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How to Support a Child in Crisis

Children’s mental health is often overlooked or under resourced, and mental health issues among young people are on the rise. Here’s what to do to support a child in crisis.

Mental health should be considered an essential part of every child’s overall health care. However, all too frequently, this component is overlooked or under resourced despite the enormity of the mental health challenges facing America’s young people.

Currently, an estimated one in five, or 20%, of children in the United States experience a mental health problem. Typically, these can involve anxiety, depression, ADHD or behavioral problems among other challenges, says Kimberly Hoagwood, professor emeritus in the department of child and adolescent psychiatry at the New York University Grossman School of Medicine and NYU Langone’s Hassenfeld Children’s Hospital.

And as those children become young adults, these problems become more prevalent. Within the 18 to 25 age bracket, one in three young adults experience a mental health problem.

Key Takeaways

Children experience mental health problems like anxiety, depression and ADHD, and rates of these issues are increasing among children and young adults.
If you’re able to notice these issues early, the options for support are extensive, and they include schools, pediatricians, telemedicine, online resources, neighbors and even social media.
In a crisis, go to a local emergency room, or call 911 or 988, the national mental health crisis hotline. Never leave a child alone if you think they may be a danger to themself or others.

“These numbers have shifted, they have gone up, they have not gone down, despite all that we know,” Hoagwood says. “Suicide is (now) the second leading cause of death among young people ages 10 through 35.”

Hoagwood was part of a panel of nationally recognized experts who shed light on this important topic during U.S. News & World Report’s virtual event “Innovating to Take On the Nation’s Pediatric Mental Health Crisis.” This event was part of Transforming Pediatric Healthcare, a series developed with support from Children’s Health and its flagship hospital, Children’s Medical Center Dallas.

The panelists offered detailed advice on how to head off mental health problems early as well as how to address crises. Their overall message: Help is out there, and you are not alone in navigating these issues. Here’s where to begin.

Important Note for Parents

Concerned adults should take a child to an emergency room or call 911 or 988 (the national suicide and crisis hotline) in urgent situations, including if they are worried a child will be a danger to themself or others.

U.S. News evaluated 84 hospitals for their care of children and teen in mental and behavioral health conditions such as autism, anxiety, depression, eating disorders, ADHD, gender dysphoria, bipolar, schizophrenia, language and learning disorders, and substance abuse and addiction. See the Best Children’s Hospitals for Behavioral Health.

Resources for Children Experiencing Mental Health Issues

Your family doctor

“Start with your primary care physician, your pediatrician, and they can channel you into the other places where care can be acquired,” says Dr. John Constantino, a board-certified child and adolescent psychiatrist, as well as the chief of Behavioral and Mental Health at Children’s Healthcare of Atlanta. Constantino is also a professor in the department of Psychiatry and Behavioral Sciences at the Emory University School of Medicine. ”I really advocate for starting with your pediatrician. It is their business to understand the mental health liability of a child.”

If you need more immediate help, call your pediatrician’s office, explain your child’s situation and ask for advice. If your child isn’t in crisis, you may be able to reach out through your health portal or schedule an in-person appointment.

Schools

Many schools have resources available for students experiencing mental health issues. While guidance counselors and resource officers aren’t trained mental health professionals, they often have connections to those who are, as well as to support groups and other options.

If you are unsure where to go, “ask your school counselor or your teacher,” says Dr. James Norcross, professor of psychiatry and chief of the Division of Child and Adolescent Psychiatry at UT Southwestern Medical Center and division director of Psychiatry at Children’s Health.

A counselor or nurse can also connect your child with in-school resources, like yoga or mindfulness clubs, extracurricular activities, sports teams and more that can help improve a child’s mental health.

Telemedicine resources

For students who may not be able to travel to a psychiatrist’s or therapist’s office for care, telemedicine can be a great option for ongoing care. Depending on your insurance and the particular therapist or practice, it’s possible that this virtual care could be inexpensive or free.

Norcross, who also oversees the Texas Child Mental Health Care Consortium Programs for UT Southwestern, cites the Texas Child Health Access Through Telemedicine (TCHATT) program as an example of this, which provides free telemedicine services for students.

The program “allows us to provide care through virtual means, to schools, and the referrals come from the schools themselves,” says Norcross.

