Intended for healthcare professionals

Student Practical skills

How to communicate with children and young people in distress

BMJ 2017; 357 doi: (Published 01 June 2017) Cite this as: BMJ 2017;357:j1696
  1. Rory Conn, year 6 specialist trainee in psychiatry1,
  2. Adam Monsell, year 2 specialist trainee in psychiatry1,
  3. Helen Bruce, consultant psychiatrist2
  1. 1Whittington Hospital NHS Trust, London, UK
  2. 2East London NHS Foundation Trust, London, UK

Strategies for supporting children and young people to share information about their wellbeing and safety

Box 1: Learning points

  • One in 10 young people aged between 5 and 16 years experiences mental health difficulties

  • Mental health of children and young people is affected by multiple protective and risk factors

  • Give children and young people the opportunity to choose where they discuss how they are feeling and who should be present, and make clear to them the concept of confidentiality

  • Do not assume that all young people who experience distress have a mental health condition—be careful not to pathologise normal emotions and reactions

  • Be flexible and responsive in your consultation style. Tailor your approach to the degree of distress and the circumstances of the assessment

  • A psychiatric assessment entails multiple meetings, using information from different sources

One in 10 young people aged between 5 and 16 years experiences mental health difficulties.1 Children and young people often communicate their distress differently from adults, in more subtle and unpredictable ways.

A key skill for any clinician is finding ways to communicate with patients in a flexible, responsive manner, and this is particularly put to the test when building a rapport with children and young people. Most children and young people experiencing distress will not have a mental health condition, and it is therefore important to try not to pathologise normal emotions and reactions.

This article introduces the biological, psychological, and social factors to consider when exploring children and young people’s mental health and suggests strategies you can use to support them to share information that is relevant to their wellbeing and safety.

Though psychiatric diagnoses are not described in this article, we hope the following pointers will help you to gather pertinent symptomatology, which you can discuss with a senior member of the team.

Box 2: Case study

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