September is National Suicide Prevention and Awareness Month, which means it is time to have some conversations that can feel uncomfortable, scary, and incredibly important.

And because September also happens to be the month when many families are attempting to recover from the annual back-to-school circus, it seems like a particularly appropriate time to talk about children's mental health.

Backpacks are purchased. School supplies have been labeled. Someone has already lost a water bottle that was purchased approximately eleven minutes ago. Parents are trying to remember which day is early release, children are trying to remember their locker combinations, and everyone is discovering that summer bedtime schedules were perhaps not the brilliant idea we thought they were.

For some children and teenagers, however, going back to school is much more than an adjustment to a new schedule.

It can be a significant emotional transition.

Transitions can be difficult for children, particularly children who already experience anxiety, depression, ADHD, autism, social difficulties, perfectionism, or other mental health concerns.

Even children who were perfectly happy in June may struggle when September arrives.

There may be a new teacher, a new classroom, academic pressure, changes in friendships, bullying, sports expectations, separation from parents, increased homework, social media pressures, or worries about fitting in.

For teenagers, those concerns can become even more complicated as academic expectations, friendships, relationships, identity development, college planning, and the general emotional roller coaster of adolescence all pile into the same backpack.

Not every child who struggles with school is experiencing a mental health crisis, and not every bad day is a sign that something is seriously wrong. Children are allowed to have difficult days. Parents are allowed to have difficult days too. Frankly, anyone who has ever attempted to get three children out the door on time understands that emotional regulation is sometimes a group project.

What matters is noticing when the struggle becomes persistent, intense, or disruptive to your child's daily life.

The National Institute of Mental Health recommends seeking professional help when emotional or behavioral difficulties last for weeks or longer, cause significant distress, or interfere with functioning at home, school, or with friends.

Parents often ask me, "How do I know if this is just normal kid behavior or something I should worry about?"

Unfortunately, there isn't a flashing neon sign that says, "Congratulations! Your child needs a therapist!"

Instead, look for changes.

You know your child. You know their usual personality, routines, interests, friendships, sleep patterns, and behavior. When something changes significantly and stays changed, pay attention.

Some signs that your child may need additional mental health support include:

• Becoming increasingly withdrawn from family or friends
• Losing interest in activities they previously enjoyed
• Significant changes in sleep or appetite
• Frequent unexplained physical complaints such as headaches or stomachaches
• Increased irritability, anger, or emotional outbursts
• Persistent sadness, hopelessness, or anxiety
• Significant changes in academic performance
• Refusing or avoiding school
• Difficulty concentrating that is noticeably worse than usual
• Increased isolation
• Sudden changes in friendships or social behavior
• Self-harm or talking about self-harm
• Increased risk-taking or destructive behavior
• Talking about feeling like a burden
• Saying they feel trapped or that things will never get better
• Talking about death or suicide

NIMH identifies hopelessness, feeling trapped, feeling like a burden, withdrawal, extreme mood changes, changes in eating or sleeping, increased substance use, and talking about wanting to die among potential warning signs of suicide.

One of the biggest fears parents have is that talking about suicide will somehow put the idea into their child's head.

It won't.

If you're genuinely concerned about your child, ask directly and calmly.

You can say:

"Sometimes when people feel really overwhelmed, they think about hurting themselves or not wanting to be alive. Have you been feeling that way?"

You don't need a dramatic speech.

You don't need to panic.

You don't need to immediately start Googling every possible mental health diagnosis while standing in the kitchen.

You need to listen.

If your child says yes, take them seriously.

Don't dismiss it with "You don't really mean that."

Don't lecture.

Don't shame them.

Don't make them promise never to tell you something like that again.

Instead, stay with them, listen, and help connect them with appropriate professional support. If they are in immediate danger or have an active plan to hurt themselves, seek emergency assistance and do not leave them alone. NIMH advises getting immediate help when a child talks about suicide or self-harm, particularly when there is an immediate safety concern.

One of the best things we can do for children's mental health and suicide prevention is to make conversations about emotions ordinary.

Don't wait until your child is falling apart.

Ask how school is going while you're driving.

Ask what was funny today.

Ask what was difficult.

Ask who they sat with at lunch.

Ask what they're worried about.

Ask what they're looking forward to.

And occasionally ask the bigger questions:

"How have you been feeling lately?"

"Do you feel like you have someone you can talk to?"

"Have things felt overwhelming?"

These conversations build emotional vocabulary and create an environment where asking for help becomes normal rather than something reserved for a full-blown crisis.

This is another important piece of the conversation.

Depression and suicidal thoughts don't always look like crying in bed.

Children and teenagers may express emotional distress through irritability, anger, withdrawal, changes in behavior, academic struggles, sleep problems, physical complaints, or loss of interest in activities. NIMH notes that children's mental health concerns can sometimes look like changes in school performance, friendships, sleep, appetite, activity levels, or behavior.

Sometimes the child who says, "I'm fine," is fine.

Sometimes they're absolutely not.

Your job isn't to become a detective with a magnifying glass and a trench coat.

Your job is to stay curious.

There is still far too much stigma surrounding mental health treatment.

Parents sometimes worry that bringing their child to therapy means they have failed.

It doesn't.

If your child needed glasses, you wouldn't tell them to squint harder.

If they broke their arm, you wouldn't tell them to think positively and hope for the best.

Mental health deserves the same willingness to seek appropriate care.

Therapy is not a punishment. It is support.

Early intervention can help children develop coping skills, understand their emotions, improve relationships, and manage mental health symptoms before those problems become more overwhelming.

September doesn't need to be about fear.

It can be about awareness.

It can be about reminding our children that they don't have to handle everything alone.

It can be about creating families where talking about anxiety, depression, stress, loneliness, bullying, grief, and suicidal thoughts isn't taboo.

And it can be about parents remembering that you don't have to know exactly what to say.

Sometimes the most important words are simply:

"I'm glad you told me."

"I'm here."

"You don't have to figure this out by yourself."

"Let's get some help together."

Those words can be incredibly powerful.

So this September, while you're buying school supplies, reorganizing schedules, locating approximately 47 missing pencils, and wondering how your child managed to forget their homework when it was literally sitting in their backpack, take a few minutes to check in emotionally, too.

Ask the question.

Listen to the answer.

And if something doesn't feel right, trust your instincts and reach out.

Because when it comes to our children's mental health, early support matters, connection matters, and knowing where to turn for help matters.

988 Suicide & Crisis Lifeline

Call or text 988 or use the online chat at 988lifeline.org. The 988 Lifeline provides free, confidential, 24/7 crisis and emotional support throughout the United States.

National Institute of Mental Health (NIMH)

NIMH provides information about suicide prevention, children's mental health, warning signs, treatment, and finding help. Visit nimh.nih.gov.

American Foundation for Suicide Prevention (AFSP)

AFSP provides education, prevention resources, support for people affected by suicide, and information about finding help. Visit afsp.org.

If your child is in immediate danger, has seriously injured themselves, or has an immediate plan or intent to die, call 911 or go to the nearest emergency department.

Looking for more on mental health coping skills? Read my post on humor as a coping skill — and why sometimes laughing at the chaos is one of the healthiest things we can do.