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Early mental health intervention can yield positive outcomes and help prevent future issues across various areas of a child’s development. This can include improvements in emotional, behavioral, academic, and social domains. Receiving care from mental health professionals (such as psychologists, psychiatrists, and counselors) can help improve emotional regulation, strengthen family relationships, enhance school performance, and support healthy long-term development (Simeonova, Akee & Copeland, 2023).
Improved Emotional Well-Being Psychotherapy and cognitive-behavioral therapy (CBT) have been found to help alleviate symptoms of anxiety and depression in youth (Dickson, Kuhnert, Lavell & Rapee, 2022; Cujipers et al., 2023). CBT and related treatments can help anxious children learn to manage fears and reduce avoidance, leading to significant decreases in anxiety symptoms and diagnoses (Dickson et al., 2022). Similarly, previous literature suggests that psychotherapy is effective for treating depression in children and adolescents, with roughly 54% of youth achieving clinically significant improvement with therapy (versus about 32% with no treatment) (Cujipers et al., 2023). These effects may be attributed to improvements in emotional regulation and self-esteem after engaging in therapy. Through techniques like reframing negative thoughts, recognizing emotions, and practicing relaxation or mindfulness, children and teens can learn healthier ways to identify and manage complex emotions. Somatic therapy can be beneficial for youth who experience trauma and post-traumatic stress disorder (PTSD) symptoms. Somatic therapies like Sensorimotor Psychotherapy (SP) and Somatic Experiencing (SE) are effective in helping youth process trauma by focusing on body-based memories and sensations rather than verbal recounting, which can be overwhelming for children (Classen et al., 2021). Body-focused therapies help children and adolescents increase awareness of bodily cues linked to stress and dysregulation, which enhances their ability to manage strong emotions like fear, anger, or sadness (Maldei, Maier & Burger, 2021). Additionally, EMDR and other somatic-based therapies have been linked to reductions in PTSD symptoms, particularly when trauma is stored as non-verbal, bodily memory in youth (Scelles & Bulnes, 2021). Dialectical behavior therapy (DBT) has been widely studied as a treatment for adolescents with pervasive suicidal ideation (S/I), self-harm behaviors, and emotion dysregulation. It combines individual therapy, group skills training, coaching, and regular therapist sessions. DBT is grounded in three main theories: behavioral theory (changing problematic behaviors), biosocial theory (understanding emotional vulnerability and invalidation), and dialectical philosophy (balancing acceptance and change) (Rizvi et al., 2024). DBT for adolescents (DBT-A) consistently shows moderate to large effects in reducing self-harm, suicidal ideation, and emotional dysregulation compared to other therapies (Kothgassner et al., 2021; Syversen et al., 2024). Findings suggest that DBT-A leads to greater reductions in suicide attempts and overall self-harm, with benefits often sustained up to 1–3 years post-treatment. Among queer youth at high risk for suicide, many experienced significant improvements in emotion regulation, depression, borderline symptoms, and coping strategies (Poon et al., 2022). DBT can help manage anger and other aspects of emotional dysregulation by utilizing coping strategies (Goldstein et al., 2023; Haktanir et al., 2023). These can include understanding anger and its sources, as well as learning how to channel and express anger more constructively. Social and Interpersonal Skills Therapy for children and adolescents can enhance their social skills and relationships with others. Many youth may struggle with peer interactions, and mental health professionals can help them develop the tools to navigate the social world more effectively. Through role-playing, group therapy sessions, or targeted social skills training, children learn and practice important interpersonal behaviors like sharing, assertiveness, active listening, and empathy (Addington et al., 2021). For adolescents, therapy can address issues like peer pressure, loneliness, or communication difficulties. By discussing their social experiences in counseling, teens often gain perspective and confidence in handling relationships. Therapists may coach them on strategies for dealing with bullying or exclusion, which can aid in building resilience (Gubbels et al., 2021; Gilmore et al., 2022). Academic and School Performance Mental health treatment for youth is linked not only to personal well-being but also to improved academic performance and school outcomes. Research shows that effective therapy can produce meaningful gains in various academically relevant areas (Sulimani-Aidan & Melkman, 2021). Psychotherapy showed an overall positive effect on academic-related outcomes, including improvements in classroom attendance, academic achievement test scores, and self-reported school adjustment (Cujipers et al., 2023). Therapy often targets skills that are crucial for academic success, such as organization, time management, and problem-solving. Many interventions aid in teaching children how to plan tasks or cope with stress. By boosting hope and self-esteem, therapy helps children feel more connected and competent at school. Long-Term Developmental Benefits Early mental health intervention can yield long-term benefits that extend into adolescence and adulthood. In a longitudinal study tracking children who received mental health treatment versus those who did not, the treated children were found to have fewer depression and anxiety symptoms by age 30. They also achieved better economic and educational outcomes in adulthood compared to their untreated peers (Simeonova et al., 2023). This suggests that getting help early not only improves how a child is doing in the present but also sets them up for a more successful and stable future. References:
