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committed relationship with a supportive adult.124 Spend time with children on activities that are meaningful to them, show them love and acceptance, praise them for the things they do well, listen to them, and communicate openly about their feelings. Encourage children to ask for help and connect them with other adults who can serve as mentors.125 Encourage children and youth to build healthy social relationships with peers. This can be done through self-directed play and structured activities such as school, after school programs, sports, and volunteering.126 Since peers can play a major role (both positive and negative) in children’s development, it’s important to help children learn how to deal with peer pressure. Have open conversations with your child about their values and teach them to be confident and comfortable in expressing their needs and boundaries. Do your best to provide children and youth with a supportive, stable, and predictable home and neighborhood environment. A lot may be outside of your control, and there will be trial and error as you figure out what works best for your child. That said, try to help children stick to a regular and predictable daily schedule, such as regular dinnertime and bedtime.117, 126, 127 Be thoughtful about whether and how to discuss stressful topics such as financial and marital problems. The American Psychological Association offers tips on how to talk with your child about difficult topics.128 It’s also important to minimize children’s exposure to violence, which puts them at risk of mental health and substance use challenges.129 What Family Members and Caregivers Can Do WE CAN TAKE ACTION Protecting Youth Mental Health: The U.S. Surgeon General’s Advisory 17 Try to minimize negative influences and behaviors in young people’s lives. Talk to children early about the risks of alcohol and other drugs, both short-term (such as car crashes and other accidents) and long-term (such as reduced cognitive abilities). The earlier a child or adolescent begins using substances, the greater their chances of developing substance use problems.131 Mental health and substance use problems can also occur at the same time. For example, some young people struggling with stress or difficult feelings turn to alcohol or drug use.132 And alcohol and other drugs can also affect mental health, for example by altering mood or energy levels.133 Ensure children and youth have regular check-ups with a pediatrician, family doctor, or other health care professional. Health care professionals can help you monitor your children's health, give you advice on how to prevent problems, and diagnose and treat physical and mental illnesses. Obtaining health insurance coverage for your children can help. To learn more about enrolling in Medicaid, the Children’s Health Insurance Program (CHIP), or a Marketplace plan, go to HealthCare.gov or InsureKidsNow.gov. Look out for warning signs of distress, and seek help when needed. Signs of distress in children can show up in a number of ways, such as irritability, anger, withdrawal, and other changes in their thoughts, appearance, performance at school, sleeping or eating patterns, or other behaviors.)134 If you notice concerning changes in your child, let them know you’re there and ready to support them however they need. Don’t be afraid to ask for help by talking to a doctor, nurse, or other professional or looking into other available resources in your community. For example, schools often have counseling services and additional accommodations (e.g., for students enrolled in special education programs). Minimize children’s access to means of self-harm, including firearms and prescription medications. Dispose of unused or expired prescriptions and keep medications out of reach for children and youth. If you choose to keep firearms in the home, ensure that they are stored safely: unloaded and locked up (e.g., in a lock box or safe). Having firearms in the home increases the likelihood of firearm-related death.135, 136 In fact, firearms are by far the most lethal means of suicide: 90% of attempted suicides with a firearm result in death, compared to less than 10% of attempted suicides overall.137 Be attentive to how children and youth spend time online. Digital technology can help young people connect with friends and family, learn about current events, express themselves, and access telehealth and other resources.138 At the same time, children can have negative experiences online, such as being bullied, finding harmful information, and negatively comparing themselves to others.139 Box 3 has a list of questions you can ask yourself about your child’s use of technology. Be a voice for mental health in your community. There are many ways to do this, from talking openly with friends and family about the importance of mental health, to going to school board meetings or a town hall, to volunteering with an advocacy group, to promoting greater funding and awareness of mental health programs in schools and local organizations, such as churches, libraries, parks and recreation, or sports teams. Protecting Youth Mental Health: The U.S. Surgeon General’s Advisory 18 BOX 3 Technology and youth mental health: Questions for families to consider Time How much time is my child spending online? Is it taking away from healthy offline activities, such as
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