When kids ask about people they see in crisis

Trying to guide them through a sometimes scary, sad, unjust world

Flickr/kennethkonica

I received a tough question from a reader last year about a topic that there’s no one good answer to:

For those of us on the west coast, we are confronted with a massive unhoused population crisis. In my town of Eugene, OR, we regularly see people in various states of extreme distress, drug use, and mental crisis, etc. How do other witches talk about homelessness, drug use, and mental crises to their young children? 

Also, I’m not sure how long my “they are sick and don’t have control of their body and mind” attempts at explaining episodes of distress will hold up. How do other witches explain public displays of distress and erratic behavior?  

For this question, I reached out to mothers who work in the fields of social work, pediatrics, public health and psychology about what they do and advise. These answers have been edited and condensed. This isn’t very witchy in the sense that it’s snarky or mother-focused, but I hope, at the very least, it can help parents be honest, have hard ongoing conversations with their kids, and let them practice compassion, empathy, and good judgment.

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Dr Devika Bhushan

is a pediatrician, public health leader, and newsletter writer in the Bay Area who writes about health innovation and equity:

What do you recommend parents say to kids about a topic that is so hard that people don’t have a good solution to?

It’s very easy for kids to develop a sense of invulnerability and a sense of otherizing people who have a very different experience on a day-to-day basis than they do. Whether it’s somebody who’s unsheltered or somebody who’s having a mental health crisis, it’s so important to try to put your kid in that person’s shoes without scaring them without making them feel like they are in imminent danger.

Any one of us could end up unsheltered. Any one of us could end up in a full-blown mental illness crisis and need help. With my two-and-a-half-year-old, I might say, “Hey, look across the street. That person may be feeling like they need help. Is there anything that you think we could do to help him?” Things of that nature create that bridge to whatever that experience is.

What do you think is a rule of thumb for talking to kids about people in public who are exhibiting significant mental illness symptoms, and it may be frightening to them? How do you explain that to them?

If you are a parent with a mental illness, be as straightforward with your kids about that as possible. My son knows I take medicine every day, that I need it for my health, and that I need to sleep a certain amount. It’s a very normalized part of our household. But the tricky part comes when you see somebody who is at an ill moment in their illness and how to explain what’s going on without creating fear. When we think about stigma, people are afraid of what they don’t understand.

Epilepsy used to be a very stigmatized and feared condition, but then we figured out the exact brain bases for different kinds of seizures and epileptic disorders, and it’s understood, and it’s no longer feared. That’s the same principle here. What is going on may look outwardly very, very stressful and fear-inducing. We can liken it to something like epilepsy; if somebody has ever witnessed a seizure, it actually can look kind of scary. The same thing can happen with a mental illness crisis. Help them understand that this person is ill right now; this is coming from a health condition, but that there are treatments for this exact health condition that this person may need help to access.

If a child did see someone, say, nodding out in a public place, what is a way to explain to them that this is a thing that these folks are technically doing to themselves, but they didn’t choose this? It’s not a matter of bad choices, and I don’t want you to stigmatize them, but also, I don’t want you to be like this. It might be scary for the kids to see.

You might say, “You know how when so-and-so drinks alcohol, they become louder, or they become this way or that way, and you can understand that there’s a chemical that is changing their brain, their behavior at that moment.” This is a very similar thing. It is a more intensive chemical if you will, that can alter brain and behavior. After you start using it, it can become something that takes on a life of its own, and it becomes a health problem where you don’t have the ability to stop using it on your own, and you need treatment, behavioral modifications and oftentimes medications to help redo the biological underpinnings.

Emphasize that a substance use disorder is very much a health condition, and it’s not something that is somebody’s free will or choice to have.

I wrote a while ago about people who take shelter at libraries. Let’s say kids are sharing a space with a person who might smell unpleasant or perhaps have private parts visible and have questions about that. How do you teach kids to be empathetic but also to trust their judgment without othering someone?

[I would say] “This person has not probably had a shower in several days and we don’t know how long it’s been because they don’t have a house, they don’t have a place to go to take a shower.” Help them understand that this person is not there to hurt them, that they are just occupying the same public space that they are entitled to, and there are reasons that their appearance or their odor or other facets of their being may be quite different from what your child is used to seeing.

There are people in the world who don’t have the help that they need, and a few dollars or a meal at a soup kitchen won’t help their problems. How can you explain that to kids in a way that won’t make them scared or feel like the world is a hopeless place?

If you see something that’s happening and you’re rushing to, let’s say, a doctor’s appointment, just say, “Okay, this is a lot and I want to unpack all of this with you. Let’s do it tonight at dinner.” You want to allow them to ask the questions, allowing you yourself to go there with them.

