Mental Health

Mental health describes a state of psychological well-being in which a child can cope with the stresses of daily life, develop their abilities, learn, and form relationships. This is how the World Health Organization (WHO) defines it. For children and adolescents, this means, in concrete terms, that they feel good most of the time, can cope with frustration and disappointment, have friendships, and make age-appropriate developmental progress.

Emotional well-being depends on a balance. On one side are stresses and challenges; on the other, the resources a child uses to cope with them. As long as these two are roughly balanced, a child remains stable, even if they feel sad, angry, or anxious from time to time. Emotional fluctuations are a normal part of development. A preschooler who cries after an argument, or a teenager who is in a bad mood for a week, is not showing signs of illness. What is considered age-appropriate changes over the years: For toddlers, the bond with parents is paramount; for adolescents, separation, their own circles of friends, and the search for identity come into play.

Experts refer to the ability to cope with stress as resilience. It is not innate. A child develops it through experiences with their caregivers and their environment. The Federal Institute for Public Health, which oversees kindergesundheit-info.de, describes several inner strengths that children develop in this process:

• Self-worth: The child feels loved and accepted for both their strengths and weaknesses.
• Self-efficacy: The child experiences that their own actions make a difference. Read more about this in the article “Self-Efficacy Expectations.”
• Self-confidence: Praise and encouragement help build confidence in their own abilities.
• Perseverance: The child learns to patiently pursue goals even after setbacks.
• Empathy: Over time, the child comes to understand the feelings and perspectives of others.

The most important protection comes from sensitive parents who pay attention to their child’s needs and respond appropriately. Reliable relationships within and outside the family, good care, school, and recreational activities further support resilience. The article “Resource Activation” shows how parents can specifically build on existing strengths.

In everyday family life, certain specific things support a child’s emotional development. An emotional bond with at least one reliable caregiver is considered crucial. Through this relationship, young children learn to make sense of their feelings. During shared soothing—or co-regulation—the parent initially takes on the tasks that the child cannot yet manage alone. This later develops into the child’s own ability to regulate emotions.

Structure provides stability. Rules, set routines, and rituals give a child a sense of security and direction because they know what comes next. Adequate sleep, physical activity, and screen-free time all affect mood and concentration. Screen time requires clear limits and supervision, especially for younger children. In day-to-day interactions, appreciation, affection, attention, and reliability matter more than individual support measures. Parental role modeling also makes a difference: Children observe how parents deal with stress, conflict, and disappointment, and incorporate some of these patterns into their own behavior.

Sadness, anger, fears, and withdrawal are all part of childhood from time to time. Treatment is needed when these symptoms persist for weeks, are severe, and significantly interfere with the child’s daily life—for example, at school, with friends, or within the family. A sudden change in behavior, self-harm, or statements about feeling tired of life are also warning signs that require prompt professional evaluation.

The BELLA study by the Robert Koch Institute shows just how common mental health issues are. According to the study, approximately 21.9 percent of 7- to 17-year-olds show signs of mental health issues, most commonly anxiety (10.0 percent), social behavior disorders (7.6 percent), and depressive symptoms (5.4 percent). The study also notes that by no means all affected children receive treatment. A stressful family environment and a low socioeconomic status are among the factors that increase the risk. The article “Mental Health Problems” discusses in detail what may lie behind such issues and how they manifest themselves.

The first point of contact is usually the pediatrician’s office. The pediatrician rules out physical causes and refers the family to other services. Free parenting and family counseling centers offer families accessible initial advice, even without a diagnosis. The field of child and adolescent psychiatry (KJP) is responsible for determining whether a behavior or symptom is part of normal development or requires treatment. Only a treating specialist can make a diagnosis through a personal consultation and a thorough examination. Information from the internet is no substitute for this.

Rückenwind “Eltern” provides coaching and support for families. Janike is a social worker and parent coach currently training to become a child and adolescent psychotherapist; she is not licensed and does not make diagnoses. If a disorder requiring treatment is suspected, the next step is to consult a child and adolescent psychiatrist or a medical psychotherapist.