COVID-19 is impacting pediatric mental health
Research clearly demonstrates that the pandemic is having a significant negative effect on the younger generation.
A November 2020 article, “Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations,” found both short-term and long-term “psychosocial and mental health implications” in this population. The article was published in Psychiatry Research.
The authors noted that severity of the impact is subject to certain vulnerability factors including developmental age, educational status, pre-existing mental health conditions, low economic status, and quarantine because of or fear of infection.
The increase in requests for treatment and lengthy wait lists confirms these findings, according to area psychologists.
Michelle Crossley, Ph.D, private practitioner in Pawtucket, Rhode Island, usually experiences an influx of new clients in December and January. This year, however, referrals and requests for appointments skyrocketed because of the pandemic.
The current mix of academic models is contributing to the rise in anxiety and depression, according to Crossley. She emphasized that socialization is very important to children, especially adolescents. Few or no opportunities to socialize because of social distancing recommendations and learning situations are creating more distress, she noted.
Primarily, therapy now takes place virtually. Crossley uses a variety of apps with colorful graphics, sounds, and emojis. However, she finds sessions with elementary school children challenging because the computer offers a lot of distractions.
Private practitioner Kathryn H. Robbins, Ph.D, of Upper Valley Child and Family Psychology, PLLC in Hanover, New Hampshire.
Private practitioner Kathryn H. Robbins, Ph.D, of Upper Valley Child and Family Psychology, PLLC in Hanover, New Hampshire, provides school consultations and evaluations and has witnessed an increase in referrals in the last year.
She said that children with pre-existing mental health conditions are at higher risk, while those with no previous issues are now experiencing pandemic-related problems.
Robbins uses an evidence-based approach as well as loss and bereavement therapy and trauma-informed therapy for her clients. She pointed out the importance of validating the child’s concerns and normalizing their feelings. Through psychoeducation and a strengths-based approach, she promotes identification and labels feelings.
Robbins is most concerned with teens, not necessarily because they are presenting most frequently in her work in schools, but because of the enormity of need. Teens respond to routine and structure, which has been shifting throughout the last year. Right now, teens can’t act on their dreams and aspirations, she said.
Ann Zimmerli, Psy.D, independent practitioner in Westport, Connecticut, said that children
are experiencing the world as a dangerous place. “We’re constantly telling them it’s not safe to play, go to school, etc.” said Zimmerli.
The outlets that make children feel better are no longer available, she noted. Children spend little or no time with friends and have no socialization opportunities.
Zimmerli’s current clients are much more clinically challenged than in the past; approximately 70 percent of her clients present with anxiety.
The various and continually fluctuating schooling models have presented another hardship for both parents and children. A small percentage of children can handle remote learning, Zimmerli noted, but there is a lot of social avoidance, more depression and anxiety, and lack of motivation.
Hybrid models don’t fare much better, Zimmerli said. In some cases, children are placed into classrooms with others they don’t know.
“The best-case scenario is kids in school full-time,” she said, but pointed out that socialization taking place in school right now is not what it used to be.
Zimmerli focuses on psychoeducation, mindfulness, and breathing techniques to help make the child aware of the “thinking brain” versus the “worry brain.” She reported that virtual therapy is challenging for certain ages, particularly elementary school children.
Whenever possible, she engages in “backyard therapy.” Walking around outside and spending time in nature makes an enormous difference, she said.
Zimmerli predicts that a transition period may follow as the COVID-19 virus diminishes. Socially anxious children have fallen out of the habit of socializing so it could be stressful to go back to school full-time. There may be a generation of children who need social practice and will have a difficult time learning friendship models and how to negotiate conflict, she added.
Zimmerli foresees one potential benefit though. “Families have gotten closer and that is a silver lining,” she said. “We have recognized that a slower pace of life can be a good time.”
Crossley agrees that post-pandemic re-adjusting to yet another “new normal” will require some transition. “Any time there is a change in routine, there is some excitement and then decompensation. You have to adjust to new rules and restrictions.”