While a nurse’s primary role is to medically care for their patients, in reality, their true role is far more encompassing.

Often, nurses become a shoulder to cry on, a listening ear, even a friend, to both patients, and their families.

They also have a role to play in identifying external issues that may not have been previously recognised, such as signs of domestic violence, addiction, or mental ill-health.

A nurse’s ability to notice and understand the signs of such issues is critical, but challenging, and becomes even more complex when children are involved.

According to Psychotherapist, Dr Karen Phillip, the signs of mental illness can differ significantly between adults and children.

“Children can often act out or retreat, they tend to self-harm and use avoidance tactics,” says Dr Phillip.

“Adults can do similar, but adults often lose their temper, they drink excessively, take drugs or increase their gambling habit to escape their reality.”

Meaning adult responses can be more obvious to external parties. Adults are also more likely to disclose how they feel, when prompted.

“Children often do not understand what they are experiencing, and are sometimes unable to articulate their feelings,” says Dr Phillip.

“Adults understand better what it is they are experiencing and can explain it to a professional and seek help or pharmacology support.”

While more subtle, there are some key signs to look out for.

“Children can become angry at themselves and everyone else because they can not understand how they are feeling or the reason they feel so unsettled, anxious or unhappy.

“They may lash out with aggression or violence. Some withdraw completely, become more socially isolated, do not want to participate in family or social activities.”

Similar to younger children, teens may add self-harming to their repertoire, says Dr Phillip.

“They have easier access to drugs and alcohol, even when young and often participate in these activities to numb their emotions and mind.”

If a nurse suspects a child in their care is suffering from a mental illness, Dr Phillip suggests raising the issue with their parents, but warns they need to tread carefully, as in some cases the child’s condition may relate to issues at home.

“Referring to a counsellor or psychologist is always a smart avenue.

“This may be via their school nurse or their local doctor. Of course, parents need to be consulted but if referral is made then the doctor or school nurse can follow-up.

“An adult can make their own choices by making informed decisions, even if they choose against seeking support.

“The child is not yet capable of making and paying for their own appointment, let alone getting to the appointment.

“It is essential adults take responsibility for the child’s therapeutic recovery enabling the child to speak safely with a therapist.”

It is essential for a child suffering a mental or emotional issue to obtain professional help, says Dr Phillip.

“Children may unfortunately experience severe issues and obtaining therapeutic support can help guide them out of their current thoughts, behaviours, and feelings into something more positive before it becomes too embedded within them, and they lose hope for a future recovery.

“While developing, a child needs understanding, empathy, support, tolerance, and love.

“Kids do not have the capacity to understand what they feel or why, it is the responsibility of the adult to protect and care for them.

“Kids continue to slip through the cracks.

“Always keep the lines of communication open, listen without judgement, paraphrase to ensure you understand them and never tell them what to do or they shouldn’t feel as they may. Kids are our future and now more than ever the complexity of life is challenging for them.”