Mental Health

Conversation Starters

Learn how to do a mental health check-in with your young person, find conversation starters by topic, and where to reach out for more info & support.

Mental Health Conversation Starters

Starting the Conversation

Written by Dahyana P. Schlosser, PMHNP-BC

As a caregiver, communication with your young person is crucial to the bond and relationship that you hold with them. Communication also has implications for their growth and development as individuals in this world. What many of us caregivers know intuitively is that communication with our young people becomes more complicated as they get older. So, you may be wondering about ways to help ease the pain of communication with a growing young person in an effort to understand them, have them understand you, and to actively contribute to their experience of the world in a positive way. While there is no one-size-fits-all magical pill for communicating with your young person, the main principles are true throughout. The golden threads of communication are ingrained in trust, respect, transparency, and an understanding of culture.

Special Considerations

If you have a young person with learning differences, consider that their emotional and learning developmental age may differ from their physical developmental age. As they develop, their body will change and they will likely have the same experiences and needs as their peers, but if they have certain learning challenges, they may need more support to understand some of the concepts.  

If needed, talk with your young person’s medical and educational team about their individualized needs and how best to explain these concepts to them. Typically, it is best to start simple to create safe, open communication. Add in more details as your young person demonstrates their understanding. It is important to normalize these conversations with them — at their comprehension level.

Where to Start the Conversation

Create and cultivate a space where questions are welcome, honesty is invited, and vulnerability is cherished.

Intentionally cultivating a space and time for you and your young person to connect and continuously get to know one another serves many purposes. An important one being, forming a deeper connection with them. It will also come in handy during those inevitable tough moments or times when difficult questions must be asked. In a safe space, communication is much easier.

When & How to Start the Conversation

Once you’ve cultivated that space, you can periodically ask your young person questions about their mental health and their experiences in the world.

Do a Mental Health Check-In:

Here are some great questions to ask them to gauge how they are doing with their mental health.

  1. If you could change one thing about your life right now what would it be?
  2. What do you need me and the other adults in your life to know about you right now?
  3. How can I support you right now?
  4. How can I advocate for you?
  5. Do you feel like you want/need someone besides me to talk to about stuff?

Scaling questions are great too! With scales you can compare the answers to previous questions to know if things have gotten better or if they have gotten worse. Have 0 mean no/minimal and 10 mean maximal.

  1. On a scale of 0-10, how sad do you feel right now?
  2. On a scale of 0-10, how worried are you about different things in life?
  3. On a scale of 0-10, how well supported do you feel by me?
  4. On a scale of 0-10, how happy are you at school?
  5. On a scale of 0-10, how well understood do you feel by me?
When to Reach Out for Support

Remember, asking questions is important but not more important than your young person’s comfort and emotional safety. When young people are struggling with their mental health, they may have difficulty answering these questions, as they may be feeling all jumbled up inside. Some signs of this are: limited eye contact, answering questions with the proverbial youth answer of “I don’t know,” or becoming emotional when you ask these questions. These could be signs that they need some time to process. If that’s the case, don’t push it and try again another time. You may also want to give them a selection of concepts to choose from (“Are you feeling angry, sad, or frustrated?”)

If you are still hitting a wall, it may be a good idea to connect them with a therapist who they may feel more comfortable opening up to, not because you are not an amazing caregiver, but more so because they need someone completely unbiased and neutral to talk to. Happy chatting!

Conversation Starters by Topic
Mood disorders & Depression
  • “I noticed that you’ve been feeling sad and a little withdrawn recently. Is there anything going on that’s making you feel that way?”
  • “I noticed that you’ve been getting angry more easily lately. I really would like to understand what’s going on. Will you tell me more about what’s happening?”
  • “You seem really stressed these days. Are you okay? I’m right here if you ever want to talk.”
  • “You know, it’s normal to feel stressed/irritable/sad/tired at times, but if you end up feeling that way all the time then it would be a good thing for us to talk about it. Things don’t have to be this way and there are ways for you to feel better.”
  • “I noticed that you seem a little depressed/sad/tired lately. Is that how you feel at the moment? Would you like to talk about it? or I want you to know I’m here for you if you need to talk.”
Trauma

Ask your young person to tell you what they are thinking and feeling. Make sure you validate their experience and show them that you understand what they have been through.

Next, ask them what they need from you or the other adults around them to start on the road towards healing. Therapy is a great suggestion, but not always one that is fully embraced right away, so it may take some time. Ultimately, therapy would be the best route to take for them to reach the pinnacle of healing from their traumatic experience. 

  • “I love you. I’ve noticed that you are struggling because you are yelling a lot at me, your little brother, and even the dog. I know it has been hard since the accident for you and I’m concerned. I want us to work together to figure out a solution.” 
  • “I’m hoping we can talk a little about everything that has been going on. I know it’s been hard on you with the divorce, and you are having a hard time navigating it. I’ve seen how you’ve changed in the last few months and I know you are trying different ways to feel better. What can I do to help you?”
  • “I just wanted to talk a bit about ____(loved one). Losing them has been so hard for me, so I can imagine it’s been tough for you. The feelings we have when we lose someone we love can be so intense sometimes. I just want you to know that you aren’t alone. You can always come to me if you ever need to talk, cry, or vent. Is there anything else I can do to help you? Would you like to talk to someone outside of our family about this?”
Anxiety
  • “I noticed that you’ve been feeling sad and a little withdrawn recently. Is there anything going on that’s making you feel that way?”
  • “I noticed that you’ve been getting angry more easily lately. I really would like to understand what’s going on. Will you tell me more about what’s happening?”
  • “You seem really stressed these days. Are you okay? I’m right here if you ever want to talk.”
  • “You know, it’s normal to feel stressed/irritable/sad/tired at times, but if you end up feeling that way all the time then it would be a good thing for us to talk about it. Things don’t have to be this way and there are ways for you to feel better.”
  • “I noticed that you seem a little depressed/sad/tired lately. Is that how you feel at the moment? Would you like to talk about it? or I want you to know I’m here for you if you need to talk.”
Eating Disorders
  • “I feel like something is bothering you, would you like to talk about it?”
  • “I noticed you haven’t eaten much at dinner lately. Is everything okay?”
  • “I am feeling concerned and worried about you and I am not sure what to do.”
Self-Esteem & Body Image

It is important to teach your young person about positive self-talk, acknowledging their efforts vs. performing tasks perfectly, and self-acceptance. 

  • “Are there any new activities you would like to try but are hesitant to do so? If so, let’s set some small, measurable goals that will allow you to achieve them.” 
  • “I see you enjoy soccer, but don’t want to join a team. Can you give me your top fears about joining?” 
  • “You are a very valuable member of this family. Can you tell me some things about you that make you valuable?” 
  • “What are some things you do that make you feel purposeful?” 
  • “What are some things you like about yourself or things you feel you are good at?”
  • Teach about the effects media can have on self-esteem. Films, TV, magazines, and social media like Tik Tok and Instagram have distorted how many of us view our bodies and ourselves. “Can you spot any examples on social media that give a distorted sense of reality?”
  • “What do you think other people would say about you if they had to describe you?” 
  • “What are you most proud of?”
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