Parents and caregivers often notice small changes in their children before anyone else does. A child who once loved school begins refusing to go. A normally social teen withdraws from friends. Headaches and stomachaches start appearing with no clear medical cause.
For many families, the hardest part is knowing whether these changes are part of growing up — or signs that a child may need additional support.
The need for earlier recognition has become increasingly urgent. According to the Centers for Disease Control and Prevention's 2023 Youth Risk Behavior Survey, 40% of U.S. high school students report persistent feelings of sadness or hopelessness, and about 1 in 5 say they have seriously considered attempting suicide. Suicide rates among youth ages 10–34 have increased by more than 50% since 2000.
Local data reflects similar challenges. The 2023 Pennsylvania Youth Survey found that roughly 16%–18% of middle and high school students in the state report seriously considering suicide. In Philadelphia, the advocacy organization Children First reports that 48% of high school students say they feel sad or depressed most days, and 24% say they have considered suicide.
Mental health clinicians say these numbers highlight the importance of recognizing concerns early, before families reach a crisis point.
"Many mental health challenges in children develop gradually," said Dr. Monika Roots, child, adolescent and adult psychiatrist and co-founder of Bend Health. "Parents often sense something is changing before a crisis occurs. Recognizing those signals early allows families to get support before challenges escalate."
Clinicians at Bend Health, a national pediatric mental health provider that works with families across greater Philadelphia through virtual care, say parents and caregivers are often the first to notice these early warning signs.
Most youth mental health concerns do not appear suddenly. Instead, they tend to build slowly and can be mistaken for normal stress, personality changes or temporary phases.
Parents and caregivers may want to pay attention to sustained changes such as:
- Withdrawal from friends or activities
- School avoidance or sudden academic decline
- Persistent anxiety, irritability or sadness
- Physical complaints linked to stress, such as headaches or stomachaches
Families often first raise these concerns with pediatricians, school counselors or teachers. These trusted adults frequently serve as the first partners in identifying when a child may benefit from additional mental health support.
"Pediatric visits, school conversations and everyday family observations are often the earliest signals that something may be affecting a child's emotional health," said Dr. Roots. "Those early conversations can help families understand whether additional support may be helpful."
Early screening does not always lead to a diagnosis. In many cases, it simply helps determine what level of support might best help a child.
Some children benefit from skills-based coaching or short-term therapy focused on building coping strategies. Others may need more comprehensive care, including psychiatric evaluation and medication management. In more complex situations, coordinated care between clinicians, families and schools may be necessary.
Bend Health clinicians work with families to assess these needs and help match children to the appropriate level of care, which can range from coaching and therapy to psychiatry and coordinated care when symptoms are more complex.
"Parents don't need to wait until things feel overwhelming to seek help," said Dr. Roots. "Mental health support can be preventive and skills-focused, helping kids build coping tools before problems grow larger."
For families across the greater Philadelphia region, experts say the most important step is simply starting the conversation. If something about a child's behavior or emotional well-being feels different, speaking with a pediatrician, school counselor or mental health professional can help determine the next step.
Early support can help children build resilience — and prevent challenges from escalating into crisis. For more information or to schedule an appointment for your child, visit https://www.bendhealth.com/states/philadelphia.
