Most parents don’t expect to worry about their elementary schooler’s mental health. But psychiatrists are seeing troubling changes. Suicide rates among preteens ages 8 to 12 have been climbing since 2008. While the numbers are still lower than among teenagers, the upward trend (approximately 8%) signals an important opportunity for early intervention and prevention.
Lokesh R. Shahani, MD, MPH, a psychiatrist at UT Physicians Interventional Psychiatry Clinic and chief medical officer for the UTHealth Houston Behavioral Sciences Campus, emphasized that recognizing warning signs early can make all the difference. While suicide remains the second leading cause of death among teenagers ages 12 to 18, addressing mental health concerns in younger children before problems escalate offers the best chance for positive outcomes.
The isolation generation
Shahani said the post-COVID-19 landscape has fundamentally changed how children connect with the world. Social isolation, increased screen time, and diminished face-to-face communication have created conditions for mental health struggles to take root.
“We are all in the same room, but unfortunately, we are all on our screens and not really connected to each other,” said Shahani, an associate professor at McGovern Medical School at UTHealth Houston. “It’s happening even at the dinner table. How many times have we seen families having dinner together, but not really talking to each other? Everyone’s busy on their screens.”
This lack of connection is especially damaging for preteens because children process their feelings by talking through them. When family members aren’t present to listen, kids feel unheard and unacknowledged. The result is a generation struggling with feelings they haven’t yet learned to articulate.
The shift away from outdoor play has compounded the problem, Shahani said. Today’s children miss out on these important opportunities to build resilience, form genuine friendships, and develop social skills that previous generations took for granted.
“Being a part of a team teaches you how to win and teaches you how to lose,” Shahani said. “It also teaches you that we as a team lost today, but we’re going to take it with a smile because there will be a good day tomorrow. If I’m not learning that in a pleasurable environment, how will I learn that in a much more stressful environment, like school?”
Who’s most at risk?
Research shows that girls, racial and ethnic minority groups, and families facing economic, housing, or food insecurity face disproportionately higher mental health risks. These socioeconomic pressures create stress within households that inevitably impacts children, even when parents try to shield them.
Recognizing the red flags
Unlike teenagers who might verbally express sadness, preteens communicate distress through actions and physical symptoms. Parents and teachers should watch for:
- Increased sensitivity to negative comments and more frequent crying
- Social withdrawal, such as isolating in their room instead of engaging with family
- Declining academic performance and difficulty concentrating
- Frequent stomach aches and headaches — surprisingly common indicators of depression due to serotonin receptors in the intestine
- Loss of interest in toys or activities they once treasured
“If a kid is not interested in their toy or they don’t care if someone else takes their toy, that’s actually a very important sign,” Shahani said.
Prevention starts with access
Texas has made significant investments in youth mental health, including the Texas Child Health Access Through Telemedicine (TCHATT) program that provides free telehealth access to psychiatrists and counselors in nearly 1,000 school districts across the state. UTHealth Houston faculty and staff participate in TCHATT as one of 12 health-related higher education institutions in Texas, working with school districts in greater Houston.
The American Academy of Pediatrics has also prioritized mental health screening during routine checkups. UT Physicians is taking prevention a step further by integrating behavioral health services into our new pediatric clinic, UT Physicians Pediatric Multispecialty – Katy. This one-stop-shop model allows physical and mental health providers to collaborate directly, creating treatment plans that address the whole child.
“Bad physical health impacts mental health, and bad mental health impacts physical health,” Shahani said. “Studies have shown that integrated behavioral and medical health is associated with better health outcomes.”
Breaking the stigma
Individuals and families need to take this message to heart: mental health problems are medical problems, not character flaws or sources of shame.
“If I have a headache, I won’t be sad or ashamed about it. I’m going to be open about it and get treatment,” Shahani said. “If I’m having depression, it’s the same problem in my head. The same place where my head is hurting is the same place where depression comes from. So why am I shy about it?”
Early screening leads to early treatment. For families concerned about a child’s mental health, the first step is simply starting the conversation — with your child, with their pediatrician, and with school counselors who can connect you to resources like TCHATT.
In the fight to protect our youngest children, breaking the silence may be the most powerful prevention tool we have.
