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Teen Mental Health: Warning Signs Parents Should Know
How parents in Mercer, McDowell, and Wyoming counties can get a teenager connected to behavioral health care, what it costs, and how school-based services and crisis lines work.
Most parents who call us about a teenager start the same way: something has changed, they are not sure how much of it is normal, and they have been going back and forth about whether to do anything.
This guide is about what to do with that uncertainty. Not how to diagnose it, but how to get a teenager connected to care in Southern West Virginia, what it costs, and how school fits in.
We are not going to give you a checklist
There is no shortage of articles listing warning signs, and we are not adding another one. Sorting out what is ordinary adolescence and what is not is a clinical judgment about a specific young person, and it depends on their history and circumstances in ways an article cannot account for.
More to the point, you do not need to make that call yourself. That is what an assessment is for.
Southern Highlands provides services for adolescents in Mercer, McDowell, and Wyoming counties. Call (304) 425-9541, or the Children’s Clinic in Princeton at 304-818-2225.
If you want general reference material about adolescent mental health from a public health agency rather than a treatment provider, the National Institute of Mental Health publishes it at https://www.nimh.nih.gov/, and SAMHSA at https://www.samhsa.gov/.
If your teen is in danger right now
Do not work through this article first.
- 911 if there is immediate physical danger
- 988, the Suicide and Crisis Lifeline, by call or text (https://988lifeline.org/)
- Text HOME to 741741 for the Crisis Text Line, which some teens will use when they will not make a phone call
- 1-800-615-0122, the Southern Highlands crisis line, 24 hours a day
- Walk into our Crisis Stabilization Unit
You do not need an appointment and you do not need to have called ahead.
You do not have to be certain before you call
Parents hesitate because they do not want to overreact, or because they are afraid of what a call sets in motion.
Calling gets you a conversation and, if you want it, an assessment. That is the whole thing. You can describe what you have been seeing and let someone who works with adolescents tell you what they make of it.
You do not need a referral from a doctor. You can call directly.
Why teens often do not ask on their own
Waiting for a teenager to come to you can be a long wait, and it helps to know why.
They think they should handle it themselves. Independence is the whole developmental project at that age, and asking an adult for help can feel like losing ground.
They think no one will get it. Including, and often especially, their parents.
They do not want to worry you. Some teens go quiet specifically to protect their families, particularly when the household is already dealing with something.
They think they will get in trouble. If there is anything going on they would be in trouble for, that calculation usually wins.
None of this means they do not want help. It means the first move is usually going to be yours.
Starting the conversation
There is no script that makes this comfortable. A few things parents tell us make it go better:
Pick a low-pressure moment. In the truck, doing something side by side, not in the middle of an argument.
Be direct and calm. “I’ve noticed things have been different lately. What’s going on with you?”
Listen longer than feels natural. The reflex is to jump in and fix it. Resist it.
Do not minimize. “Everyone feels that way” ends the conversation, even when it is true.
Ask open questions. Anything answerable with yes or no will be answered with yes or no.
Make getting help sound ordinary. Because it is. Plenty of people around here see somebody.
If the conversation goes badly, it is not wasted. You have told them the door is open, and teens often come back to it days later.
If they will not talk to you
Common, and not a dead end.
- Suggest another adult they trust: an aunt, a coach, a youth pastor, a school counselor.
- Offer counseling specifically as somewhere they can talk that is not the family.
- Give them numbers they can use on their own, including 988 and the Crisis Text Line at 741741.
- Call yourself and ask what your options are. You can start the process without their buy-in.
What to expect logistically
Privacy. Teens are usually seen individually for at least part of the appointment. What they discuss is treated as confidential, with limits: if they are in danger, if someone is harming them, or if someone else is at risk, the clinician acts and involves you. Ask the clinician to explain exactly how they handle this at the first appointment, and ask in front of your teen so everyone hears the same answer.
Parent involvement. You should be getting regular check-ins about how things are going and what the plan is. Individual time for your teen does not mean you are shut out.