For some children, seeing a mental health provider remotely from a safe place like their own home can feel more comfortable than going into an office.

Crowdsourcing help for children

With all of these great resources, don’t forget the power of recommendations and advice from trusted friends and family. Dr. Ron-Li Liaw, chair of the Pediatric Mental Health Institute at Children’s Colorado, calls this “crowdsourcing.”

From conversations with neighbors to Facebook groups, you’ll find recommendations for resources and professionals. It’s important to do your homework, though. Especially when considering recommendations from social media, Liaw emphasized the importance of doublechecking them against “other national resources that have been vetted for quality.”

Online resources

There are many other virtual resources available for parents and caregivers, which can provide great information about warning signs and symptoms, connect you with local mental health professionals and suggest education opportunities via webinars, videos and podcasts.

Hoagwood’s recommendations include:

National Alliance for Mental Illness (NAMI)
Mental Health America
National Federation of Families
Family-Run Executive Director Leadership Association
Active Minds
Youth MOVE National

Resources for Children in Crisis

As noted, if you think your child may harm themselves or someone else, you should immediately call 911 or 988, or take the child to the emergency room. Do not leave a young person in crisis alone.

Local hospitals

Just like you’d go to the ER for a broken bone or another injury, your local children’s or general hospital is the place to go if your child is experiencing a mental health crisis.

Go to “your hospital emergency room if it’s a crisis, especially if it’s off hours,” says Norcross.

An emergency room will be open all hours of the day, every day of the year. Doctors there can provide immediate care. This may involve treatment, assessment of a child’s symptoms, and referral to a mental health provider. While this may not immediately address the root cause of the problem, it can help stabilize the situation while a plan is put in place. When the emergency room refers you to a mental health professional or recommends next steps, it’s important to follow that plan to prevent another crisis.

Call centers

The 988 mental health crisis help line is available 24 hours a day, and you can call or text this number to access help. Trained professionals on the phone can help caregivers navigate a mental health situation with a child and provide resources and support for the future.

You can also encourage a young person to make use of this resource directly. Accessing professional help through a text conversation might make them more comfortable.

A call center will not, however, be able to prescribe medications nor provide long-term treatment. For that, you will have to tap into other counseling sources mentioned above.

Bottom Line

For a child experiencing a mental health crisis, if they may be a danger to themselves or others, local hospital emergency rooms and call centers can provide urgent, 24/7 help and they should never be left alone until they are out of danger.

For children who have less urgent mental health needs, there are a plethora of resources out there to help parents and caregivers ensure that a mental health problem does not escalate into a crisis.

Contributor: Annika Urban – U.S.News & World Report

9 Great and Easy Ways to Reset Your Metabolism Naturally

Long gone are the days of our youth, when we could eat what we wanted and never worried about exercise thanks to a ridiculously fast metabolism. But age isn’t the only thing that can cause your metabolism to take a hit. Diets poor in nutrients, fad dieting, and even environmental toxin accumulation can all contribute to a waning metabolism, which in turn puts you at risk of lowered bone density, weak muscles, lack of energy, and of course, difficulty burning calories and keeping off the pounds.

Luckily, there are a number of steps you can take to naturally reverse your declining metabolism and give it a much-needed boost.

Lift something heavy

Lifting heavy objects builds muscle, and studies show that building muscle is instrumental in boosting metabolism. In a study published in The Journals of Gerontology, a group of men between the ages of 60 and 75 were given a resistance training program and were closely monitored during the course of the 16 weeks of training. The study found that those in the resistance training group lost body fat, gained muscle, and achieved metabolic improvements similar to those of young men. The takeaway from this is that introducing weight-lifting or weight-bearing workouts into your weekly exercise routine can result in significant improvements to your metabolism.

Don’t skimp on food

Those who are suffering from weight gain, or are struggling with a sluggish metabolism, tend to make the situation worse by skimping on meals or deliberately starving themselves in an attempt to keep the pounds off. This actually works against you, because if you don’t give your body the fuel it needs, your metabolism will automatically slow itself down to conserve fuel. Some researchers have even gone so far as to suggest that operating on an empty stomach may be worse than operating on a stomach filled with doughnuts.

Either way, lowering your food intake to the point where you’re constantly hungry isn’t the answer. Eat healthy food when you’re hungry to ensure your body gets the fuel it needs to operate efficiently, but don’t overeat.

