Untreated or unresolved mental health issues in childhood can result in enduring consequences. We recognize that when parents, family members or the youth themselves first notice changes in behavior, it may be difficult to talk about the changes or know what services are available and where to find the services. We want parents, guardians, youth, and family members to know that you are not alone, there is hope, there is help, and you matter.

The Department of Behavioral Health seeks to make it easy for residents to access quality behavioral healthcare when needed. We recognize that needs, services and priorities are very individualized and often complex. To help, the Department of Behavioral Health is making available a Behavioral Health Resource Link, an online resource directory of mental health and substance use services and resources. Through the Behavioral Health Resource Link, you will find mental health and substance use disorder services for all ages, and specific services and information for children, youth and families, as well as a myriad of additional resources to foster self-reliance and recovery.
 

Emotional, Behavioral, and Mental Health Concerns

Infancy and Early Childhood

A primary task of the infant is to experience and develop strong attachments with caregivers and begin the establishment of the foundation for his or her social, emotional, and intellectual development.  As a toddler and preschooler, the child is actively exploring the environment, experiencing mastery, and developing friendships with other children.  Risk factors during infancy and early childhood which may impact and influence the experience of a behavioral health condition include:

• Irritability
• Fearfulness
• Marital Conflict
• Negative Events
• Specific trauma experiences
• Lack of control or mastery experiences
• Difficult temperament
• Insecure attachment
• Hostile to peers, socially inhibited
• Parental drug/alcohol use
• Poor academic performance in early grades
• Head injury
• Motor, language, and cognitive impairments

Middle Childhood

During this time, the child is learning and identifying areas of skill, strength, and mastery.  Risk factors during middle childhood which may impact and influence the experience of a behavioral health condition include:

• Shyness
• Witnessing community violence
• Lack of control or mastery experiences
• Negative self-image
• Poor social skills and peer rejection
• Poor social problem-solving skills
• Parental anxiety and/or depression
• Parental rejection, lack of parental warmth
• Poor grades and achievement
• Marital conflict or divorce
• Poverty and stressful community events
• Head injury
• Motor, language, and cognitive impairments

Adolescence

The adolescent is establishing a sense of self and his or her place in the world.  Peer and team activities increase in interest and value.  Exploration of identity, self-awareness, and self-management are also important.  Risk factors during adolescence which may impact and influence the experience of a behavioral health condition include:

• Low self-esteem, perceived incompetence
• Shyness
• Parental drug/alcohol use
• Community-level/School-level stressful or traumatic events
• Negative family environment
• Poverty
• Traumatic event
• Parental anxiety and/or depression
• Peer rejection
• Poor academic achievement

Common Anxiety Disorders Affecting Children and Adolescents include:

• Generalized Anxiety Disorder
• Specific Phobia
• Separation Anxiety
• Social Anxiety Disorder
• Panic Disorder

Some of the Depressive Disorders Affecting Children and Adolescents are:

• Disruptive Mood Dysregulation Disorder
• Major Depressive Disorder
• Persistent Depressive Disorder
• Bipolar Disorder
• Schizophrenia
• Typically affects only 1 in 40,000 children

Symptoms/Behaviors of Anxiety Disorder

• Frequent absences
• Refusal to join social activities
• Isolating behavior
• Many physical complaints
• Excessive worry about homework or grades
• Low frustration tolerance
• Dizzy/shortness of breath
• Drug or alcohol abuse
• Irritable
• Tension about everyday life events
• Frequent bouts of tears

Symptoms/Behaviors of Major Depression

• Somatic complaints/clinging behavior
• Defiant or disruptive
• Refusal to participate in school activities
• Fidgety or restless, distracting other students
• Isolating, quiet
• Failing grades
• Refusal to do school work and general non-compliance with rules
• Forgetfulness/inability to concentrate
• Overreaction to criticism
• Lack of energy or motivation/sleeping in class
• Talks about dying or suicide
• Symptoms/Behaviors of Bipolar Disorder
• Feeling worthless or guilty
• Very sad – lasting a long time
• Talking a lot
• Racing thoughts
• Explosive, lengthy, and destructive rages
• Defiance of authority
• Overly silly or joyful mood that is unusual for the child/teen
• Risk-taking behaviors
• Inappropriate or precocious sexual behavior
• Delusions and hallucinations
• Grandiose belief in own abilities
• Complaints of frequent pain, such as headaches and stomach aches
• Symptoms/Behaviors of Schizophrenia
• Confused thinking
• Vivid and bizarre thoughts and ideas
• Hallucinations and delusions
• Severe anxiety and fearfulness
• Extreme moodiness
• Odd behavior
• Severe problems in making and keeping friends
• Problems planning and organizing
• Unpredictable agitation
• Disorganized speech
• Lack of motivation
• Poor memory

