Conversations with children and teenagers.

Find a quiet place where you can talk without interruptions. Explain why you are talking and how much time you have. Adapt questions to the child's age, language and way of communicating. Use a qualified interpreter when needed.

Be clear about your role. As a teacher, you can listen, support and make adjustments. As a healthcare professional, you can also assess symptoms and healthcare needs within your responsibilities.

For a child: “I've noticed that you often leave the classroom. How are you feeling? Is there anything you would like me to know?”

For a teenager: “You mentioned that pain makes the school day difficult. Could you tell me more about what that is like for you?”

Ask open questions one at a time and let the child use their own words. Explore what they tell you without steering their answers. You might ask: “What do you mean by that?” or “What would you like help with now?”

1. Let the child or teenager finish speaking. Allow silence and breaks.
2. Summarise using the child's own words: “Have I understood you correctly when you say …?”
3. Explore how the experience affects daily life, including school, sleep, friendships and leisure activities.
4. Ask what the child would like to happen next. They may want information, practical support, another conversation or contact with a healthcare professional.
5. Agree on a specific next step, who is responsible and when you will speak again.

Find out what the child is actually experiencing before deciding whether a symptom is common. Even common symptoms may need attention when they affect daily life. A good conversation makes room for both the child's account and the need for further follow-up.

Some teenagers experience mood changes after starting or switching hormonal contraception. These can include low mood, irritability, mood swings or other mental health symptoms. Take these experiences seriously, even when the cause is uncertain.

Some population studies have found associations between hormonal contraception and depressive symptoms or diagnoses. However, findings vary, and an association does not necessarily mean contraception caused the symptoms. Risks and experiences may differ between individuals and methods. Other circumstances in the young person's life can also affect mental health.

Ask about their experience

Begin with how the teenager describes the change. For example, ask:

• “What have you noticed is different about your mood?”
• “When did you first notice these changes?”
• “How does this affect your sleep, school, friends or other parts of everyday life?”
• “Has anything else happened during this time that you would like to tell me about?”
• “What would you like help with right now?”

If the teenager brings up contraception, you can ask: “You say this began after you started contraception. Have you had a chance to talk about it with a healthcare professional?”

Distinguish support from medical assessment

As a teacher, you can listen, acknowledge the teenager's experience, arrange appropriate adjustments and help them contact a school nurse or other healthcare professional. Avoid drawing medical conclusions or recommending a particular contraceptive method.

Qualified healthcare professionals can assess the symptoms, the timing of starting or switching contraception, relevant mental health history and other possible explanations. The assessment must also consider severity, effects on functioning and any need for further healthcare.

If switching or stopping a contraceptive method is considered, the teenager needs individualised advice. Consider the need for continuing pregnancy protection and the risks of a possible gap in contraceptive use.

Take the teenager's concerns seriously

Avoid responses that dismiss the experience or assume contraception must be the cause. For example: “I hear that things have felt different since you started contraception. It is important that we explore how you are feeling and find out what support you need.”

Explain confidentiality so the teenager understands what information may be shared with parents and others. Adapt follow-up to age, circumstances and applicable rules.

When symptoms are severe

A teenager with significant low mood, reduced functioning or other serious mental health symptoms should receive a healthcare assessment. Ask directly about self-harm and suicidal thoughts when there is cause for concern.

If there is an immediate risk of suicide or another threat to life or health, call 113 and ensure the teenager is not left alone. For urgent medical assessment that cannot wait until the GP is available, call 116 117.

Explain early on what can remain confidential and when you may have a responsibility to involve others. You might say: “I will treat what you tell me with care. If I am concerned about your safety, I may need to seek help. I will explain what I am doing.”

Teachers and healthcare professionals have different requirements for confidentiality, documentation and information sharing. Know the rules applicable to your role. Share information where there is a legal basis or obligation, and use your organisation's approved systems.

In healthcare, the general rule is that parents receive information when a child is under 16. Exceptions apply, including for children aged 12–16 whose reasons for confidentiality should be respected. From 16, teenagers generally make their own healthcare decisions. Until 18, parents may still be entitled to information necessary to fulfil their parental responsibilities. Healthcare professionals must assess each situation.

Take the disclosure seriously. You might say: “Thank you for telling me. You will get help.” Let the child speak in their own words and at their own pace. Ask open questions necessary to understand immediate safety and support needs. Leave detailed investigation to the responsible qualified authorities and avoid making the child repeat their account to many adults.

Follow applicable procedures and assess the need for immediate protection. The duty to report to child welfare services is personal when the legal conditions are met. Consulting a manager may help but does not replace the duty or justify delaying a necessary report.

If violence or sexual abuse is suspected, contact with parents requires separate consideration. If providing information could put the child at risk or hinder protection, consult child welfare services or the police about next steps before informing parents.

For an immediate threat to life or health, call 113. For urgent medical assessment when the GP is unavailable, call 116 117. Ensure that a responsible adult supports the child during an emergency.

For concerns without immediate danger, help the child access the school health service, GP or another appropriate service. Make the next steps concrete by agreeing on contact, responsibilities and follow-up.

“Help me explain” supports children and teenagers in putting their experiences into words. It can be used before or during a conversation. The child decides whether to share the text with you. Use the tool alongside professional judgement and avoid entering identifying information.