Here’s a study that helps us understand that children as young as 5 can understand structural factors that drive inequities. Understanding structural inequities helps kids displace false narratives around individual culpability that might be driving outcomes like being unhoused or having a mental health crisis.

When we don’t give them information that they are seeking and even craving, we run the risk of fostering false narratives and increased fear. Fear is driven by having insufficient solid information and understanding about something, and when we don’t directly address the questions our kids have, they live in a heightened state of anxiety about the situation at hand and may turn to alternate sources for information that are less complete, more biased, and even more fear-inducing.

Rather than seeing this as a shattering of their innocence, I would encourage caregivers to understand these tough and important conversations as setting the stage for children to become more empathic, nuanced, and informed citizens of this world.

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Noemie Lemasson is a licensed master social worker in New York City with experience working in the shelter system:

I don’t know what your philosophy is, but something that comes up with kids is, “Why don’t we just go give money to all the homeless people that we see?” How can you explain that that’s not feasible or going to necessarily be helpful?

If my son wants to be generous with what he has, then I encourage it. I don’t always think it’s the answer. But what we tend to do is ask somebody, “Do you want something? Do you want us to go get you a slice of pizza?” We’re helping someone who needs help. Even if it’s just for that moment, we gave them kindness.

I do explain that it’s not the answer. What’s important when you’re talking to children is to use the Socratic method to ask them questions instead of just spoon-feeding them what you’re thinking. I want him to learn to think critically and to ask questions. “What are some reasons someone might be homeless?” We talk about race as well. I also teach him that things come from the top down, and that’s why it’s important to who we vote for and the policies that we advocate for. I try and be a good model of that as well.

I’m honest with him about what we do, how it does take money, and how it’s important that we have these advocates. It’s important to fund them. I tell him, “We can’t fix everybody’s problem.”

If you see someone in public having a mental health crisis, how do you talk about it with your child?

As my son was younger, I thought about how to explain mental health in a way that’s palatable. If someone’s having a mental health crisis, I would say, “This is someone’s mind playing tricks on them. Did you ever sit in a room and maybe you think you hear something and the other room and there’s nothing there?” and equating it to medical issues.

We don’t blame people who have diabetes, we don’t blame people who have high blood pressure, we give them care, and we consider it a legitimate medical condition. As he got older, I started talking to him about the many systems that have failed these people.

Sometimes, you have to keep your own safety in mind, so I was just curious when that comes into play how you advise talking to kids about that who might be frightened of folks whom they may perceive as threatening.

In terms of yelling and screaming, I explain that that man’s or that woman’s mind is playing tricks on them. Whoever they’re talking to is very, very real to them. In terms of emergency situations, when I’m with my son, his safety comes first, so I never want to put myself in a situation where he could get hurt. That’s a natural maternal instinct.

Maybe two years ago, I witnessed somebody who was having an emergency. I had Narcan on me, but I also had my son, and he got scared to the point where I said, “It’s too much. It’s becoming traumatizing to him.” I made sure the man had help; someone had called 9-1-1. But the instinct for me to help, I had to rein it in because he was clearly having a hard time with it.

In terms of whether it starts to get aggressive, then when you’re with your child, you have to just put that first. But when I’m by myself, I definitely help out when I can.

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Erin O’Connor is a developmental psychologist in New York, the host of the podcast Parenting Understood and the chief of education at the parenting coaching platform Cooper:


Tell me what kind of conversations you have with your kids about the people you see in New York who might be in crisis.

Being unsheltered and having mental illness don’t always go hand in hand, so the conversations can be different based on what you’re seeing.

With my youngest one, who’s three and a half, she asked, “Why is that person sleeping on the street?” I try to provide a pretty concrete answer. “Unfortunately, they don’t have a place to sleep. Not everybody has a place to sleep.” In very child-friendly terms, I said, “We pay money to live in our apartment. They just don’t have the money for that.” I leave it at that.

You want your children to feel comfortable coming to you with all different sorts of stuff. This is one of those topics where you have the opportunity to show them that you are honest and open and comfortable discussing these things.

When it comes to behavior indicative of a mental difference or substance abuse, any sort of behavior that’s out of the norm for that one, with young children, [it’s best to be] very honest, concrete and simple. “We all have brains and brains help our bodies determine what to do. Sometimes people’s brains work differently and that makes them act in a way that maybe makes it uncomfortable, but their brains are just acting differently maybe than ours.” Just leave it at that, not getting into too much.

Tell me about the kind of conversations that you have with your 15-year-old compared to your younger child.

