Warning signs in a teenager after the move and where to turn

Terms used

• Médico de cabecera — The médico de cabecera is the family doctor (GP) at your local public health centre.
• Centro de salud — The centro de salud is your local public health centre, where family doctors and pediatricians see patients.
• Orientador/a — The orientador/a is the school's counselling specialist, who supports students with learning or emotional needs and refers families to outside services.
• Evaluación psicopedagógica — The evaluación psicopedagógica is a school assessment of a student's learning and emotional needs.
• Urgencias — Urgencias is the emergency department of a hospital.

Key rules

• Immediate danger: If your teen is in immediate danger, call 112.
• Suicidal thoughts: For suicidal thoughts without immediate danger, call 024.
• Two weeks: Seek professional help if low mood, withdrawal, school refusal or sleep and eating changes last two weeks or more and are getting worse or disrupting school and home life.
• First stop: Start with the pediatrician or GP, who can refer your teen to specialist mental health services.

Normal adjustment or something more?

Homesickness, sadness and reluctance to go to school are normal after a move. They usually ease over the first weeks and by about three months. A teen who is slowly finding their feet is most likely adjusting.

Signs that point to something serious

Worry more when you see several of these together, most days:

• Low mood or irritability that does not lift.
• Loss of interest in nearly everything.
• Big changes in sleep or appetite.
• Pulling away from everyone, including old friends online.
• Falling grades or refusing to go to school.
• Hopelessness, panic attacks or constant worry.
• Aches and pains with no medical cause.
• Using alcohol or drugs.

Signs of self-harm risk are different and more urgent: cuts or burns, hiding the body under clothes, talk of death or of being a burden, giving away belongings, and searching for methods of self-harm.

How long is too long

Seek professional help if low mood, withdrawal, school refusal or sleep and eating changes last two weeks or more and are getting worse or disrupting school and home life. Don't wait for the three-month mark.

Emergency numbers

• Immediate danger: call 112. It is free, works 24 hours and has English-speaking operators. Stay with your teen, remove anything they could use to harm themselves, and stay calm and listen without judging. Follow the operator's instructions. If it is safe, take them to the nearest hospital emergency department (urgencias).
• Suicidal thoughts without immediate danger: call 024. It is free, confidential and open every day, all day. Parents, relatives and friends can call, and so can teens. Counselling is in Spanish, with regional languages in some regions. English support is not guaranteed.

First routes to help

Start with the doctor. In the public system, this is the family pediatrician (up to age 14 or 15, depending on region) or the médico de cabecera at your centro de salud. They assess your teen and can refer them to the child and adolescent mental health unit. Names vary by region, and waiting lists can be long. You need your health card to use the public route. Access to that card is covered on the healthcare pages.

Use the school. Ask your teen's tutor for a meeting with the orientador/a. This person is the school's counselling specialist and can arrange extra support, language help and an evaluación psicopedagógica. Public schools offer this free, and many concertados and private schools have a similar department. The orientador/a can refer your teen on but does not replace therapy.

Go private if you prefer. Psychologists and child psychiatrists work privately, paid directly or through private insurance. If nobody nearby speaks your language, online therapy in English or your own language is an option. The checklist below covers how to find and vet a therapist.

For self-harm or suicidal risk, don't wait for an appointment. Go to hospital urgencias, where a psychiatric assessment is available.

Timeline and deadlines

• Expect homesickness, sadness and reluctance to ease as your teen settles in: within the first weeks to about three months after the move

• Book the pediatrician or GP if low mood, withdrawal, school refusal or sleep and eating changes continue and are getting worse or disrupting school and home life: when they last two weeks or more

• Get professional help straight away for any self-harm or suicidal talk: immediately, at any point after the move

Checklist

• Ask the orientation department for an evaluación psicopedagógica (a learning and emotional needs assessment) if you think your teen needs one.

• Search directories of English-speaking therapists in Spain, or of therapists in your own language.

• Ask your region's Colegio Oficial de Psicología (the psychologists' professional body) to confirm a psychologist is registered.

• Ask your international school or embassy for a list of recommended therapists.

• Confirm the therapist has experience with teenagers and, if it matters to you, with expatriate families.

Check any therapist's registration and languages directly, as directories and referral lists are not always up to date.

What to watch out for

• Mistaking serious low mood for ordinary unhappiness: Persistent low mood or irritability, loss of interest in nearly everything, marked changes in sleep or appetite, withdrawal from everyone, hopelessness, panic attacks, constant worry, falling school results, school refusal, physical complaints with no cause or substance use can point to depression or anxiety. Waiting for it to pass can let it get worse. Seek professional help if these last two weeks or more and are getting worse or disrupting school and home life. Start with the pediatrician or GP.

• Missing the signs of self-harm risk: Cuts or burns, hiding the body, talk of death or being a burden, giving away belongings and searching for methods are signs of self-harm risk. Any talk of suicide or self-harm needs immediate professional attention. Stay calm, listen without judgement and get professional help straight away. Do not wait for an appointment.

• Immediate danger to your teen: If your teen is in immediate danger, every minute counts and they should not be left alone. Call 112 (free, 24 hours, with English-speaking operators). Stay with your teen, remove access to means of harm and follow the operator's instructions.

• Suicidal thoughts without immediate danger: Suicidal thoughts need support even when there is no immediate danger, and waiting alone at home can leave your teen without help. Call 024, the free, confidential suicide prevention line, open 24 hours a day. You or your teen can call.

Frequently asked questions

Can my teenager call the 024 line themselves?

Yes, teens can call 024 themselves, and so can parents, relatives and friends worried about someone. The line is free, confidential and open 24 hours a day, every day. Counselling is in Spanish, with regional languages in some regions, and English support is not guaranteed.

Who do I see first if I think my teenager needs mental-health help?

Start with the family pediatrician, or the GP (médico de cabecera) at your local health centre (centro de salud). Pediatrician care usually runs up to age 14 or 15, depending on the region. They assess your teen and refer to the child and adolescent mental health unit, where waiting lists can be long. Private psychologists and child psychiatrists are the alternative.

Is the school counsellor enough to help my teenager?

No, the orientador/a is not a replacement for clinical therapy, but is a good first contact at school. They can support emotional needs, coordinate help for newcomers and refer you to outside services. Ask the tutor for a meeting to start.