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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.

By Southern Highlands Community Mental Health Center Published July 20, 2026 · Updated August 10, 2026

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 may be seen individually for part of an appointment, depending on the service and circumstances. Their information is protected by privacy law, but parents and guardians generally have rights involving a minor’s care and records, subject to legal exceptions. Information may also be used or disclosed for treatment, payment, safety, reporting, court orders, and other purposes permitted or required by law. Ask the clinician to explain the rules 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

Routine clinic-school coordination commonly uses a parent or guardian authorization, but information may also be disclosed in circumstances permitted or required by law. School-held records may be governed by FERPA rather than HIPAA. Ask what operational information the school receives, what remains in the clinical record, and whether any session information would be shared before services begin.

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. Medically necessary adolescent behavioral health services may be covered when eligibility, provider, service, school arrangement, authorization, and current program requirements are met. Verify clinic-based and school-based services separately.

Private insurance. Coverage, network status, authorization, exclusions, and cost-sharing vary by plan and service. Call the number on the card and ask about the specific service and setting.

No insurance. As a CCBHC, Southern Highlands serves people regardless of ability to pay, but that does not make every service free. Ask the business office at (304) 425-9541 whether a household-income-based sliding fee applies, what documentation is required, and what charge may remain.

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?

Around-the-clock crisis contacts remain available: call or text 988, call 1-800-615-0122, text HOME to 741741, or call 911 for immediate physical danger. Call the local crisis line before traveling when possible to confirm the appropriate location, current capacity, and next step.


If you would like to request 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. You can contact the clinic directly, but a health plan or particular service may apply referral, authorization, eligibility, or medical-necessity rules.

Important Numbers and Websites

24/7 Crisis Line

1-800-615-0122

Available 24 hours a day, 7 days a week

Crisis Stabilization Unit (CSU)

(304) 431-2869

Direct line for crisis assessment

Mobile Crisis (Adult & Adolescent)

(304) 308-9293

988 Suicide/Crisis Lifeline

988

Crisis Text Line: Text HOME to 741741

988lifeline.org / crisistextline.org

National Sexual Assault Hotline

(800) 656-4673/HOPE rainn.org

National Runaway Safeline

(800) 786-2929/RUNAWAY 1800runaway.org

WV Safe Schools Helpline

(866) 723-3982/SAFEWV wvde.us

SAMHSA National Helpline

(800) 662-4357/HELP samhsa.gov

DHHR Centralized Intake for Abuse/Neglect

(800) 352-6513 dhhr.wv.gov

WV State Police

(304) 746-2100 wvsp.gov