Protective Factors for Mental Disorders in Early Childhood, Middle Childhood, and Adolescence

• Mastery of communication and language skills
• Secure attachment
• Support for early learning
• Good peer relationships
• Consistent discipline
• Positive teacher expectations/mentors and support
• Positive partnering between school and family
• School policies and practices to reduce bullying
• Good coping skills and problem-solving skills
• Engagement and connections in two or more of the following contexts: school, with peers, in athletics, employment, religion, culture

 

Getting Children and Youth with Mental Health Problems Help as Early as Possible

Gaining a better understanding of mental health disorders will foster better communication, advocacy, and partnership in treatment. The following tools from the Child Mind Institute are provided as a resource to further support your exploration and knowledge:
http://www.childmind.org/en/health/disorder-guide/
http://www.childmind.org/en/quick-facts

Access HelpLine
Access HelpLine, at 1-888-7WE-HELP, is the easiest way to connect with services, 24 hours a day, seven days a week. Calls are answered by caring professionals who can answer your questions or get you or your loved one immediate help. Call Access HelpLine to:

• Get emergency help for you or someone you know, including help for someone who is in crisis
• Ask for mobile crisis services, which travel to you or your loved one to give help
• Find services near you and make an appointment
• Get advice on what kind of mental health or substance use services might be useful for you, a loved one, or your child

The Department of Behavioral Health Child/Youth Ombudsman Program

The Department of Behavioral Health Child/Youth Ombudsman Program was created to assist parents, guardians and youth with any challenges related to behavioral health needs for children/youth (up to 25 year old)  with the following:

•  concerns or complaints about services,
•  questions about rights,
•  navigation assistance to access services and benefits,
•  ideas for making services better,
•  general questions or the need for information concerning services for persons with behavioral health needs.

Patricia C. Thompson-Embrack, M.S.
Ombudsman Program Officer for Children and Youth Dept. of Behavioral Health
821 Howard Road SE
Washington, DC 20020
Direct Line: 202-698-2329 or 202-671-4035
Main Office 202-673-2200

District of Columbia Government & Other Child, Youth and Family Serving Agencies
Child and Family Services Agency (CFSA)
(202) 442-6100
The DC Child and Family Services Agency (CFSA) is the public child welfare agency in the District of Columbia responsible for protecting child victims and those at risk of abuse and neglect and assisting their families.

Department of Behavioral Health (DBH)
(202) 673-7440
DBH provides prevention, intervention and treatment services and supports for children youth and adults with mental and/or substance use disorders including emergency psychiatric care and community-based outpatient and residential services.

Department on Disability Services (DDS)
(202) 730-1700
The Department on Disability Services is composed of two Administrations that oversee and coordinate services for residents with disabilities through a network of private and non-profit providers: Developmental Disabilities Administration (DDA) and Rehabilitation Services Administration (RSA). DDS also supports the District’s Disability Determination Division where Social Security Disability Insurance claims determinations are processed.

Department of Employment Services (DOES)
(202) 724-7000
The Department of Employment Services provides comprehensive employment services to ensure a competitive workforce, full employment, life-long learning, economic stability and the highest quality of life for all District residents.

Department of Corrections (DOC)
(202) 673-7316
The DC Department of Corrections (DOC) is one of 17 agencies under the District of Columbia’s public safety cluster. The DOC mission is to provide a safe, secure, orderly and humane environment for the confinement of pretrial detainees and sentenced inmates, while affording those in custody meaningful rehabilitative opportunities that will assist them to constructively re-integrate into the community.

Department of Health (DOH)
(202) 442-5955
The Mission of the Department of Health is to promote and protect the health, safety and quality of life of residents, visitors and those doing business in the District of Columbia. Our responsibilities include identifying health risks; educating the public; preventing and controlling diseases, injuries and exposure to environmental hazards; promoting effective community collaborations; and optimizing equitable access to community resources.

