when separated from parents or carers. Specific fears and phobias (for example, fear of the dark, animals or thunder) are common in pre-school children. As children get older, they may experience anxiety in social situations or at times of transition such as starting secondary school.

Anxiety can become a problem when it is severe or persistent and starts to interfere with everyday life, such as school or social activities.

Types of anxiety can include generalised anxiety, specific fears and phobias, social anxiety, school-related anxiety, separation anxiety and obsessive-compulsive disorder (OCD).

Supporting children with anxiety

There are many useful strategies to support children who experience anxiety. The approaches below may be particularly helpful for neurodivergent children and young people.

  1. Understand the anxiety
    • Identify possible triggers, such as changes in routine, sensory overload (noise or bright lights), social situations or unclear expectations.
    • Use tools such as behaviour diaries, anxiety logs or ABC charts to understand triggers and patterns.
  2. Create predictability
    • Maintain consistent routines whenever possible.
    • Give advance warning before changes to reduce uncertainty.
    • Use visual schedules, timers and social stories to prepare for transitions or new experiences.
  3. Support communication
    • Some children may not express anxiety verbally. Look out for signs such as avoidance, shutdowns, meltdowns, physical symptoms (headaches or stomach pains) or an increase in repetitive behaviours.
    • Use communication aids (such as emotion cards) to help your child express how they feel.
  4. Build coping skills
    • Try different calming techniques to find what works for your child, such as deep breathing, counting, fidgets or taking breaks.
    • Practise coping strategies when your child is calm, not during anxiety spikes.
    • Offer safe spaces at home and school where your child can self-regulate. Agree a simple signal at school (for example, a time-out card).
    • Model helpful self-talk, for example: “I’m OK. They didn’t mean to hurt me, they were just moving too fast to stop.”
  5. Accommodate sensory needs
    • Create a sensory-friendly environment, for example noise-cancelling headphones, low lighting and sensory tools (chew toys, fidgets, sensory boxes, a wiggle cushion or therapy ball).
    • Build in sensory breaks throughout the day.
  6. Use positive reinforcement
    • Celebrate small steps and efforts to manage anxiety.
    • Focus on strengths and interests, which can also be grounding in anxious moments.
  7. Involve your child or young person
    • Offer choices and a sense of control where possible (for example, choosing coping tools or choosing between two tasks).
    • Encourage self-awareness using age-appropriate tools such as emotion thermometers or journals.
    • Work towards consistent support across settings (home and school).

Helpful resources on anxiety

This is a helpful video to watch on trying to support anxiety:

Useful websites

Useful books

  • Helping Your Child with Fears and Worries by Cathy Creswell and Lucy Willetts – practical CBT-based guidance for parents to support children with anxiety.
  • Facing Mighty Fears About Trying New Things (Dawn’s Mini Books About Mighty Fears series) – child-friendly stories to help children name worries and practise brave steps.
  • Starving the Anxiety Gremlin by Kate Collins-Donnelly – a workbook for young people using CBT tools to understand and manage anxiety.

Low mood

Low mood can occur at different times in childhood and adolescence. It may show up as sadness, irritability, loss of interest in activities or changes in sleep and appetite. For neurodivergent children and young people, low mood may be harder to recognise because it can present differently. Some children may show distress through behaviour changes (withdrawal, meltdowns or increased rigidity) rather than describing sadness.

Supporting children and young people with low mood

  1. Listen and validate feelings: encourage your child to share their experiences and let them know their feelings are real and important.
  2. Keep routines steady: predictable routines can provide comfort and reduce stress.
  3. Encourage enjoyable activities: help them find small moments of enjoyment, such as play, hobbies or quiet time.
  4. Model coping strategies: show healthy ways to manage stress, such as deep breathing, exercise or talking things through.
  5. Create a calm environment: reduce sensory overload where possible and offer safe spaces for downtime.
  6. Stay connected: support friendships and family relationships, even in small ways, to reduce isolation.

Helpful resources on low mood

Useful websites

Useful books

  • Helping Your Child with Low Mood and Depression: A Self-Help Guide for Parents by Shirley Reynolds and Monika Parkinson – a structured guide for parents using evidence-based strategies.
  • Autism: How to Raise a Happy Autistic Child by Jessie Hewitson – practical support for understanding autistic wellbeing and building confidence and resilience.

When to seek help

If low mood persists, worsens or significantly interferes with daily life, speak to your GP, school or a professional involved with your child.

Self-harm

Sometimes children and young people may hurt themselves as a way of coping with overwhelming feelings they cannot put into words. This can be distressing for parents and carers.

If you are worried your child may be self-harming, try to stay calm, listen and let them know you take their feelings seriously. Avoid blame or punishment and encourage safer ways of coping such as talking, drawing or physical activity. Parents and carers can also speak to their GP, school or a professional involved with their child.

Useful websites

Emotional dysregulation and behaviour that challenges

Emotional dysregulation refers to difficulty managing emotional responses in a way that fits the situation. This can lead to frustration, meltdowns and behaviour that challenges.

