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Pediatric mental health: A crisis within a pandemic
Dr. Becky Alford
Dr. Bailey Alford - photo by Photo submitted

By Dr. Bailey Alford

The effects of the COVID-19 pandemic have been far-reaching, disrupting “normal” life in a way unprecedented in modern history. Besides the obvious physical illness this virus brings, the aftermath of fear, anxiety, depression and disturbed routines has left children across the world in a mental health crisis.

Pre-pandemic, according to the American Academy of Pediatrics, one in 10 children in the U.S. suffered from mental illness. According to the CDC, during April-October 2020 alone, U.S. hospitals saw a 24 percent increase in mental-health-related ER visits in children 5-11 years old and a 31 per increase in children 12-17 years old. Couple this with numbers showing a drastic decrease in outpatient mental health services received by children, despite telemedicine, and there is a recipe for disaster — a crisis within a pandemic. 

What are the signs of mental illness in children? How do you find help for your child? What are things you can do in your home to foster healthy coping skills?

Signs and Symptoms

· Social withdrawal: Children suffering from depression or anxiety will often disengage from social and family functions. Adolescence is a time of emotional lability with ups and downs in mood. However, depression is suspected when the symptoms occur for an extended period of time and interfere with day-to-day life. Anxiety that keeps your child from wanting to attend school or hang out with friends should be a red flag.

· Changes in personality: If your previously happy, outgoing, rule-following child is exhibiting more anger, aggression, and risk-taking behaviors, they may be suffering from depression. The symptoms can range from appearing withdrawn and sad to being overly emotional with frequent crying.

· Poor school performance: Children and adolescents with depression will likely show a decline in school performance with poor grades, decreased attention, and failure to turn in assignments. Teachers often observe these changes in behaviors and will often bring their concerns to the parent’s attention. It’s always a good idea to check in with your child’s teacher if you see concerning behaviors at home to see if similar behavior is being noted at school.

· Decreased appetite: Children who are depressed may not only lose interest in friends, family, and school but also in eating as well.

· Changes in sleep patterns: Depression can lead to the inability to fall or stay asleep, with children having restless sleep and fatigue during the day. The opposite end of the spectrum is also true with an increase in fatigue and sleepiness with frequent napping.

Seeking help

If you are concerned your child may be suffering from mental illness, talking to their pediatrician is a great first step. There is a lot of stigma surrounding mental illness in society today. This stigma extends to include parents being embarrassed, in denial or hesitant to seek help for their children.

Your child’s pediatrician can help validate your concerns and point you in the right direction towards a specialist who can help your child. Treatment is usually aimed at some form of therapy/counseling and may include medications. Psychiatrists, psychologists, developmental pediatricians, licensed counselors, social workers and school psychologists are all great resources and integral parts of the treatment team. 

Even during the current pandemic, during which time some medical services may be unavailable in person, telemedicine can be a useful adjunct, especially in older children and adolescents. If you are worried your child is having active thoughts of harming themselves or others, do not hesitate to take them to the nearest emergency room or call the National Suicide Prevention Hotline at 1-800-273-TALK.

Make your home a safe mental health space

Children often mirror the moods and behaviors they observe in their caregivers. It’s important as a parent to take care of your own mental health, especially during times of stress. Your children are looking to you to learn coping skills to handle stress that they will utilize when they encounter stressful situations in the future. 

Make your home a safe space where your children feel at ease being themselves and are encouraged to ask and discuss the tough questions regarding the changes they are seeing in the world around them. Your home should be a refuge full of love, honesty, support and optimism for a healthy future.