Scheduling. Ask about the earliest and latest appointment slots, and whether anything can be done by video, especially if you are driving in from Wyoming or McDowell County.
Records. Bring insurance information, a photo ID, custody paperwork if it applies, a list of any medications, school records or grade reports, and contact information for previous providers.
If your teen flat-out refuses
“I’m not crazy.” “I don’t need this.” “You can’t make me talk.”
Things other parents have found useful:
- Give them control over the parts you can. Let them have a say in the appointment time.
- Tell them they do not have to say anything in the first session.
- Be honest about why you are asking rather than dressing it up.
- Consider going yourself first, so it is something the family does rather than something being done to them.
- Call and tell staff your teen is refusing. They have handled this before.
School-based services
Southern Highlands provides school-based services in Mercer, McDowell, and Wyoming county schools, and for teenagers this often works better than a clinic appointment.
Why:
- No drive, no gas money, no evening appointment after a shift
- No time off work for you
- Your teen does not have to announce to the household that they are going
- The clinician can coordinate with school staff, with your written permission
How to start:
- Talk to your teen’s school counselor
- Call SHCMHC at (304) 425-9541
- The school can refer with written parent permission
Nothing is shared between the school and the clinic without a release you sign, and session content is not reported back to teachers.
The “just push through it” problem
There is a strong culture in Southern West Virginia of dealing with things privately. “I’ve been through worse.” “Other people have it harder.”
It is not a character flaw, and in a lot of situations it has served families here well. But it keeps people from making a phone call that would not cost them anything, and teenagers absorb that message from the adults around them.
If your teen has picked it up from you, the most useful thing you can do is contradict it out loud.
Cost
WV Medicaid and WV CHIP. Adolescent behavioral health services are covered, including school-based services. Staff can verify coverage before the first visit.
Private insurance. Most plans cover adolescent behavioral health. Copays vary by plan. The number on the back of the card will tell you what yours requires.
No insurance. We use a sliding fee scale based on household income. You bring documentation of household income and the fee is set from there. As a CCBHC, our job is to serve the people in our service area, and cost is meant to be worked out rather than to end the conversation. Ask for the business office at (304) 425-9541.
Getting there
- Telehealth, where the service allows it. Ask when you call.
- School-based services, which remove the trip entirely.
- Medicaid non-emergency medical transportation. Staff can explain how to arrange it.
- Scheduling around trips you already make into Princeton or Mullens.
Frequently Asked Questions
Do I need a referral?
No. Call (304) 425-9541 and schedule directly.
Where are adolescent services available?
Services for children and adolescents are based at our Children’s Clinic in Princeton, with children’s services also at our Mullens clinic, plus school-based services in Mercer, McDowell, and Wyoming county schools.
Will my teen tell the clinician things they will not tell me?
Probably, and that is part of why it works. Ask the clinician at the first appointment to explain their confidentiality practices and the limits on them, so you and your teen hear the same thing at the same time.
What if my teen says something serious in session?
Confidentiality has limits. If your teen is in danger, if someone is harming them, or if someone else is at risk, the clinician acts on it and involves you.
Can I make my teen go?
You can require them to show up. Call and tell staff you are dealing with a reluctant teenager, and ask how they usually handle it.
What if we cannot afford it?
Ask about the sliding fee scale. Fees are set from household income.
Can appointments be done by video?
Some can. It depends on the service. Ask when you call.
What do I do at 2 a.m. when nothing is open?
Everything is open. Call 988 or 1-800-615-0122, text HOME to 741741, or call 911 if there is immediate physical danger. The crisis line is staffed around the clock, and you can walk into the Crisis Stabilization Unit.
If you would like to schedule an appointment for a teenager in Southern West Virginia, call Southern Highlands at (304) 425-9541, or the Children’s Clinic in Princeton at 304-818-2225. We serve Mercer, McDowell, and Wyoming counties. No referral needed.