Responding helpfully to a child or young person who appears to be hearing voices

HandsOnScotland Toolkit

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It is common for young people to hear voices under certain circumstances. For example, a high fever, problems with diet and hydration and experimenting with drugs might all lead to hearing voices. It is quite normal for all of us to occasionally hear sounds or voices around the time that we are falling asleep or waking up. This is the result of there being an overlap between dreaming and being awake and is normally nothing to worry about.

It is also common for younger children to report on conversations they are having with an imaginary friend. Relationships with imaginary friends become important to some children as a mechanism to support them through periods of uncertainty or simply when they are alone and want someone to play with or talk to, in the same way that they will talk to a teddy bear or doll.
There is some evidence suggesting that 2-3% of the adult population hear voices but only one in three ever become a psychiatric patient. Many people function well with their voices.

Hearing voices can sometimes occur as part of a coping mechanism in response to a traumatic event or severe emotional distress, for example, sudden bereavement or abuse.

Hearing voices as part of mental illness is less common and would only normally occur in older teenagers. On occasion, other senses can be involved such as seeing or smelling things that are not real. When mental illness is involved there will usually be other signs that the young person is troubled, for example:

• The young person might talk or laugh aloud as if having a conversation with an invisible person.
• They may become withdrawn and less inclined to mix socially.
• They may have difficulty in concentrating on studies or TV programmes, etc.
• They may lose interest in normal activities.
• Their thoughts and ideas may appear to be all mixed up and sound like nonsense.
• They may talk about or express unusual or even bizarre ideas that they are having which are not shared by any other people, for example, the feeling someone is directly inserting thoughts into their mind or they are being spied on by the Government. They will not be persuaded against these beliefs by facts and logical argument.
• Care in their appearance and self care may deteriorate.
• They may become lethargic and lose motivation or be agitated and overactive.
• It might be that hearing voices is not disclosed by the young person but others notice that they appear to be distracted or are acting out of character.

Young people who are hearing voices and are suspected of having serious mental health problems should be considered as vulnerable and may be a risk to themselves. Psychiatric advice should be sought as soon as possible and they will always be treated as a high priority by the local mental health specialists.