Department of Healthcare Finance (DHCF)
(202) 442-5988
The Department of Health Care Finance (DHCF), formerly the Medical Assistance Administration under the Department of Health, is the District of Columbia’s state Medicaid agency.
The mission of the Department of Health Care Finance is to improve health outcomes by providing access to comprehensive, cost-effective and quality healthcare services for residents of the District of Columbia. In addition to the Medicaid program, DHCF also administers insurance programs for immigrant children, the State Child Health Insurance Program (S-CHIP or CHIP) and Medical Charities (a locally funded program).

Department of Human Services (DHS)
(202) 671-4200
The mission of the Department of Human Services (DHS), in collaboration with the community, assists low-income individuals and families to maximize their potential for economic security and self-sufficiency.

Department of Parks and Recreation (DPR)
(202) 673-7647
The DC Department of Parks and Recreation (DPR) provides quality urban recreation and leisure services for residents and visitors to the District of Columbia. DPR supervises and maintains area parks, community facilities, swimming pools and spray parks, and neighborhood recreation centers. The agency also coordinates a wide variety of recreation programs including sports leagues, youth development, therapeutic recreation, aquatic programming, outdoor adventure, camping, and senior citizen activities. Adaptive programs and facilities are available for persons with disabilities.

Department of Youth Rehabilitation Services (DYRS)
(202) 299-3977
The Department of Youth Rehabilitation Services (DYRS) is responsible for the supervision, custody, and care of young people charged with a delinquent act in the District in one of the following circumstances:

• Detained in a DYRS facility while awaiting adjudication.
• Committed to DYRS by a DC Family Court judge following adjudication.

Youth can be initially committed to the agency until the age of 18 and may remain in DYRS’ care until the age of 21. The agency provides comprehensive support services to committed youth, both in its secure facilities and within the community, and is designed to help young people get on the right track and successfully transition into adulthood. DYRS works with other District agencies, community partners, and juvenile justice experts to implement innovative, research-based models that are in line with best practices in the juvenile justice and youth development fields.

District of Columbia Public Library (DCPL)
The District of Columbia Public Library is a vibrant center of activity for residents and visitors in the nation’s capital. The library provides environments that invite reading, learning and community discussion and equips people to learn all their lives, to embrace diversity and to build a thriving city. We are proud to be a recognized force in the community for engaging the mind, expanding opportunities and elevating the quality of life.

District of Columbia Public Schools (DCPS)
(202) 442-5885
Our purpose is to ensure that every DCPS school provides a world-class education that prepares all of our students, regardless of background or circumstance, for success in college, career, and life.

Office of Disability Rights (ODR)
(202) 724-5055
The mission of the DC Office of Disability Rights (ODR) is to ensure that the programs, services, benefits, activities and facilities operated or funded by the District of Columbia are fully accessible to, and useable by people with disabilities. ODR is committed to inclusion, community-based services, and self-determination for people with disabilities. ODR is responsible for overseeing the implementation of the City's obligations under the Americans with Disabilities Act (ADA), as well as other disability rights laws.

Office of Human Rights (OHR)
(202) 727-4559

Office of the State Superintendent of Education (OSSE)
(202) 727-6436
The Office of the State Superintendent of Education (OSSE) is the State Education Agency for the District of Columbia charged with raising the quality of education for all DC residents. OSSE serves as the District’s liaison to the US Department of Education and works closely with the District’s traditional and public charter schools to achieve its key functions.

Public Charter School Board
(202) 328- 2660
Our goal is to ensure that students and families in Washington, DC have access to quality public charter school education. We do that by setting tough academic standards, using a comprehensive charter application review process and effective oversight, providing meaningful support and actively involving parents, school leaders, the community and policy makers.

State Board of Education (SBOE)
(202) 741-0888
The Mission of the District of Columbia State Board of Education is to provide policy leadership, support, advocacy, and oversight of public education to ensure that every student is valued and learns the skills and knowledge necessary to become informed, competent, and contributing global citizens. The State Board views its role in the achievement of this mission as one of shared responsibility, whereby it engages families, students, educators, community members, elected officials and business leaders to play a vital role in preparing every child for college and/or career success.

View information on Children, Youth and Family Services.