Children's Mental Health Standards

At present, the global clinical psychology community has not yet introduced a completely unified and quantifiable standard for determining children’s mental health. The mainstream consensus is that all assessments must anchor the developmental characteristics of children at their age and make comprehensive judgments from the five core dimensions of emotional response, social adaptation, cognitive development, behavioral patterns, and self-perception. There is no “one-size-fits-all” scale that applies to all children.

I have been working in a child psychology clinic for nearly 6 years, and I have seen too many parents use the "Mental Health Self-Assessment Form" found online to rate their children, and they shed tears when the score is two points lower. Last week, I met a mother who brought her 7-year-old son. The teacher said that the child couldn't sit still in class, which must be due to attention deficit and unhealthy psychology. As a result, I spent half an hour with the child playing space-themed Lego. His eyes were as bright as light bulbs, and he didn’t even raise his head when I handed him a bottle of water. After finishing the game, he told me about the principles of rocket launch for ten minutes - do you think this child is mentally unhealthy? He was just not interested in the pinyin dictation in Chinese class.

Speaking of differences in judgment standards, the focuses of different academic schools are actually quite different. Psychoanalytically oriented counselors will pay more attention to the quality of children's attachment in early years. They believe that children who can establish a secure attachment with their primary caregiver before the age of 3 will basically have a good psychological background. Even if they have a little temper or occasionally roll around, it is normal to vent their emotions. On the contrary, children who have been "too well-behaved" since childhood and never dare to make requests to adults are more likely to hide emotional problems. Researchers in the behaviorist school pay more attention to observable explicit behaviors, such as whether they will engage in extreme behaviors that hurt themselves or attack others when encountering setbacks, and whether they can independently complete age-appropriate life and learning tasks. These visible performances will be regarded as the core evaluation basis. Most of the psychological screening scales commonly used in primary and secondary schools in China are formulated with reference to the "Psychological Development Guidelines for Children and Adolescents Aged 3-17" issued by the National Health Commission. However, every time I give training to school teachers, I will repeatedly say that the results of these scales are only early warnings and must not be regarded as diagnostic conclusions.

Last month, I went to the community to do some parent-child science popularization. A grandma asked me, saying that her 5-year-old granddaughter always cried a lot and would cry for half an hour when someone touched her toys. Was she too fragile and had a psychological problem? I told my grandma at the time, if you have a 10-year-old child crying for half an hour because of this, you don’t need to worry. A 5-year-old child’s emotional brain has not yet fully developed and cannot express dissatisfaction in words. Crying is the most direct way to vent. It is so normal. A pitfall that many parents easily fall into is that they regard "sensible", "obedient" and "not losing temper" as the criteria for mental health. They want their children to be like little robots that run according to the program. In fact, they stifle their children's normal emotional outlets.

Nowadays, many institutions and schools attach great importance to "attention span", and even regard "not moving for 45 minutes in class" as a hard indicator of mental health. This is actually very controversial in the academic circle. Developmental psychology has long had clear research conclusions. A child's intentional attention span is age multiplied by 2 to 3. A 5-year-old child only has 10 to 15 minutes, and a 7-year-old primary school student only takes about 20 minutes. Requiring a child who has just entered primary school to sit motionless for 45 minutes is inherently against the laws of development. If there are children who can do this, we should pay attention to whether they are too anxious and are deliberately suppressing themselves because they are afraid of being criticized.

In the past two years, there has been an increasingly recognized point of view, which is that the existence of neurodiversity must be taken into account when assessing, and all manifestations that are "different from most children" cannot be regarded as psychological abnormalities. For example, a child with Asperger syndrome may not be social and only like to immerse himself in his own interests. However, as long as he is emotionally stable and can complete age-appropriate tasks normally, he falls into the normal category of neurodiversity and is not considered mentally unhealthy. I have met an 11-year-old Asperger's boy before. He usually doesn't like to play with his classmates, but he is very interested in paleontology. Last time he won the first prize in the province's paleontology knowledge competition. His mother used to be worried that he was not gregarious, but now she thinks about it. The child's own comfort is more important than anything else.

In fact, in the final analysis, children's mental health standards are never a model used to label children, but a reference ruler to help parents and teachers understand children's signals. You don’t have to remember those complicated dimensions. Just observe your children: Are they relaxed and happy most of the time? Do you have at least one favorite thing that you can concentrate on doing? When you encounter difficulties, will you take the initiative to seek help from someone you trust? If these three points are met, then there is basically no big problem. After all, each child's growth rhythm is different. If we insist on a unified set of standards, it will be easy to "cure" problems for good children.