The kids are not alright. Adolescence has always been tough, but today’s tweens and teens are under so much pressure that in 2021, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association all declared a national emergency in children’s mental health.
In 2023, more than eight million young people between the ages of 12 and 17 — nearly a third of American adolescents and teens — received mental health treatment. Still, in 2025, only 59% of teens said they receive the emotional and social support they need.
[READ: Types of Therapy: Choosing the Right One for You.]
Mental Health and Substance Use Often Go Hand in Hand
Mental illness and substance use disorders co-occur more often than not, especially among teenagers, according to Dr. Travis Fahrenkamp, a child and adolescent psychiatrist at Hazelden Betty Ford Treatment Center for Teens, Young Adults and Families in Plymouth, Minnesota.
“Oftentimes, teenagers are using substances to try to mitigate symptoms of depression or anxiety or other things, so having specialized services available within the site where they’re receiving treatment is super important,” Fahrenkamp says.
According to a 2023 report from the U.S. Substance Use and Mental Health Services Administration (SAMHSA), 856,000 of 12- to 17-year-olds had both a major depressive episode and a substance use disorder in the past year.
[READ: How Can I Find the Best Psychiatrist?]
Does Your Child Need Mental Health Treatment?
Adolescence can be a real struggle, and it’s not unusual for teens to be moody or nervous about an upcoming test, sports match or even a party. It’s also common for some teens to experiment with drugs or alcohol. So, how do you know if you need to call in a professional? The short answer is when the behavior or mental health challenge starts to negatively affect your teen’s life, it’s time to get outside help.
Some of the warning signs parents might see:
— A decline in academics
— Withdrawing from friends they usually spend time with
— Withdrawing from family and becoming more isolated or reclusive
— Withdrawing from activities they used to enjoy, like sports or clubs
— Engaging in risky behaviors that raise concerns for their well-being
“If parents are seeing signs that the use of drugs or alcohol are becoming more problematic, it might be time to intervene,” Fahrenkamp says. He adds that early intervention is crucial and provides the best outcomes.
If you suspect that your child needs treatment for mental health issues, including a substance use disorder, take heart. There is no shame in needing mental health care, and there’s a good chance that some of your child’s friends are also seeing a mental health specialist.
[Read: How to Find a Therapist or Mental Health Professional for Your LGBTQ+ Child]
Where to Begin With Substance Abuse Treatment
The first thing people ought to do, though many people forget to, is to talk to their primary care provider, advises Dr. Christine Crawford, a child psychiatrist and associate medical director at the National Alliance on Mental Illness. “Talk to the pediatrician because mental health concerns are primary care concerns,” she says.
A PCP can assess the severity of what’s going on and help guide the parents toward the appropriate level of care, Crawford says.
A substance use assessment can be helpful if the teen doesn’t want to go into treatment or if they don’t believe they have a substance use problem. Fahrenkamp says using diagnostic criteria is an objective way to determine (and explain to parents) if the use is becoming more problematic. And, as with mental health issues, a substance use assessment can help determine the level of care that will be appropriate.
Addiction medicine specialists and doctors who specialize in treating substance abuse can also be helpful resources.
Types of Substance Use Recovery Treatments
Thanks to Hollywood, substance use recovery is often associated with inpatient residential treatment centers, but there are different levels of treatment. Fahrenkamp says assessments are used to determine the patient’s level of care based on the support of their family, their willingness to be involved in treatment and how substance use is affecting their daily life.
Substance abuse recovery may involve any combination of the following:
— Meeting regularly with a therapist or psychiatrist
— Outpatient treatment in the evenings after school
— Intensive outpatient treatment for a couple of hours several days per week
— Outpatient treatment programs with similar hours to a school day during the week
— Residential treatment program at a facility
Crawford stresses that moving to a residential treatment facility should be the last resort. “When we’re talking about treatment centers, you have to have gone through a lot of different steps before you even explore that,” Crawford says.