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 Trauma is a phenomenon that occurs when our natural coping mechanisms are unable to deal with a specific event or experience. We all have natural coping mechanisms, like emotional appraisal, social support or religion, to provide us a sense of control and safety under stressful conditions. However, certain events are so overwhelming that our defense mechanisms fail and affect our lives even after the event (Neurobiology of trauma). These events may include serious accidents, death of a loved one, sexual assault, domestic abuse, war, torture, etc (NHS). In the majority of cases, trauma leads to temporary, acute disturbances that lead to minimal functional impairment to the life of the individual. The three main classes of symptoms include 1) intrusive recollection of exposure (flashbacks and nightmares), 2) activation (hyperarousal, increased anxiety, irritability and impulsivity), and 3) inactivation (emotional numbing, avoidance, depression). In a minority of cases, however, these effects of a traumatic experience are more long-lasting and can seriously impair daily life functions (Bisson, 2015). These cases are labeled as Post-Traumatic Stress Disorders (PTSD) and occur in approximately 1 in 3 individuals that have experienced trauma (NHS). Unfortunately, the exact cause of PTSD and other trauma-related disorders is unclear and highly debated. One theory is that the lasting effects of trauma are a form of defense mechanism against future similar situations. For example, emotional numbing may be a way to deal with the extreme emotional stress that comes with trauma (Fang, 2020). Hyperarousal and increased anxiety may be a way to be more prepared and aware of potentially dangerous situations. Flashbacks may be a way to remind yourself of the traumatic event so that you are better prepared if a similar event happens again (NHS). Another more neurobiology-based theory is that PTSD is a result of changes in the brain chemistry that lead to abnormal regulation of certain hormones and neurotransmitters. This, in turn, leads to abnormal levels of these hormones and neurotransmitters in the brain and may be responsible for the effects of PTSD (Sherin, 2011). The major area of the brain that is affected by PTSD and is thought to be responsible for the effects of PTSD is the limbic system. The limbic system includes the amygdala, hippocampus and hypothalamus. The amygdala is the “fear” center of the brain and is responsible for processing threatening or frightening stimuli such as encountering a bear in the forest or your brakes not working on the freeway. So, it makes sense that the amygdala is one of the parts of the brain most affected by trauma. Trauma response and memory are stored in the amygdala, which is why a lot of emotions are evoked when recalling a traumatic experience. The hippocampus is the memory organ of the brain and has been found to be smaller in volume in PTSD patients (Sherin, 2011). This may explain why PTSD patients have difficulty accurately recalling the exact events of a traumatic experience in the correct chronological order, a phenomenon called fragmented memory (Bedard-Gilligan, 2012). The hypothalamus is the part of the brain responsible for maintaining homeostasis and activating the fight or flight response. The hypothalamus is also believed to be affected by trauma and may explain the abnormal regulation of hormones in the brain.  Another area of the brain that is linked to the effects of PTSD and is the focus of research on PTSD is the HPA (hypothalamus-pituitary-adrenal) axis. The HPA axis includes the hypothalamus, anterior and posterior pituitary glands and the adrenal glands. The different organs of the HPA axis communicate with one another to ultimately facilitate the activation and release of hormones responsible for the normal stress response and homeostasis. PTSD is thought to impair the HPA axis in a way that either overexpresses or underexpresses levels of these hormones in our body (Sherin, 2011). One hormone linked to PTSD is cortisol, also known as the “stress hormone” for its role in regulating our stress response under conditions of high stress. PTSD patients have been found to have generally lower levels of cortisol, which may explain their improper stress response and reduced ability to deal with future stressful situations. Another such hormone is the thyroid hormone, which controls metabolism in our body. Two thyroid hormones, T3 and T4, have been found at increased levels in PTSD patients and may be linked to subjective anxiety in these patients (Sherin, 2011).  