Mental Health Problems

Is this your child's symptom?

  • Mental health problems that often need urgent help
  • Examples are anxiety attacks, suicide threats, substance (drug) use and acting out
  • Resources include hotlines, helplines, mental health experts and your child's doctor

Types of Serious Mental Health Problems

  • Suicide thoughts, threats, plans or attempts
  • Homicide thoughts, threats or plans
  • Child abuse
  • Drug or alcohol use
  • Anxiety attacks or panic attacks
  • Depression

Types of Non-Serious Behavior Problems

Many childhood behavior problems are common and not serious. Your child's doctor can often manage them. Pediatricians are often the first point of contact for these problems. Examples are:

  • Temper tantrums
  • Sleep problems
  • Toilet training problems
  • Eating problems
  • Developmental delays

Behavior Scale: How to Judge Severity

  • Mild Symptoms: symptoms do not keep the child from any normal activities. School, play, relationships and sleep are not changed. Treatment: parenting groups or books.
  • Moderate Symptoms: symptoms keep the child from doing some normal activities. New behaviors mainly happen at home. They affect how the child and parent interact. They may also keep him or her from going to child care or school. Your child may not sleep well because of these symptoms. Treatment: most often, brief counseling from a mental health provider or your child's doctor.
  • Severe Symptoms: symptoms keep the child from doing most normal activities. They affect the way the child acts with parents. Symptoms also impact relations with siblings and friends. Adults at child care or school may also be impacted by the child's actions. Treatment: these patients often need to be seen urgently by a mental health provider.

When to Call for Mental Health Problems

When to Call for Mental Health Problems

Call 911 Now

  • Physical harm or abuse is occurring now. Reason: police are needed.
  • Child is threatening serious harm to others now. Reason: police are needed.
  • Child has attempted or is threatening suicide now

Go to ER Now

  • Threats of harm to self or others, but not present now (or call 988, the Suicide and Crisis Lifeline)
  • You do not feel safe at home now
  • Drug or alcohol use is suspected and has symptoms now
  • Confused or bizarre behavior
  • Child is very upset; can't be calmed down (or call 988, the Suicide and Crisis Lifeline)
  • Child is very angry; out-of-control (or call 988, the Suicide and Crisis Lifeline)
  • You think your child needs to be in a hospital
  • Child abuse concerns and physical findings are present

Call Doctor or Seek Care Now

  • Child abuse concerns and no physical findings. You can also call your local Child Protection Services.
  • You want an urgent psych exam for your child (or call 988, the Suicide and Crisis Lifeline)
  • Needs mental health services and symptoms are urgent. You can also call 988 or a local mental health resource.

Contact Doctor Within 24 Hours

  • Drug or alcohol use suspected, but no symptoms now
  • Symptoms are constant and keep patient from doing their normal tasks of daily living
  • Needs mental health services and symptoms are not urgent. You can also call a local mental health resource.

Contact Doctor During Office Hours

  • Common behavior problems (such as temper tantrums)
  • Toilet training problems
  • Sleep problems
  • Eating problems
  • School problems
  • You have other questions or concerns

Self Care at Home

  • Needs a resource or info on getting help for a mental health problem that is not urgent

Call 911 Now

  • Physical harm or abuse is occurring now. Reason: police are needed.
  • Child is threatening serious harm to others now. Reason: police are needed.
  • Child has attempted or is threatening suicide now

Go to ER Now

  • Threats of harm to self or others, but not present now (or call 988, the Suicide and Crisis Lifeline)
  • You do not feel safe at home now
  • Drug or alcohol use is suspected and has symptoms now
  • Confused or bizarre behavior
  • Child is very upset; can't be calmed down (or call 988, the Suicide and Crisis Lifeline)
  • Child is very angry; out-of-control (or call 988, the Suicide and Crisis Lifeline)
  • You think your child needs to be in a hospital
  • Child abuse concerns and physical findings are present

Call Doctor or Seek Care Now

  • Child abuse concerns and no physical findings. You can also call your local Child Protection Services.
  • You want an urgent psych exam for your child (or call 988, the Suicide and Crisis Lifeline)
  • Needs mental health services and symptoms are urgent. You can also call 988 or a local mental health resource.