Exercise regularly

In addition to using weight-bearing exercise to encourage muscle mass and hence metabolic improvements, exercising regularly throughout the week is essential for re-establishing a strong metabolism. Doing a minimum of three high-intensity, 15-minute (or more) workouts per week has been shown to be sufficient for maintaining healthy muscles, while every other day you can do something fun and laid-back. This can include going for a 30-minute walk, jog, or cycle — or even rollerblading for 20 minutes.

Move quickly and spontaneously

Studies have shown that our metabolism increases when the stress hormone cortisol, along with adrenaline, elevate rapidly then drop back down just as quickly. One of the best, healthiest and easiest ways to get this rise and fall of your stress hormones is to introduce small, rapid movements into your day. These can include walking quickly for 30 seconds, sprinting to your car in the parking lot, or doing 10 squats in your cubicle or office at work. Get creative!

Get plenty of omega-3s

Omega-3s are highly anti-inflammatory and help to regulate blood sugar. For this reason, they can assist your body in regulating and maintaining a healthy metabolism. Ensure you’re getting plenty of omega-3-rich foods in your diet every day, including avocados, walnuts, chia seeds, wild-caught salmon and grass-fed beef.

Eat often

The health community has long ummed and ahhed on this topic, but the verdict is finally in: snacking is good for your metabolism! Grazing on healthy foods throughout the day (no, this is not an excuse for you to go crazy on chips and candies) helps to keep your metabolism operating steadily and also prevents blood sugar spikes.

Eat plenty of protein

If you’re big on meat, you’ll love this one. Your digestive system takes a long time to digest protein, particularly from animal sources. This means your body expends more energy breaking these foods down, which keeps your metabolism running at full speed for longer.

Get enough sleep

Many people don’t realize just how important sleep is to our health. It affects almost every aspect of our day-to-day lives, and this includes metabolism. Studies show that not getting enough sleep can seriously affect your metabolism and set you up for a day of poor digestion and weight gain. Make sure you set aside plenty of time to get the sleep you need.

Don’t be afraid of a little hot sauce

Capsaicin, a compound found in chili peppers (and therefore in most hot sauces and many Asian dishes), has been found to increase metabolic rates by as much as 30 percent. Not only this, spicy foods reduce hunger and keep us feeling satiated for longer. If you can’t handle the heat, consider getting your hands on a good-quality capsaicin supplement.

Diet is a huge part of maintaining a healthy metabolism. Here are 17 foods that will help you to supercharge your metabolism naturally.

Contributor: Alternative Daily

Those NFL Snack Ads Are Fun, But You Should Be Careful of the Foods They Sell, Study Shows

This Super Bowl Sunday, keep an eye out for bad calls, fouls and dangerous sodium levels.

Foods advertised in National Football League commercials contain an average of nearly 40% of the daily recommended sodium intake, according to a new study.

“We proved what probably a lot of people have long suspected, and that is that foods advertised during NFL games … are frequently high in sodium and calories and fat content,” said senior study author Dr. Paul Hauptman, dean of the University of Nevada, Reno’s School of Medicine and chief academic officer for Renown Health.

Researchers recorded 10 NFL games between September 2023 and November 2023 and analyzed the number and duration of commercials advertising food products. The team then looked at the nutritional information of those foods.

About 10% of the content, or 102 commercials, were advertising food, according to the study published Thursday in the journal JAMA Network Open.

The sodium content of those foods ranged from 220 milligrams to 1,872 milligrams, with a median amount of 910 milligrams, the study showed.

The Dietary Guidelines for Americans recommends people consume less than 2,300 milligrams per day. Fast-food restaurants advertised the products with the highest amount of sodium, the researchers found.

Salt’s impact on heart health

Eating too much salt can have many negative effects on your health.

High levels of sodium in a diet can lead to worsening of heart failure and hypertension, or high blood pressure, Hauptman said.

“Blood pressure is directly related to stroke, cardiovascular disease –– even to death from cardiovascular disease and heart failure,” said hypertension specialist Dr. Stephen Juraschek, an associate professor of medicine at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston. He was not involved in the research.

“Hypertension affects nearly half the US population, 1.5 billion adults worldwide, and is growing,” he added. “This is a tremendous problem.”

