May is Mental Health Awareness Month, a time to recognize the emotional well-being of children, teens, families, and the adults who support them. For young people, mental health affects how they learn, build relationships, manage stress, respond to conflict, and begin to understand themselves.

Across the country, youth mental health remains a serious public health concern. According to the 2023 Youth Risk Behavior Survey data, 40 percent of U.S. high school students reported persistent feelings of sadness or hopelessness, 28 percent reported poor mental health, 20 percent seriously considered attempting suicide, and 9 percent attempted suicide during the previous year. These numbers represent young people who may be carrying stress, grief, anxiety, trauma, loneliness, or uncertainty that adults may not always see.

Mental health challenges in children and teens do not always look the way adults expect them to look. The National Institute of Mental Health notes that warning signs may include:

• Irritability, frustration, restlessness
• Appears fearful or worried
• Physical problems without a clear medical cause
• Changes in sleep
• Academic struggles
• Loss of interest in activities
• Low energy
• Isolation
• Risky behaviors
• Substance use
• Thoughts of suicide or suicide attempts

A young person who is struggling may not always say, “I am sad” or “I need help.” Their distress may show up as withdrawal, anger, avoidance, conflict, shutting down, or difficulty participating in everyday routines. This does not excuse unsafe behavior, but it does encourage adults to look beyond the surface and respond with consistency, structure, and support.

This is where the CARE model is especially relevant. Developed by Cornell Universtiy, CARE is a principle-based model that helps adults understand young people through a developmental, trauma-informed, relationship-based lens. Rather than asking only, “What is wrong with this behavior?” CARE encourages adults to ask “What does this young person need right now?” and “How can we respond in a way that builds safety, trust, and competence?”

Such quality relationships with caring adults have been associated with lower prevalence of one or more mental health or suicide risk indicators among high school students. Research also points out other protective factors that guard children and teens against poor mental health outcomes, including getting at least eight hours of sleep, having a household adult who tried to meet basic needs, high parental monitoring, high school connectedness, physical activity, and participation on a sports team. While these findings do not specifically study residential care, they reinforce that young people benefit from environments that provide connection, consistency, support, and opportunities for healthy development.

Connection does not always require a major intervention. Sometimes it begins with a predictable routine, a calm adult response, a meal shared together, encouragement after a hard day, or a staff member noticing when a young person seems quieter than usual. These interactions may seem simple, but for a child or teen who has experienced trauma, instability, or rejection, consistency can be powerful.

Mental health support has to be part of the everyday environment. Young people need adults who are steady, observant, and willing to look beyond behavior. They need routines that feel predictable, relationships that feel safe, and opportunities to build skills before stress reaches a breaking point.

At George Junior Republic, CARE reminds us that healing is clinical and relational. It happens through structure, safety, family involvement, competence-building, and everyday interactions that help young people feel seen and supported.

Children and teens are facing increased adversity. With consistent support and caring relationships, young people can build resilience against adversity instead of being defined by it. Awareness is important, but action is what makes awareness meaningful for the young people in our care.

Sources

National Institute of Mental Health. (2024). Child and adolescent mental health. U.S. Department of Health and Human Services, National Institutes of Health. https://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health

National Institute of Mental Health. (2024). Depression. U.S. Department of Health and Human Services, National Institutes of Health. https://www.nimh.nih.gov/health/publications/depression

Verlenden, J. V., Fodeman, A., Wilkins, N., Jones, S. E., Moore, S., Cornett, K., Sims, V., Saelee, R., & Brener, N. D. (2024). Mental health and suicide risk among high school students and protective factors — Youth Risk Behavior Survey, United States, 2023. MMWR Supplements, 73(4), 79–86. http://dx.doi.org/10.15585/mmwr.su7304a9