Red Flags & When to Go In Person for Low Mood in Children

Audience: pediatric

Low mood in children is common and can be caused by many factors, including stress, changes at home or school, or illness. Telemedicine can help families understand symptoms and get advice quickly. However, some signs suggest the child needs an in-person medical evaluation. These include thoughts of self-harm, sudden behavior changes, or difficulty functioning at school or home. Recognizing these red flags helps keep children safe and ensures they get the care they need. Telemedicine is a useful tool for initial support and follow-up but cannot replace hands-on exams or emergency care. Parents and caregivers should prepare for tele-visits by noting symptoms, changes in mood, and any concerns. After a tele-visit, following recommended steps and watching for worsening symptoms is important. This guide helps families decide when to use telemedicine and when to seek in-person care for a child's low mood.

Red flags — go in person / ER

• Child talks about or attempts self-harm or suicide — seek emergency care immediately.
• Sudden, severe changes in behavior or mood causing inability to function — arrange urgent in-person evaluation.
• Signs of physical illness with low mood (e.g., fever, injury) — seek prompt medical attention.

What telemedicine can do

• Initial assessment of low mood symptoms and concerns.
• Providing guidance on coping strategies and support.
• Monitoring mood changes and treatment progress remotely.
• Determining if in-person care is needed based on symptoms.

What telemedicine cannot do

• Emergency situations such as suicidal thoughts or self-harm attempts.
• Physical examinations requiring hands-on assessment.
• Severe behavioral changes needing immediate intervention.
• Diagnosis of complex psychiatric or medical conditions requiring in-person tests.

Understanding Low Mood in Children

Low mood, sometimes called sadness or feeling down, is a normal part of childhood. It can happen after stressful events like moving, family changes, or school problems. Often, low mood improves with time and support from family and friends. However, when low mood lasts for weeks or affects daily activities, it may need professional help.

When Telemedicine Can Help

Telemedicine allows you to talk with a healthcare provider from home. It is helpful for discussing symptoms, getting advice on managing mood, and deciding if further care is needed. Providers can offer support, suggest coping strategies, and help monitor your child's condition remotely.

Red Flags That Need In-Person Care

Certain signs mean your child should be seen in person quickly:

If you notice these, seek emergency or urgent care immediately.

Preparing for a Telemedicine Visit

To get the most from a tele-visit:

After the Telemedicine Visit

After your tele-visit:

When to Seek Emergency Care

If your child:

Call emergency services or go to the nearest emergency room immediately.

How to prepare for your tele-visit

• List your child's symptoms and how long they have been present.
• Note any recent changes in mood, behavior, or daily functioning.
• Prepare questions or concerns to discuss with the provider.
• Ensure a quiet, private space with a reliable internet connection.
• Have a device ready with camera and microphone enabled.
• Have information about your child's routine, support system, and any medications available.

After your tele-visit

• Follow the healthcare provider's recommendations and treatment plan.
• Monitor your child's mood and behavior for changes or worsening symptoms.
• Keep a symptom diary if advised to track progress.
• Schedule follow-up telemedicine or in-person visits as recommended.
• Seek immediate in-person care if red flags or emergency signs develop.

FAQs

Can telemedicine diagnose depression in children?

Telemedicine can help assess symptoms and provide guidance, but a full diagnosis often requires in-person evaluation, including physical exams and sometimes psychological testing.

What should I do if my child refuses to talk during a tele-visit?

Try to create a calm environment and encourage your child gently. Let the provider know about the difficulty; they may use different techniques or suggest an in-person visit.

Is telemedicine safe for managing low mood in children?

Yes, telemedicine is a safe and effective way to get initial advice and support. However, it is not a substitute for emergency or hands-on care when needed.

How can I help my child between visits?

Provide a supportive, understanding environment. Encourage healthy routines like regular sleep, physical activity, and social connections. Follow any coping strategies recommended by your provider.

When should I stop telemedicine and seek in-person care?

If your child's symptoms worsen, if they show red flags like self-harm thoughts, or if the provider advises, seek in-person evaluation promptly.

Sources

1. Depression in Children and Teens — MedlinePlus | U.S. National Library of Medicine.
2. Child and Adolescent Mental Health — World Health Organization (WHO).
3. Managing Mental Health Disorders in Children — American Academy of Pediatrics.
4. Telehealth for Mental Health — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational and informational purposes only and is not a substitute for professional in-person medical care. If your child shows any emergency signs or if you have concerns about their health, seek immediate in-person medical attention.