A recent report from the CDC shows that emergency room visits for mental-health related issues rose 31% among teens and 24% among elementary-aged children just during the 7 month period after COVID-19 shutdowns began in 2020. The startling statistics have been getting widespread coverage, highlighting the continued need to focus on mental health even as the pandemic wanes.
This data is not surprising to those working in the mental health field. Children and teens, while incredibly resilient, are also vulnerable to the effects of stress, isolation, grief, and uncertainty that have been ever-present during the pandemic.
Paying Attention to Warning Signs
As shutdowns ease and families begin thinking about in-person school for the fall, parents, teachers, and everyone working with children should continue to pay attention to the signs and symptoms that a child or teen might be struggling.
Warning Signs for Teens
- Feeling very sad and/or withdrawn for more than 2 weeks.
- Severe out-of-control, risk-taking behaviors that cause harm to self or others.
- Sudden overwhelming fear for no reason. Sometimes with a racing heart, physical discomfort or difficulty breathing.
- Seeing, hearing, or believing things that aren’t real.
- Drastic changes in mood, behavior, personality, or sleeping habits.
- Extreme difficulty concentrating or staying still that put a person in physical danger or causes school failure.
- Intense worries or fear that get in the way of daily activities.
- Throwing up, using laxatives, or not eating to lose weight; significant weight loss or weight gain.
- Excessive use of alcohol or drugs.
- Trying to harm oneself, attempting suicide, or making plans to do so.
Warning Signs for Young Children
- Changes in school performance
- Excessive worry or anxiety, for instance, fighting to avoid bed or school
- Hyperactive behavior
- Frequent nightmares
- Frequent disobedience or aggression
- Frequent temper tantrums
Preparing for Back-to-School
For kids, the uncertainties around returning to school may feel as big and scary as the original school shutdowns. While we can’t fix every concern, there are some easy ways to set them up for success as they experience this change.
- Ask how they feel and what questions they have. Give kids of all ages space to share how they feel about returning to school. Some will be excited. Some will be nervous. Some will feel conflicted. Help answer questions they might have and reinforce that it’s okay to have any of these feelings. You also might be surprised by what exactly they are worried about.
- Do a practice run-through. Visit the school, if possible, before classes begin to remind them of where they will go. Even driving to the parking lot and pointing out where they will walk inside can be helpful.
- Validate, validate, validate. Sometimes worrying about something is worse than the actual thing we’re nervous about. Debrief with them after the first day. If they had a great time, validate the feelings. Be careful not to say, “see there was nothing to be nervous about,” but share that you are proud of how brave they were. If they had a hard day, give them lots of reassurance that you are there for them and that it’s okay to have lots of emotions about their day.
- Check in often. Even if the first few days or weeks were pretty easy, anxieties and stress come up later. Don’t be afraid to ask questions more than once and pay attention to any warning signs of a bigger issue.
We’ve compiled a few of our favorite resources for those looking for ways to support the children and teens in their lives and better manage feelings of uncertainty and fear.
Let's Talk about Depression and Suicide youtube.com
Videos from Integral Care on recognizing depression and suicide risk
For teens: English or Spanish
Parents/Teachers: English or Spanish
Talking to Kids About the Coronavirus childmind.org
Tips from the Child Mind Institute on talking to kids about coronavirus in a reassuring way
Learning to Help Your Child And Your Family nami.org
Short web guide with suggestions and information for parents of children with a mental illness
NAMI Basics namicentraltx.org
Free 6-week class for parents and caregivers of children experiencing signs of behavioral or mental health concerns. Available in closed group (scheduled periodically) or On-Demand
Parents guide to Emergency Hospitalization childmind.org
Guide for what to expect if emergency hospitalization is needed for a mental health concern.
Symptom Checker childmind.org
While not a diagnostic tool, the Symptom Checker analyzes your answers to give you a list of psychiatric or learning disorders that are associated with those symptoms.
Managing Back to School Anxiety namicentraltx.org
Mind Matters webinar with Meagan Butler, M.Ed, LPC, and Wanda Montemayor, LPC/S/AT, ATR/BC, ATCS. They share techniques for parents on how to manage their back-to-school anxiety, help children cope with changes to routine, and address their children's fears about going back to school. Recorded 2020.
Hack Your Brain to Feel Better: Everyday Regulation for Hard Times namicentraltx.org
Mind Matters webinar featuring brain-science-based “bottom-up” and “top-down” regulation strategies, as well as coping skills that children, teens and adults can use themselves and teach others. Recorded 2020
Tips for Managing Emotions for Younger Children instagram.com/waves.of.childhood
The Early Childhood Specialist who runs Waves of Childhood shares helpful tips and language to help adults understand kids' emotions and give them tools to support positive emotional regulation.