We’re all feeling it. Stress. Anxiety. Depression. Trauma. The COVID-19 pandemic and its outcomes have negatively impacted our well-being, and now the Centers for Disease Control and Prevention confirmed mental illness puts us at higher risk for severe COVID-19 experiences. We are in a mental health crisis, and the latest potential consequences are most concerning in our most vulnerable and least vaccinated populations — children and youth.

Mental illness among children and youth was rising before the pandemic, and now it’s an emergency.

Since March 2020, research indicates that due to experiencing more social isolation, remote learning, fear, loss and trauma during the pandemic, more children and youth are experiencing moderate to severe anxiety and depression. Suicide remains the second leading cause of death among young people between the ages of 10 and 24. There’s been an increase in emergency room visits for mental health reasons for children and youth, as well. The White House is rightly concerned. We should be, too.

I’ve spent the bulk of my career communicating about mental health, working in partnership with children, youth and their families. Through this work, I know that breaking down stigma and increasing understanding about mental illness is essential to help children, youth and their families address mental health issues. The key is that you can’t be afraid to ask potentially uncomfortable questions.

Years ago at a children’s mental health event, I was introduced to a transgender young person who was dealing with mental health challenges, exacerbated by bullying and other upsetting behaviors at school. Frankly, I had never met a transgender person and I wasn’t sure how to address the individual. I decided to ask directly. The joy in the response was palpable. That day I learned a new pronoun — ze — and gained the trust of a new friend who would go on to speak proudly and loudly about zirs mental health.

As we continue to navigate how to protect our children and youth during this pandemic, caring for their mental health is as important as ever. Words are powerful; they can harm or heal. Together we can create environments where children and their families feel supported and willing to seek and receive help for mental health challenges. Here are some recommendations for accurately, fairly and sensitively discussing mental illness with children, youth and their families.

• Use person-first language. Words should describe a child as having a mental health condition, rather than as the condition. For example, “Ricardo experiences mental illness,” versus “Ricardo is mentally ill.” The same rule can apply to other scenarios as well, such as “Cristina is experiencing homelessness,” instead of “Cristina is homeless.” We wouldn’t consider describing someone as “cancerous” any more than we should be referring to individuals as “bipolar.”
• Amplify voices. Youth can be amazing advocates for how they are affected by mental health issues; their stories of lived experience are powerful and should be amplified to inspire change. Too often caregivers and adults “speak” on behalf of children and youth experiencing mental health challenges. In my experience working with youth and young adults, it is their right to own their voice and their lived experiences. We should create platforms for them to stand on, provide the microphones, and offer safety and support as they share what they’re comfortable sharing about their experiences and perspectives. “Nothing about us, without us” is their rallying cry and each of us can protect and honor their request in dialogues and discussions.
• Fight stereotypes. Don’t play into the narrative that mental health conditions explain a child or youth’s unusual acts or behavior. Often we communicate labels that wrongly define people with mental illness as unstable, untrustworthy or even violent. Beyond the fact that people with mental illnesses are not violent and are more than four times more likely to be victims of violent crime than the general population, how likely is it that families would reveal a child’s mental health needs and seek support if they are concerned that communities would perceive them as unbalanced or aggressive? Counter assumptions with facts and examples.
• Avoid blame. “What’s wrong with that child?” is the wrong question to ask when talking about children’s mental health. It’s language that puts the blame on the person experiencing the illness and perpetuates the stereotypes we should be fighting. Like the title of Oprah Winfrey’s most recent book, we should be asking “What happened to you?” instead. Traumatic experiences are often a factor when we are experiencing mental health challenges, and children and youth are no different.
• Honor identities. When people say that they are “colorblind” when it comes to racial identity or “gender isn’t important,” it is a microaggression that denies the presence of people’s identities — the layers that make up who they are and how they experience the world. Acknowledging and respecting the existence of a person’s identity communities, such as their races/ethnicities, age, ability, sexual identity, or asking for and using pronouns, recognizes the intersectionality of those identities and the impact they may have on mental health. For many identity communities that have been marginalized or discriminated against, there are reasons to distrust health care professionals. For those negative experiences or other identity culture factors, we need to use language that honors others’ identities to build trust and understanding and make them feel seen and valued during a vulnerable time.
• Highlight recovery. We know that with services and support, recovery is possible. Mental health recovery is a journey, not a destination — yet in supportive communities, it is a path that can offer children and their families dealing with mental health challenges opportunities for healthier and productive lives. We can help by focusing on strengths and accomplishments as we do with any other illness or disability. We should highlight the positive outcomes that children with mental illnesses can achieve and showcase that with access to mental health services and supports, everyone has an opportunity to lead inclusive, productive futures.

By being more inclusive and intentional in our language, we can minimize stigma and hesitancy to address children’s mental health in our communities and offer hope and possibilities to the children and youth in our neighborhoods, networks and families.

For a more comprehensive guide to language-related behavioral health issues, check out the Carter Center Journalism Resource Guide on Behavioral Health, the Diversity Style Guide or the Mental Health Media Guide developed by a coalition of entertainment industry and mental health advocacy organizations.