Salt isn’t the only problematic ingredient in a lot of the foods advertised on television. The fat and calorie contents are often high as well, which can have an especially negative impact on people with diabetes, Hauptman said.

The emotions of eating

Many aspects of watching a football game can impact the way you eat. It’s a sedentary activity, people often serve special foods to share, and the commercials make unhealthy foods look exciting to eat, Juraschek said.

“Advertising in general is intended to encourage certain types of behaviors, and when you look at products when they’re being advertised, they’re usually showing people smiling in kind of memorable, exciting occasions, maybe with loved ones or friends,” he added.

Many of the elements that go into how you make your food choices are emotional, Juraschek said. Maybe you celebrate certain occasions with a particular food, or a certain dish is associated with spending time with people you love.

Advertisements may be trying to send you the message that partaking in the food they are trying to sell you will contribute to feeling close to your loved ones or having a good time, he added.

“And if those items are high in sodium and are highly processed … folks will be directed towards consuming more of those products, which is really concerning,” Juraschek said.

Because food choices are so often tied to traditions and memories and it can be so hard to adjust, Juraschek recommends being careful about what you are feeding children.

“It’s so important early on that we don’t overexpose young children to high sodium,” Juraschek said. “Getting them hooked at a young age can contribute to a lifetime of chronic disease and disability.”

How to reduce your sodium

Eating a healthy diet isn’t always easy.

One essential step is to recognize where the sodium in your diet is coming from, Juraschek said.

Many patients say they don’t add salt in their cooking, but it’s also important to look at the processed foods you eat –– such as breads and deli meats –– which can have a surprising amount of sodium.

“Whenever you get away from the produce and kind of the fresh meat sections of the store and get to the middle, you’d be like, ‘Wow, there’s so many different products here, but almost every single one, universally, has a large amount of sodium,’” Juraschek added.

Going to a restaurant also can result in higher sodium consumption than home-cooked food, he said.

Next, try to make simple switches to lower-sodium options, Juraschek said. Not all chips, dressings or dips have the same sodium content.

“We grow up with certain traditions, exposures –– we have memories around those food items,” he added. “That’s one way that we can still kind of enjoy that product, but maybe with less exposure.”

And you might find that, over time, you don’t miss the salt so much.

“Patients who are able to adhere to a low-sodium diet, not only are their symptoms better if they have heart failure, but their palate sort of adjusts,” Hauptman said.

Then, when patients are given foods high in sodium, they can taste it –– and they don’t often like it, he added.

“Eat in moderation, and just try to read labels,” Hauptman said.

Contributor: Madeline Holcombe, CNN Health

A New Definition of Obesity Goes Beyond BMI. What This Could Mean for You

For years, medical experts have defined obesity primarily based on body mass index, which measures stored fat by calculating height and weight, to determine a person’s health risks.

Major public health organizations, including the World Health Organization and the US Centers for Disease Control and Prevention, define adult obesity as a BMI of 30 or greater and overweight as a BMI between 25 and 29.9.

Recently, an international commission proposed a revised definition of obesity that focuses on how excess body fat affects the body, and factors in waist circumference, rather than simply calculating BMI. This new definition, published January 14 in the journal The Lancet Diabetes & Endocrinology, could shift the paradigm of clinical care for the 890 million adults worldwide who are currently considered to have obesity.

What is BMI, and what have been criticisms of its usage? How is the new definition different? In what ways could it change clinical care? Will these changes be forthcoming? And while revisions are being considered, what should people consider asking their health care providers?

To help answer these questions, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously was Baltimore’s health commissioner.

CNN: What is BMI? What are the advantages and criticisms of its usage?

Dr. Leana Wen: Body mass index, or BMI, is a calculation performed by dividing a patient’s weight in kilograms by their height in meters squared. For those who are more used to weight in pounds and height in feet and inches, there are a number of online calculators. You can input weight and height and obtain an individual’s BMI.

The main advantage of BMI is ease of calculation. All you need to know someone’s BMI is a scale and ruler. Another advantage of using BMI as a basic indicator of health in a clinical setting is that it has been used for decades in many research studies, which have consistently shown higher BMI is associated with a number of chronic diseases including type 2 diabetes, high blood pressure, high cholesterol, heart disease and cancer. Conversely, lowering BMI is associated with a reduction in these risks.

