Psychologist discusses mental crisis affecting children | Messages

In December 2021, the US Surgeon General issued a recommendation on the mental health crisis in children caused by the COVID-19 pandemic. In response, Kentucky Children’s Hospital (KCH) has joined the Sound the Alarm For Kids campaign, which aims to raise awareness and provide resources to address this crisis.

“Providers everywhere are calling for changes in access to children’s mental health services,” said Scottie B. Day, MD, chief physician, Kentucky Children’s Hospital. “But first we need to work together to reduce stigma and have conversations about mental health.”

UK child psychologist Alissa Briggs, Ph.D., of HealthCare answers frequently asked questions about the unprecedented crisis facing children and adolescents today.

You know: What are providers seeing in the KCH and in the children’s clinics?

Briggs: As a provider of mental illness for adolescents, I see the same psychological concerns as before the pandemic. However, the new psychological concerns of several patients are directly related to the pandemic. In addition, many patients who struggled with their mental health prior to the pandemic are either doing worse or having difficulty healing. Most teens cite persistent peer isolation, broken relationships with peers, and the lack of organized activities outside the home as factors contributing to their mental health deterioration. We’ve definitely seen an increase in eating disorders and self-harm, and unstructured time at home is likely a contributing factor to that increase. When school and activities resumed, mental health improved for some, but some remained stuck with depression, anxiety, and self-harming behaviors.

You know: What has contributed to the increase in suicide attempts and suicidal ideation?

Briggs: Hopelessness, financial stress, feelings of burden and loss of relationship are driving factors for suicide. The pandemic has certainly increased feelings of hopelessness, financial stress and changes in relationships in many. Since many parents struggled to reconcile distance learning, quarantine and work, it can be assumed that this could make some children and adolescents feel uncomfortable.

You know: How do factors such as socio-economic status, race, sexual orientation and gender identity play a role?

Briggs: Many young people who do not fall into the cisgender and straight category rely on the support of their peer group. You can be at school and not at home. In these teens, lack of access to affirmative peers and / or a positive environment could contribute to stress and suicidal behavior. On the other hand, adolescents who were discriminated against and harassed in school because of their sexual orientation and / or gender identity may have found it a relief to be at home with their parents. If at least one parent affirms the young person’s gender identity and sexual orientation, the young person’s risk of suicide is significantly reduced.

You know: Do you think the social stigma surrounding mental health prevents parents from talking to their children or taking their children’s mental health concerns seriously?

Briggs: In fact, I think that the inability to see the signs that an adolescent is struggling with mental health and limited emotional communication skills prevent parents from dealing with their adolescent’s mental health. When people are in a stress reaction, they can react with fighting (an increase in arguments, outbursts, and irritability), fleeing (avoiding people and situations), or freezing (shutting down, crying, and noncommunication). These can be interpreted as behavioral problems and addressed with a more punitive approach than as signs that an adolescent is having difficulty. Young people can demonstrate their need for support in such a way that they crowd out precisely those people who need them.

Also, many parents haven’t learned to really listen. Listening is much more than just listening. It involves making eye contact, positioning your body towards someone, making a supportive expression, reflecting on emotions you sense in the other person, and rewriting what you hear say. Looking at a phone is a major obstacle to beginning communication because of the non-verbal behavior required. Have phone-free time at home. In addition, many parents try to solve problems instead of focusing first on the emotions and worries that the adolescent is trying to express. Many teenagers I visit for therapy say they don’t feel that their parents really understand what they are feeling or what they are trying to tell them. I recommend the “How To Talk So Kids Will Listen and Listen So Kids Will Talk” series by Adele Faber and Elaine Mazlish to all parents.

You know: How has the pandemic affected the mental health of children and adolescents?

Briggs: It made things worse for teens who were already struggling and made things difficult for teens who were fine.

In addition, many teenagers have experienced trauma-related infections from family members. Trauma activates the stress response system, and when that system is activated frequently or continuously it becomes difficult to turn it off. When the stress response system persists, we get depression, anxiety, and symptoms of post-traumatic stress.

You know: What are the signs that a child is struggling with their mental health?

Briggs: Think of “fight, flight, or freeze” – our automatic responses to activation of our stress response system.

  • Fight: Is Your Teen More Belligerent? Irritable? Aggressive?
  • Escape: Do you avoid situations or interactions?
  • Freeze: Do they seem closed and withdrawn? Are you more tearful?

I think it’s also important to remember that we cannot choose our own stress response style. Teens can learn strategies to counteract and prevent the stress response, but the overall response is not controlled. There was a time when a quick, automatic response was adaptive (i.e., when faced with death from a tiger or a member of another tribe). Our society has evolved faster than our stress response system, and the way we automatically react doesn’t always make sense.

An adolescent who becomes irritable and argumentative has no more control over this reaction than an adolescent who becomes tearful and withdrawn. Unfortunately, teenagers who have a tendency to “fight” receive more punitive reactions and more guilt for their behavior, which deteriorates their overall mental health.

You know: What can parents, carers, and teachers do if they are concerned about a child’s mental health?

Briggs: Contact your pediatrician who can provide recommendations and resources. Also, contact a supportive teacher, career counselor, or administrator at the school. Most schools have increased the availability of mental health professionals in the school and your teen may have access to therapy during the school day. If the school does not have resources, they may know the resources that are available in the community.

You know: What resources are available to parents and carers? How can we continue to support you?

Briggs: There are plenty of parenting books to choose from that can be overwhelming. There are some gems out there, however. Everything from Ross Greene is worth reading, and he has a website with a wealth of resources, including ways to connect with other parents. As I mentioned earlier, the How to Talk series can improve your relationship and communication with your teen.

There is a lot that employers can do to support parents and carers. In our culture we are very focused on what the individual can do, but sometimes the individual needs the systems in which they participate in order to change. Parents, especially parents of elementary school age children and younger, have been burning at both ends of the candle for the past two years to provide for their families and keep their jobs going. Employers can allow parents time to get therapy and take their children to therapy. Employers can increase flexibility so that parents can work remotely outside of normal business hours if necessary, in order to reconcile work and family. Additionally, employers can find ways to increase pay to attract and retain workers to allow this flexibility. Given the challenges many industries face in recruiting, employees are able to bargain. I think these are reasonable requests from parents that can lead to some helpful changes.

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