We’ve been having a lot of conversations around substance use. We were in San Francisco recently, and we witnessed somebody shooting up, and she said to me, she’s like, “I know what’s going on.” This poor person had blood all over their arm.

I said, “Sometimes people make decisions about trying substances and there’s just a biological reason that they cannot get off them without a lot of help. That help is there, but it’s not always that available for everybody. People get into this cycle of substance abuse it’s hard to get out of.”

My 8-year-old found a penny on the ground, and he said he wanted to go give it to a homeless person, and I’m like, “I love your impetus, but...” It was hard to explain why someone might not appreciate that.

One thing that a friend of mine did, which I thought was a neat idea, was she has a jar, and when they have extra change or her child finds something, she’s like, “Put it in the jar. Once we’re at $10, we’re going to donate to the soup kitchen, and they’ll use it to give food to people who need it.”

Sometimes, interactions with people in crisis might be scary for children. How do you handle that?

When my older daughter was probably eight, we were walking down a side street. Someone lunged at us, and it was scary. I found the nearest doorman building, and we went in there, and I explained to him what was happening. Afterwards, I checked in with my older one. “What was that experience like for you?”

She was like, “That was scary.” I focused more at that point on what you do in a situation like that. I was like, “We got away. We went to a safe place.” We called 311. I said, “We’re also trying to find help for that person who’s obviously in distress right now. We can’t help them ourselves other than by calling people who know how to handle a situation like this.”

I don’t know if it was the right way to handle it, but just that idea of personal safety some action you can take.

Anything else that you have learned from your work in academia in addition to being a mom about what kids can handle?

When we address the homeless issues, make sure we don’t always couple it with substance abuse and mental illness in our conversations with children is important. Those are three distinctive, sometimes overlapping concerns.

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Bethany Dayton is a mental health therapist in Tennessee specializing in women’s mental health and trauma. She emailed me her response to the original writer’s question:

When it comes to your children, listen and watch: What are they asking? What do they think? What do they feel? Do I know this before I start to answer? This also includes knowing your child’s disposition. Are they anxious? Sensitive? Let them know you care about what they are asking. You think what they think and feel is important.

Regarding psychoeducation, we have to separate the three large topics: unhoused, addiction and severe mental illness. Experts disagree on the Venn diagram here. Not to mention they disagree on the problem and the solution.

Simply put, life is harder for some people than others. This is a crucial statement for our kids to understand. There are a lot of holistic reasons for this (physical, mental, spiritual, environmental, financial etc). 

There are people who do not have enough resources and support to have housing. With preschool age it makes sense to explain they don’t have enough resources to have a house. Maybe we have more than enough, so this is how we share and help. Let them have some idea. My 4-year-old loves to pick out food for our local food box.

We have people who, I believe, are unhoused with addiction issues that walk down our street screaming at each other. This is an example of me calmly bringing my kids inside and explaining that I’m going to look to make sure they are safe. “Wow, they were loud and angry with each other, but they were not yelling at us. We are okay and safe. I’m going to check and make sure they are okay.”

When it comes to severe mental illness, if we see someone who is responding to internal stimuli, we can explain to our children that their brains work differently than ours. They are responding to something they are hearing or seeing inside of their own brain and not experiencing the world in the same way you and I do. They might not be feeling what it seems like they are feeling, and this can be confusing. Someone might be yelling and seem angry, but they are not actually angry.

As always, it is helpful and wise to sometimes say, “Wow, that is a good question. One that I am not even sure how to answer. I’m going to go read some and talk to people who know about this more than I do for some help.”

Remember, we as parents can’t be experts on every difficult topic. We are going to make mistakes; we will say things wrong. Be gentle and kind with yourself.

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Resources:

In terms of organizations to help people who are unhoused, Noemie recommended New York Cares and Coalition for the Homeless. If you aren’t based in New York, she recommended seeking out community-based organizations that work where you live.

Dr. Bhushan recommends checking out UCSF’s housing and homelessness initiative and they’re doing a series of op-eds in strategic places around the country on common myths and misperceptions. They’ve done deep dives into substance use disorder or mental illness, and homelessness as they intersect.

For more information on talking to children about hard things, Bethany recommends resources like Janet Lansbury and Dr. Becky and the American Psychological Association, as well as Child Mind Institute, The Trauma Institute, Greater Good Magazine, and the Housman Institute.

Finally, I bookmarked this guide from Vox over the holidays about interpersonal, systemic and financial ways you and your children can try to help.

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One witchy thing

I was at my friend’s house yesterday, picking up my son, and I noticed this kids’ checklist on their door.

Then I looked again and saw the witchy part.