With substance use disorder, some kids may benefit from outpatient treatment programs that are team-based. The team might consist of a psychologist to do an initial assessment of underlying mental health issues that may be driving the ongoing substance use and a psychiatrist to prescribe medication for intense drug cravings or if their substance use has masked underlying mental health conditions. Peer recovery coaches, adults with lived experience of substance use as young people, are also often part of the team.
“These peer recovery specialists are available to meet with the teen out in the community,” Crawford says. “They’ll go and hang out at the mall, or the peer recovery specialist will come see the teen after school at home.” By spending time with the teen in a natural environment, the peer support specialist can provide them with tools and strategies to cope with the substance use, Crawford adds.
Whether your teen has mental health issues or substance use disorder (or both), and whichever type of recovery model you ultimately choose, parents should do their due diligence to fully understand the provider’s approach.
[Read: How to Support a Child in Crisis]
Questions to Ask About Recovery Treatment for Your Child
Our experts recommend asking the following questions when considering recovery options.
1. How much will my child’s school be involved?
Many parents don’t think about this, but Crawford says it is an essential consideration because kids spend most of their day in school and may behave differently at school than at home. The provider should communicate with the school guidance counselor, social worker, school psychologist or teacher. This helps the provider get a more holistic view of your teen’s behavior in different environments. Knowing how they present in school helps pinpoint triggers in the school environment.
2. Do you offer different levels of care?
Recovery from substance use and mental health disorders doesn’t happen all at once; it’s a process. Fahrenkamp says that care teams can work together to transition patients to a higher level of care when things are more problematic or to a lower level as symptoms continue to improve.
3. What if my child doesn’t want to go to treatment?
Crawford says this is frequently the main barrier to parents seeking care. Treatment is not necessarily a waste of time as many parents fear, if the child is not initially accepting of help.
Many therapists who find it challenging to engage with a child still request they come in for regular sessions, knowing it may take weeks or even months for teens to feel comfortable disclosing what’s going on in their lives.
The most effective providers are persistent in establishing a rapport, so ask the provider about their strategies for doing so. Some therapists will meet parents or caregivers when the child doesn’t want to engage, which can be very beneficial for improving communication in the home.
4. How do you handle matters around privacy?
A lot of parents assume that if they bring their teen in for therapy and pay the therapist, the therapist works for them and will provide a rundown of everything that happens in sessions. That’s not the case.
Therapists should also explain their policy to the teen at the beginning of therapy and let them know that everything that’s being discussed is strictly between the teen and the therapist, except a teen who has expressed an interest in harming themselves or others, in which case the therapist is required to break confidence. Both the parents and the teen should know the policies up front.
5. What do you think about the role of medication in treatment for my child?
The therapist may be totally against medication or use it when necessary, and you want to know this before your teen begins treatment. If the therapist thinks the teen may benefit from depression medication or other pharmacological treatment, they should communicate that to the parent and refer the parent to a psychiatry colleague. Therapists may also work with a primary care physician to prescribe medication.
Seek Support
There is no one-size-fits-all solution for mental health or substance use disorders, but both Crawford and Fahrenkamp stress that parents should look for a program offering evidence-based therapies, the proper expertise and an appropriate level of family involvemen.
“Many of the most successful substance use programs for teens have individual as well as group therapy for the parents, so they’re with other parents and caregivers who are also struggling to raise a teen challenged by a substance use problem,” Crawford says. She adds that without family involvement, the underlying issues contributing to substance use may not be effectively addressed.
It’s also important to find a program that has family services so parents can learn about addiction, their communication patterns and how they can support their child.
“When kids have a strong recovery environment, outcomes are much better,” Fahrenkamp says.
Group therapy — where other teens struggling with substance use or mental health disorders share their experiences and strategies — can also be quite beneficial for some people.
Ultimately, when seeking treatment for mental health or substance use disorders for their child, parents should aim to find providers who understand the stigma associated with treatment and who will offer love and support throughout the recovery process.
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How to Find the Best Recovery Treatment for Your Child: 5 Questions to Ask originally appeared on usnews.com
Update 04/21/25: This story was previously published at an earlier date and has been updated with new information.
