Recent statistics show that over 214,000 children in this country have lost a parent to the COVID-19 pandemic, an event that “can severely affect a child’s mental health,” said Jackie Baker, a licensed social worker and behavioral health therapist at UPMC Behavioral Health.
“Even before the pandemic, an alarming number of young people struggled with feelings of helplessness, anxiety, depression and thoughts of suicide — and rates have increased over the past decade,” Baker said.
Other statistics show that rates of childhood mental health concerns and suicide rose steadily between 2010 and 2020. By 2018, suicide was the second-leading cause of death for youth ages 10 to 24.
“The pandemic has intensified this crisis: across the country, we have witnessed dramatic increases in Emergency Department visits for all mental health emergencies,” Baker said.
Before the pandemic, mental health challenges were the leading cause of disability and poor life outcomes in young people, with up to 1 in 5 children ages 3 to 17 in this country having a mental, emotional, developmental or behavioral disorder. From 2009 to 2019, the share of high school students who reported persistent feelings of sadness or hopelessness increased by 40%, to more than 1 in 3 students, according to Baker.
“There was a lot going on, and it was a perfect storm of factors that will have rippling effects for years to come,” Baker said.
The pandemic disrupted lives adding to pre-existing challenges that many youth faced.
Also, just as in adults, adolescents who were vulnerable to begin with were most negatively affected by the pandemic. This includes youth with disabilities, racial and ethnic minorities, LGBTQ+ youth, low-income youth, youth in rural areas, youth in immigrant households, youth involved with the child welfare or juvenile justice systems and homeless youth, Baker said.
During that time of social distancing and isolation, many therapists transitioned from in person to other modes of care, such as virtual and telehealth, but still many people faced challenges trying to get care with appointments being canceled or delayed.
At the end of last year, the US Surgeon General, the American Academy of Pediatrics, the American Academy of Childhood Adolescent Psychiatry and the Children’s Hospital Association issued advisories stating that there is an “urgent need to address the nation’s youth mental health crisis and the future wellbeing of our country depends on how we support and invest in the next generation,” Baker said.
“The pandemic hit, placing a lot of social constraints on our teens and children which disrupted every aspect of their lives — at home, in school and out in the community,” Baker added.
What do parents need to look for?
“Being mentally healthy during childhood means reaching developmental and emotional milestones and learning healthy social skills and how to cope when there are problems,” said Dr. Olufunke Oladejo, pediatrician at UPMC Pediatrics.
“Mentally healthy children have a positive quality of life and can function well at home, in school and in their communities,” she said.
Children may have fears, even strong ones, and feel sad and hopeless from time to time, but Oladejo cautioned that “although fears and worries are typical in children, persistent or extreme forms of fear and sadness could be due to anxiety or depression.”
Parents should be aware that depression, anxiety, ADHD, eating disorders and many other mental health issues present differently in children than they do in adults.
“An adolescent or teenager with depression may overreact, have behavioral problems, be very irritable, whereas an adult may come across as just being melancholy and sad,” she said.
In order for parents to distinguish what is normal for their child requires knowing what is their child’s normal behavior and what is not.
Some of the red flags that parents should look for, according to Oladejo, include an increasing withdrawal from formerly pleasurable activities, changes in diet or appearance, struggles with schoolwork, overreaction to mundane activities and voicing dread or unease.
Knowing if your child is experiencing depression or anxiety and not just normal adolescent mood swings is not always easy because children often hide how they’re truly from their parents, Oladejo said.
“When bringing up the subject of mental health with children, it’s helpful to have a non-judgmental attitude and avoid using words like ‘crazy’ or minimizing your child’s feelings by normalizing their behavior as a ‘part of growing up,’” Oladejo said.
Parents also need to remember that not all children may want to talk to them about their feelings. Trying another form of communication, such as texting or a letter might be preferable to a face-to-face talk.
“What matters is that a parent keeps trying,” she said.
Another aspect of a child’s healthy mental development to be considered is their parents’ or caregivers’ own mental health.
“Parents who have their own mental health challenges, such as coping with symptoms of depression or anxiety (fear or worry), may have more difficulty compared to parents who describe their mental health as good. So, parents need to have a realistic understanding of their own mental health before they try to help their children,” she explained.
Help is available
There are a number of treatments available for children and teens. School counselors can offer children and teens a safe space to learn healthy coping skills and find emotional support.
Individual therapy is another treatment option, as well as group therapy and family therapy in order to “engage the family unit as a whole in effectively supporting the child or teen,” Baker said.
A good starting point is with a health care provider, such as your child’s primary care provider.
“Healthcare providers are trained on what to look for related to risky behavior as well as how to assess patients in a non-threatening way,” Oladejo said.
“Parents should talk with their child’s healthcare provider and share their concerns and also encourage their child to feel comfortable to open up to their provider. If there is a concern the provider will start the process of a full evaluation of what’s going on and can also help connect the family with resources,” she said.
In the past it was easier to admit having a fatal disease than it was to seek treatment for any type of mental health issue. Unfortunately some of that stigma still exists.
“Unfortunately, many people, adults and children still believe they need to keep their issues bottled up — even if it becomes debilitating or all-consuming,” Baker said.
“Stigma in society today causes feelings of shame and helplessness, but there are resources available, and there is hope,” she added.
Baker offered some suggestions for overcoming the stigma, such as talking openly about mental health and learning about it and teaching others.
“Be aware of the language you use. Mental illness is a disease, not something you can control. Show compassion and empathy — don’t be judgemental,” she said.
“Seek treatment and talk about it. Mental illness is not a phase or something you will get over if you try hard enough. If you have a mental illness, you already carry a heavy burden. It is important to receive support from your inner circle and your doctor,” Baker said.
“Don’t add to the stigma,” she said.