Contact Doctor Within 24 Hours

  • Drug or alcohol use suspected, but no symptoms now
  • Symptoms are constant and keep patient from doing their normal tasks of daily living
  • Needs mental health services and symptoms are not urgent. You can also call a local mental health resource.

Contact Doctor During Office Hours

  • Common behavior problems (such as temper tantrums)
  • Toilet training problems
  • Sleep problems
  • Eating problems
  • School problems
  • You have other questions or concerns

Self Care at Home

  • Needs a resource or info on getting help for a mental health problem that is not urgent

Care Advice and Resources for Mental Health Problems

Threats of Harm to Self or Others - How to Respond:

  • Children who threaten harm to self or other people need to be seen now. Emergent psych exams are done in the ER no matter the time of day.
  • The risk assessment for suicide or homicide is usually made by a mental health expert. ER doctors may do the first screening.
  • Some of these children may need to be in the hospital.
  • If anyone is in danger, call the police ( 911 ). Examples are spouse abuse.
  • If anyone is in a mental health crisis, call 988.
  • For child abuse concerns, call the Child Protection Services (CPS) Hotline in your state.

Child or Teen Already In Treatment With A Mental Health Provider:

  • Contact your mental health provider first.
  • If can't reach your provider and problem is urgent, call 988 or another crisis resource. See below.

Hotlines: Local and National Mental Health Hotlines or Crisis Lines (US numbers):

  • Hotlines (Crisis Lines) are available 24/7. They provide counselors who can help you now.
  • Suicide and Crisis Lifeline: 988.
  • Domestic Violence Hotline: 1-800-799-7233.
  • Child Abuse Hotline: 1-800-422-4453.
  • Substance Abuse Hotline: 1-800-662-4357. This is a 24/7 substance abuse and mental health referral line. They can give you local treatment choices and numbers for support groups.
  • National Poison Control Number: 1-800-222-1222.

Helplines: Local and National Mental Health Helplines (US numbers):

  • Helplines are not crisis lines. They provide services Monday through Friday during regular hours.
  • Call your local or state mental health resource first, if you have the number. If not, call a national helpline for assistance.
  • National Alliance on Mental Health (NAMI) Helpline: 1-800-950-6264. This is an information and referral source for finding local mental health programs.
  • Postpartum Depression Helpline: 1-800-944-4773.

Website Resources for Mental Health Concerns:

  • American Academy of Pediatrics parenting website: www.healthychildren.org.
  • American Academy of Child and Adolescent Psychiatry has several articles about talking to children about violence, shootings, etc. Website: www.aacap.org.

Call Your Doctor If:

  • You think your child needs to be seen
  • Your child becomes worse
  • You have other questions or concerns

Copyright 2000-2025 Schmitt Pediatric Guidelines LLC. Date Updated: Mar 31 2025 13:42 Version 0.1

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February 12, 2026
There are cases of measles in NC, and we are aware of exposures in Chapel Hill, Durham, and Wake County. We can give the MMR dose early to families who want it. This applies to infants 6-12 months who have not gotten a dose yet or kids under 4-5 years who have not gotten their second MMR dose. At this time, the NC DHHS and health departments are not recommending this unless traveling or living in an area with sustained transmission. 2 doses of the MMR vaccine are highly effective (97%) at preventing measles infections. At CHCAC, children receive their first dose at 12 months of age and a second dose at 4 years of age, ensuring they are fully protected as soon as possible, in accordance with the most up-to-date AAP recommendations. Some infants aged 6 months to 11 months who travel internationally or in high-prevalence areas may need a dose to protect them; however, they still require the 1-year and 4-year-old doses as well. If you are ever concerned about a possible exposure to measles, please CALL before entering our office. DO NOT ENTER the office. NC DHHS keeps a list of areas with measles exposures here . This is a highly contagious illness, and special precautions must be taken to prevent spread. The virus can be present in the air for 2 hours after an infected person is in the room, and 90% of susceptible patients can be infected. As always, if you have questions, we are here to help make sense of it all!
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