One third of Tennessee parents with children aged 6-17 are worried their child has an undiagnosed mental health condition, a new poll from the Vanderbilt Center for Child Health Policy found.

The findings in the poll led by researchers at Monroe Carell Jr. Children’s Hospital at Vanderbilt and Vanderbilt University Medical Center, also found that about 30% of parents said their child had been diagnosed with a mental health condition, such as attention deficit hyperactivity disorder (ADHD), anxiety or depression.

“Mental health conditions are common among children and adolescents,” said S. Todd Callahan, MD, MPH, associate professor of Pediatrics and director of the Division of Adolescent and Young Adult Health. “Mental health symptoms can be a serious threat to a child’s health, growth and development. The good news is that these symptoms usually improve with intervention and treatment.”

The findings were collected before the COVID-19 pandemic interrupted children’s academic and social lives in unprecedented ways. This underscores the importance of addressing and understanding mental health challenges in children to better keep them healthy and safe, said Stephen Patrick, MD, MPH, a neonatologist and director of the Vanderbilt Center for Child Health Policy.

“COVID-19 disrupted the routines of children across the state, creating stress for parents and children alike. Now more than ever, parents should not be afraid to talk to their kids about mental health and wellbeing,” Patrick said.

The Vanderbilt Child Health Poll asked a statewide sample of 1,100 Tennessee parents about their concerns related to children and mental health (social, emotional and behavioral health) before coronavirus began to spread in the state.

Attention deficit disorder/hyperactivity disorder (16%), anxiety (11%) and depression (8%) were the most common mental health diagnoses, often in combination with another of these three conditions. Nearly 20% of parents reported that their child had been diagnosed with two or more mental health conditions.

A notable finding for researchers is that 10% of parents reported they were unsure how to talk to their children about suicide and couldn’t identify warning signs. Over 500 young Tennesseans have died from suicide in the past ten years, and suicide was recently declared a state crisis by the Tennessee General Assembly.

Parents were mostly afraid that talking about suicide would lead to more thoughts of suicide (16%), were worried others would judge them (13%) or didn’t know how to help (13%).

“Parents are often afraid to discuss depression and thoughts of suicide with their youngsters and may not realize they don’t know how to express their feelings,” said Catherine Fuchs, MD, professor of Psychiatry and Behavioral Science, and Pediatrics at VUMC, who helped craft the survey. “Even though kids don’t admit it, knowing that parents are interested in how they are feeling and modeling how to talk about it can provide tremendous relief.”

Fuchs recommended using art activities, reading books about emotions or watching shows about appropriate expression of emotions to help guide the conversation.

Over 30% of parents surveyed said they would turn to their child’s physician for help with concerns about their child’s mental health. If parents have concerns about their children, they can talk to their physician. Parents can also call the National Suicide Prevention Helpline at 1-800-273-8255 or the Tennessee Crisis Line at 855-CRISIS-1 in emergencies or with general questions.

The mental health of Tennessee children is a key priority for parents, and an issue that necessitates increasing attention in light of the COVID-19 pandemic., Patrick said. Health care providers, policymakers, educators, faith leaders, and others involved in the care of kids in Tennessee should make child mental health a priority, he added.