Editor’s Note: The Tulsa World sent questions about youth mental health during the pandemic to two experienced advocates: Gail Lapidus, executive director of Family and Children’s Services, and Terri White, executive director of Mental Health Association Oklahoma. Here are their answers:
What does prevailing data show about how the pandemic has affected children and youth mental health?
Children are particularly vulnerable to the mental health effects of the pandemic resulting from school closures, the interruption of social connections, isolation, loneliness and the strain on their families.
The pandemic has created a prolonged state of physical isolation from their friends/peers, teachers, extended family and community, along with a loss of school-based social support, activities, routines and rituals. The impact of lockdown will vary between children. Some will bounce back, and others will struggle.
There is growing concern that the prolonged state of disruption to children’s lives will create a tsunami of mental health needs.
Research shows prolonged loneliness can be devastating to the mental health of children and teens — giving rise to possible depression, anxiety, distraction and irritability.
Younger children may appear to be managing the stress and anxiety but that is often because they do not know how to express those feelings. They rely heavily on the adults around them for support, which means if the family is stressed, and many are right now, the child carries that stress, and it comes out in many ways. Bedwetting, temper tantrums, changes in eating and sleeping habits, aggression are all symptoms that might appear in overly stressed children.
Children with preexisting mental health challenges are particularly vulnerable.
Between 30% to 50% of children received mental health care in schools. With school closings, many of these children lost their access to mental health services they counted on.
Children with adverse childhood experiences are also of particular concern. Adverse childhood experiences include traumas like child abuse, neglect, exposure to domestic violence, etc., and children experiencing these issues are at risk for their trauma to be exacerbated by the prolonged pandemic.
The harm to children during isolation and quarantine may go unnoticed and unreported during the time school is not open. Most incidents of child abuse or neglect are identified in school settings. Consequently, reports of child abuse have significantly decreased across our community, resulting in fewer children and families in treatment now, but we should anticipate a later surge.
As many as 30% of children involved in quarantines may experience post-traumatic stress disorder — a rate that is seven times higher than for children who do not experience quarantine.
Children from lower socioeconomic levels are also disproportionately at greater mental health risk. Experts expect the children most affected by COVID-19 will be those facing economic, racial and other inequities that have become more pronounced and traumatic since the pandemic began.
How is this different from what adults are going through?
The impact of the pandemic on employment, income, housing and food security threatens basic survival creating significant stress and anxiety for some adults.
Frontline workers and essential workers have another level of stress altogether. Parents, especially mothers, are overburdened with worries during the pandemic: potential job loss, COVID-19 exposure at work, eviction fears, working remotely and simultaneously parenting and adapting to online or hybrid learning educating their children.
Adults with preexisting mental health or substance use disorders may find their conditions exasperated by COVID-related stressors. Stress may look different for each person, but it all can lead to anxiety and depression for some individuals and that increases the rates of substance use, suicide, aggression, and abuse — all of which impact children.
What could be the longer-term mental health effects of this past year on kids?
During the pandemic, one day you’re going to school and then one day — maybe because of a COVID-19 exposure in the school — you’re not going to in-person classes. Instability can be hard on everyone.
Children’s brains are still wiring to master self-regulation and that takes consistency, and this year has been anything but consistent.
Professionals are especially concerned about the long-term effects on families coping with economic instability, and particularly those with children who have behavioral issues or other special needs. The accumulation of stressors with no end in sight can foster poor mental health outcomes for them and their children.
It is thought that children and teens are probably more likely to experience higher rates of depression and anxiety during and after enforced isolation ends.
The need for more mental health resources for children and youth is not new to Oklahoma, but what can be done in the immediacy for communities to mitigate the strain?
Parents and caregivers can play a big part in reducing their child’s anxiety, anger, loneliness or depression about how the pandemic has disrupted their lives.
It is important for parents to remember the stress on their children is worsened by the loss of their day-to-day normal structures and routines including school, friends, extended family, sports and other activities.
Parents should talk to their children often, give age-appropriate information and reassurance that they are safe, and that life will return to normal. The dinner table, car rides and taking walks are great talk-time opportunities that can help a child manage anxiety.
Parents can nurture their child’s resilience and model and teach children healthy coping strategies including getting adequate sleep, healthy nutrition, physical activity, and self-care.
Parents can also develop a home schedule that can help their children have a structure, routine and ability to keep up with their studies. Parents should help create safe ways for their children to combat loneliness.
For instance, parents could help their child connect with extended family or friends whether by Zoom or in safe spaces.
Not all children and parents respond to stress or adversity in the same way. Parents need to look for serious changes in the way their child typically learns, copes, behaves, along with handles stress and self-control. If a child’s mental health is being challenged, you may see changes in their behavior which can include:
Excessive crying and annoying behavior;
Increased sadness, depression or anxiety;
Nightmares, inability to sleep;
Explosive temper or out-of-control behavior;
Difficulties with concentration and attention;
Changes in, or avoiding, activities that they enjoyed in the past;
Unexpected headaches and pain throughout their bodies;
Changes in eating habits; and
Talk about not wanting to live anymore.
If a parent sees a major decrease in their child’s ability to function, this is the time to seek help with a mental health professional who can talk with you and your child and create pathways to solutions.
Where do parents go for assistance for kids who need extra help with their mental health?
Sometimes parents do need extra help with their child’s mental health. We must empower parents to feel comfortable saying, “I don’t feel equipped to handle this mental health situation on my own.”
Services are available throughout the community.
Mental health and counseling services in schools are ideal for many parents and kids with convenient access to quality care in a private confidential environment. Most school districts in the Tulsa metropolitan area have licensed mental health providers placed into primary and secondary schools through partnerships with a variety of children’s mental health organizations.
With parental approval and consent, children can be provided high-quality mental health assessment and treatment at school either in person or virtually through telehealth.
Children in pre-K or younger may also present with mental health challenges. Your child’s pediatrician or early childhood program can link you to community resources.
Another valuable resource is COPES FOR KIDS (918-744-4800). This telephone hotline and mobile crisis service operated by Family and Children’s Services is available 24/7 for any parent to call if they think their child is in a mental health crisis.
Professional staff will work to stabilize the crisis immediately and make connections to community resources for ongoing services.
Who do parents call if they do not know what kind of mental health help their child needs?
Parents can reach out for referrals to their child’s school, health care provider, other organizations they trust for guidance, or they can contact Mental Health Association Oklahoma’s free Mental Health Assistance Center at (918)585-1213. Staff will find the best fit with different agencies or private therapists.
Any Oklahoman can call 211 and ask about counseling and mental health.
If you are concerned about your adolescent’s mental health, Mental Health Association Oklahoma’s free Student Mental Health Screening is a youth wellness program that identifies general health and mental health concerns in 6th to 12th graders in the Tulsa and Oklahoma City areas.
Your child will complete a computer-based survey of mental health concerns. If the screener identifies a mental health concern, including suicidal thoughts or behavior, the parent and the screener will work through a plan to connect your teen with the necessary support and treatment.
The screener will continue to provide support to your family until your teen engages in treatment if you choose to seek services. You can get all the details at mhaok.org or calling the Mental Health Assistance Center.
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