Despite BMI’s ubiquity of use by health care professionals, it’s far from a perfect measure. To begin with, it measures total weight, rather than the weight attributed to fatty tissue. That means muscular people, including athletes, can have high BMI and could be considered on paper to have obesity when in reality they do not have too much body fat, also known as adiposity.

On the other hand, an individual could have normal BMI but have an unhealthy proportion of adiposity. Another criticism has been that BMI measurements do not provide consistently accurate results across racial and ethnic groups. This is an issue previously raised by multiple medical groups, including the American Medical Association, which in June 2023 issued a report that pointed to BMI as an imperfect way to measure body fat across different demographics. Some critics also think there should be separation between those who have obesity as defined by certain criteria and those who experience health consequences as a result of obesity.

Instead of using body mass index solely to define obesity, also measuring waist circumference is a good way to determine whether a person has excess body fat.

CNN: How is the new definition proposed by this global commission different?

Wen: This commission, composed of 58 experts worldwide, proposes that obesity be thought of differently from the traditional definition in two ways. First, instead of using BMI to define obesity, the authors propose using it as part of an initial screen to determine who should be assessed for excess body fat. These methods include measuring waist circumference, determining the waist-to-hip ratio or using special equipment, such as a DEXA scan, which measures bone density, to figure out body fat percentage.

Second, the commission proposes differentiating those who have obesity into two groups. The first is made up of those who are “clinically obese,” defined as those who already have signs of obesity affecting their body systems. Individuals who have obesity and also have diabetes or heart disease, or who are experiencing joint or back pain, or other obesity-associated medical conditions, would be considered clinically obese. Medical providers should consider these individuals for treatment to specifically address their disease of obesity.

On the other hand, there are those who are “pre-clinically obese.” The commission defines these individuals as those who have obesity, but whose obesity is not yet causing additional disease processes. For these people, obesity is a risk factor and should be addressed as such to reduce the risk of chronic conditions developing, but they do not yet have medical complications caused by obesity.

CNN: What are advantages and disadvantages of this type of classification? In what ways could it change clinical care?

Wen: I think it’s good to be more precise about defining obesity. On a population level, it may be more convenient to measure BMI for the purpose of research studies, but on an individual patient level, BMI should be an initial screening tool — not the only measure that’s taken into account when determining whether someone has obesity.

Those who support the commission’s change point to the need to differentiate between individuals with obesity who need treatment with medications like the blockbuster GLP-1 agonist drugs approved for weight loss and those who could be managed with lifestyle changes alone. Perhaps the new approach could direct people with downstream consequences of obesity to receive needed medical care sooner. The proposed change in definition could also help reduce stigma around obesity so that it is treated as a chronic medical condition.

At the same time, BMI alone has long been known to be a major risk factor for the development of serious chronic ailments. Moreover, some clinicians may disagree with the classification of “pre-clinical obesity,” as they may wish to treat a serious chronic condition before complications arise. If this shift in definition catches on, one could imagine insurance companies denying certain forms of treatment until complications are seen, which would not be good from a preventive health care standpoint.

CNN: Do you think there will be big changes based on this commission’s report?

Wen: It’s possible, but I don’t think the changes will take place right away. BMI is such an ingrained part of clinical practice and research; I don’t think it will be easily replaced.

That said, I think a lot of clinicians and medical groups have already moved away from using BMI as the sole tool to assess for obesity. Perhaps this report can further push clinicians not to rely on BMI alone.

CNN: For patients who want to go beyond the BMI measurement, what should they ask their health care providers?

Wen: I think it’s very reasonable to ask your provider to measure your adiposity, as recommended in this commission’s report. Again, this can be as simple as a measurement of waist circumference. Studies have shown that the amount of belly fat is an important determinant that correlates with the risk of chronic diseases because it is a sign of adipose tissue accumulation around the organs.

I also think everyone should be aware of the health consequences associated with obesity. This is a condition that should not be met with stigma, but rather with compassion and targeted treatment, which includes nutrition, physical activity and, when appropriate, medical interventions — the same that would be considered for other chronic medical conditions. individuals should discuss all of these options with their providers.

Contributor: Faye Chiu, CNN – Health