All children learn emotional regulation over time. Developing these skills is an important part of development, like learning to walk and talk. For example, temper tantrums are common in pre-school children who are still developing emotional regulation. During adolescence, hormonal changes can also lead to heightened emotional reactions. For neurodivergent children and young people, emotions can feel overwhelming, intense and hard to control, which can increase difficulties with emotional dysregulation.

The term “behaviour that challenges” is often used when children or young people show behaviour that is aggressive (for example, hitting, pushing, kicking), destructive (throwing or breaking things), disruptive (interfering with family life or disrupting learning) or self-injurious (hurting themselves by hitting themselves). These behaviours are often linked to underlying emotional regulation difficulties, but there can be other underlying causes.

What can you do?

A helpful first step is to understand why your child might be showing dysregulated behaviour. Can you identify any triggers? Were there early warning signs you could look out for next time, to help prevent escalation?

It can also help to reflect on how you or others responded and whether that response was helpful, or may have unintentionally reinforced the behaviour.

Common causes

Some common reasons children and young people (particularly those who are neurodivergent) may show emotional dysregulation or behavioural challenges include:

  • Sensory overload: loud noises, bright lights, crowded spaces or uncomfortable clothing.
  • Difficulty with transitions: unexpected changes or disruptions in routine.
  • Executive function challenges: difficulties with impulse control, flexible thinking or organisation.
  • Social difficulties: misinterpreting social cues or experiencing exclusion.
  • Communication difficulties: behaviour can be a form of communication when a child cannot communicate needs in another way.
  • Emotional processing differences: emotions may feel more intense and harder to identify or express.
  • Unrealistic demands: demands may feel unmanageable, especially if a child cannot communicate this.
  • Fatigue and sleep: poor sleep can reduce emotional resilience.
  • Diet and nutrition: changes in blood sugar can affect mood and regulation.

Supporting emotional regulation skills

Parents and carers can support children to develop emotional regulation skills. Strategies work best when used consistently. It can also help to notice what supports your own emotional regulation, as this helps you stay calm and model regulation.

Understand the behaviour

  • Use a diary or ABC chart to record:
    • Antecedents (what happened before the behaviour, or the trigger)
    • Behaviour (what happened, and how often and how severe it was)
    • Consequences (what happened afterwards and how people responded)
  • This can help you understand triggers, what the behaviour may be communicating and what might be maintaining it.

Create a supportive environment

  • Use calm, predictable routines and visual schedules to ease transitions.
  • Offer a quiet, sensory-friendly space for self-regulation and plan quiet time after school if helpful.
  • Be aware of triggers such as loud noises or overwhelming environments.
  • Offer down-time in a way that suits your child (relaxation, physical activity or time with a special interest).

Teach emotional awareness and coping tools

  • Help your child name and understand emotions using charts (such as a feelings thermometer) or apps.
  • Model emotional literacy by talking about your feelings, why you feel that way and how you notice it in your body.
  • Teach coping tools such as breathing exercises, guided relaxation, movement breaks or sensory supports (fidgets, noise-cancelling headphones, sensory-friendly clothing).
  • Use frameworks such as Zones of Regulation or The Incredible Five-Point Scale to build self-awareness.
  • Praise moments when your child manages emotions successfully.

Supporting demand-avoidant behaviour

  • Be flexible and consider your child’s capacity on the day. Demands may need to be reduced at times.
  • A calm, non-confrontational approach and appropriate humour can be more effective than confrontation.
  • Use gentler language such as “I wonder whether…” and offer fixed choices to increase a sense of control.
  • Use your child’s interests to support adult-led tasks where possible.

Further guidance:

Advocate for support in education settings

  • Share concerns with your child’s teacher or Special Educational Needs Coordinator (SENCO) so support is consistent across home and school.
  • Request reasonable adjustments to accommodate sensory and emotional needs.

Helpful resources

Useful websites

Useful books for parents and carers

  • The Out-of-Sync Child by Carol Kranowitz – a useful resource on sensory processing challenges and how they can impact emotional regulation.
  • The Explosive Child by Ross W. Greene – a compassionate approach to understanding and supporting children who struggle with frustration and flexibility.
  • The Incredible 5-Point Scale by Kari Dunn Buron and Mitzi Curtis – a practical visual tool to help children recognise and manage different emotional states.

Useful books for children and young people

For young children (ages 4 to 8):

  • Neurodiversity! What’s That? by Nadine Ramina Arthur – a gentle introduction to neurodiversity for children, including feelings and differences.
  • The Panda on PDA by Glòria Durà-Vilà and Rebecca Tatternorth – a child-friendly explanation of demand avoidance, which can help families understand big reactions and overwhelm.

For tweens and teens (ages 9 to 16):

  • The Awesome Autistic Go-To Guide by Yenn Purkis and Tanya Masterman – a practical handbook covering emotional regulation, wellbeing and self-advocacy.
  • Young, Autistic and ADHD by Sarah Boon – a supportive guide for neurodivergent young people on emotional wellbeing, relationships and executive functioning.