Additionally, abnormal levels of certain neurotransmitters have also been associated with PTSD, like Norepinephrine (NE) and Serotonin. NE, which is released by the adrenal glands, is responsible for the autonomic stress response system, better known as the fight or flight response. NE causes increased blood pressure, heart rate and skin conductance under high stress conditions to prepare our bodies to cope with the stress. NE hyperactivity in PTSD patients may help explain the hyperarousal, increased anxiety and flashbacks that patients experience (Sherin, 2011). Serotonin is another key neurotransmitter that is responsible for regulating sleep, appetite, impulsivity and happiness. Decreased levels of serotonin have been found in PTSD patients, which may help explain their impulsivity, depression and suicidal tendencies. For example, MDMA, which artificially increases serotonin levels, has been found to have therapeutic potential for treating PTSD (Sherin, 2011). It is unclear whether these factors associated with PTSD are the result of trauma, or are pre-existing conditions that predispose certain individuals to PTSD after traumatic experiences. Certain genetic factors have been associated with increased susceptibility to PTSD. For example, studies have shown that PTSD-like brain structures, like reduced amygdala, may be heritable and can therefore predispose an individual to higher risk of PTSD. Another such factor is gender, where females may be more susceptible to PTSD due to their increased HPA stress response. Lastly, early developmental factors may predispose an individual to PTSD. For example, children with date violence experience have been shown to be more susceptible to PTSD in the future (Sherin, 2011).  Although there are many correlating factors to trauma and trauma-related disorders, there is no clear neurobiological cause of PTSD. Future research should look into which of these factors directly leads to the symptoms we see in PTSD and what can be done to prevent trauma-related disorders. It is also important to study which factors impact resiliency and vulnerability to be able to better prepare for potentially traumatic experiences and cope with the lasting effects of trauma (Sherin, 2011). References
Bedard-Gilligan, M., & Zoellner, L. A. (2012). Dissociation and memory fragmentation in post-traumatic stress disorder: an evaluation of the dissociative encoding hypothesis. Memory (Hove, England), 20(3), 277–299. https://doi.org/10.1080/09658211.2012.655747 Bisson, J. I., Cosgrove, S., Lewis, C., & Robert, N. P. (2015). Post-traumatic stress disorder. BMJ (Clinical research ed.), 351, h6161. https://doi.org/10.1136/bmj.h6161 Fang, S., Chung, M. C., & Wang, Y. (2020). The impact of past trauma on psychological distress: The roles of defense mechanisms and alexithymia. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.00992 Neurobiology of trauma - the sexual trauma & abuse care center. (n.d.). NHS. (n.d.). Causes - Post-traumatic stress disorder. NHS choices. Sherin, J. E., & Nemeroff, C. B. (2011). Post-traumatic stress disorder: The neurobiological impact of psychological trauma. Dialogues in Clinical Neuroscience, 13(3), 263–278. https://doi.org/10.31887/dcns.2011.13.2/jsherin An important aspect of veterans' mental health is moral injury (MI) and its impact. A moral injury can occur in response to acting or witnessing behaviors that go against an individual's values and moral beliefs. In traumatic situations, people may perpetrate, fail to prevent, or witness events that contradict deeply held moral beliefs and expectations (Norman & Maguen, 2021). Of veterans, over half have experienced moral injuries (Koenig et al., 2019). It’s often associated with a comorbidity of mental health issues such as suicide ideation and post-traumatic stress disorder (PTSD).
Research has shown that moral injury is common among veterans with PTSD (Currier et al., 2019). Moral injury can accompany feelings of guilt, shame, self-condemnation, loss of trust, loss of meaning, and spiritual struggles. Veterans who experience PTSD symptoms might struggle with co-occurring cognitive, emotional, and behavioral conflicts that may have been caused by moral injuries. For some individuals, transgressing cherished moral values or experiencing betrayal by trusted others in high-stakes situations may be severely traumatic (Koenig et al., 2019). The identification and treatment of MI among those with PTSD may help in the management of symptoms. Recent research suggests that exposure to potentially morally injurious experiences may be associated with an increased risk for suicidal behavior among US combat veterans. Data from survey results were analyzed and showed that depression and PTSD were strong correlators of suicide ideation and attempts among those who experienced moral injury (Nichter et al., 2021). The events in combat and other missions may violate one’s deeply held belief systems and, for some service members, may result in inner conflict. Exposure to wartime atrocities and combat-related guilt has been shown to predict increased suicidal ideation (Bravo et al., 2020). To better inform prevention and treatment efforts among veterans, it’s important to identify risk factors that may moderate associations between moral injury and suicidal behavior. Moral injury can be self-directed or other-directed. The two categories are defined by the attribution of responsibility for the event: personal responsibility (veteran's reported distress is related to his own behavior) versus responsibility of others (veteran's distress is related to actions taken by others) (Schorr et al., 2018). In one study, self-compassion was found to combat feelings of overidentification, or a tendency to overidentify with one’s failings and shortcomings that resulted after self-directed moral injury. Mindfulness and social connectedness also were found to weaken the impact of other-directed moral injury (Kelley et al., 2019). Prayer and meditation teach individuals to bring awareness to the present moment, with a sense of nonjudgment and acceptance of current thoughts, emotions, and sensations. These may be variables that mental health professionals should consider when working with veterans who have experienced moral injuries. Some resources on moral injury include:
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