Crisscross: Our Youth

We already had a youth mental health crisis. Now what?

Posted May 18, 2020

 Mubariz Mehdizadeh/Unsplash
Source: Mubariz Mehdizadeh/Unsplash

May is Mental Health Month in America, and it comes not a moment too soon.

In reporting that “1 in 6 U.S. youth aged 6-17 experience a mental health disorder each year; 50% of all lifetime mental illness begins by age 14 and 75% percent by age 24; and suicide is the 2nd leading cause of death among young people aged 10-34,” the National Alliance on Mental Illness also says, “Millions of people in the U.S. are affected by mental illness each year. It’s important to measure how common mental illness is, so we can understand its physical, social and financial impact—and so we can show that no one is alone. These numbers are also powerful tools for raising public awareness, stigma-busting and advocating for better health care” (NAMI, 2019).

A step forward on such measurement was recently announced by the Center for Adolescent Research and Education (CARE) and Total Brain, a mental health and wellness monitoring and support platform. Together, CARE and Total Brain plan to survey thousands of young people facing the stress of transition, specifically those moving from high school to college and college to workforce, cohorts that regularly report high levels of stress, anxiety, and depression (PR Newswire, 2020).

Making matters worse is the pandemic of COVID-19, a global virus decimating communities and families. Young people are at risk of related mental distress.

Indeed, the Journal of the American Medical Association says, “The COVID-19 pandemic may worsen existing mental health problems and lead to more cases among children and adolescents because of the unique combination of the public health crisis, social isolation, and economic recession” (Golberstein et al, 2020).

Perhaps chief among the contributing factors to virus-related mental health outcomes has been the closure of schools, important sources of structure, routines, and support.

According to an April 2020 article by Joyce Lee in The Lancet, “For children and adolescents with mental health needs, such closures mean a lack of access to the resources they usually have through schools … School routines are important coping mechanisms for young people with mental health issues. When schools are closed, they lose an anchor in life and their symptoms could relapse” (Lee, 2020).

Common threads that tie all affected by the virus, at home and abroad, are loss and attendant grief.

Therapist Lori Gottlieb, in her New York Times article “Grieving the Losses of Coronavirus,” explains, “Right now, in addition to the tragic losses of life and health and jobs are the losses experienced by people of all ages: missed graduations and proms, canceled sports seasons and performances, postponed weddings and vacations, separation from family and friends when we need them most” (Gottlieb, 2020).

While many, if not most, youth are facing the fallout of the pandemic, certain subgroups may be particularly at risk. For example, Lee explains, “Children with special education needs, such as those with autism spectrum disorder, are also at risk.” Lee quotes psychiatrist Chi-Hung Au in revealing, “They can become frustrated and short-tempered when their daily routines are disrupted.”

Another population to worry about is LGBTQ youth. The Trevor Project, the world’s largest suicide prevention and crisis intervention organization for lesbian, gay, bisexual, transgender, queer, and questioning young people, offers, “Although youth and young adults are estimated to have the lowest mortality rates from COVID-19 … they are not immune to its consequences, including as it relates to mental health and well-being. Even prior to the pandemic, LGBTQ youth have been found to be at significant increased risk for depression, anxiety, substance use, and suicidality. These risks are even more pronounced among youth who are transgender and/or nonbinary ... Thus, LGBTQ youth may be particularly vulnerable to negative mental health impacts associated with the COVID-19 pandemic” (Green et al, 2020).

So, what do we do?

The Centers for Disease Control and Prevention (CDC) advises that parents monitor changes in their child’s behavior, including the following (CDC, 2020).

  • Excessive crying or irritation in younger children
  • Returning to behaviors they have outgrown (for example, toileting accidents or bedwetting)
  • Excessive worry or sadness
  • Unhealthy eating or sleeping habits
  • Irritability and “acting out” behaviors in teens
  • Poor school performance or avoiding school
  • Difficulty with attention and concentration
  • Avoidance of activities enjoyed in the past
  • Unexplained headaches or body pain
  • Use of alcohol, tobacco, or other drugs

In addition, the CDC says parents can support children during this difficult time in these ways.

  • Talk with your child or teen about the COVID-19 outbreak.
  • Answer questions and share facts about COVID-19 in a way that your child or teen can understand.
  • Reassure your child or teen that they are safe. Let them know it is ok if they feel upset. Share with them how you deal with your own stress so that they can learn how to cope from you.
  • Limit your family’s exposure to news coverage of the event, including social media. Children may misinterpret what they hear and can be frightened about something they do not understand.
  • Try to keep up with regular routines. If schools are closed, create a schedule for learning activities and relaxing or fun activities.
  • Be a role model. Take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members.

As children and teens experience disruption to their daily schedules with the coronavirus crisscrossing so many critical areas of their lives, including school, recreation, and important social connections, we are all well-advised to focus on their mental health to keep them safe and alive.

References

CDC. (2020). Stress and coping. Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention. April 30, 2020. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html (11 May 2020).

Golberstein, E., Wen, H. and B. Miller. (2020). Coronavirus disease 2019 (COVID-19) and mental health for children and adolescents. JAMA Pediatrics. April 14, 2020. https://jamanetwork.com/journals/jamapediatrics/fullarticle/2764730 (11 May 2020).

Gottlieb, L. (2020). Grieving the losses of coronavirus. The New York Times. May 6, 2020. https://www.nytimes.com/2020/03/23/well/family/coronavirus-grief-loss.html (11 May 2020).

Green, A.E., Price-Feeney, M. and S.H. Dorison. (2020). Implications of COVID-19 for LGBTQ youth mental health and suicide prevention. New York, New York: The Trevor Project. April 3, 2020. https://www.thetrevorproject.org/2020/04/03/implications-of-covid-19-for-lgbtq-youth-mental-health-and-suicide-prevention/ (11 May 2020).

Lee, J. (2020). Mental health effects of school closures during COVID-19. The Lancet. https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30109-7/fulltext (11 May 2020).

NAMI. (2020). Mental Health Month. National Alliance on Mental Health. https://www.nami.org/Get-Involved/Awareness-Events/Mental-Health-Month (11 May 2020).

NAMI. (2019). Mental health by the numbers. National Alliance on Mental Health. September 2019. https://www.nami.org/mhstats (11 May 2020).

PR Newswire. (2020). Total Brain partners with Center for Adolescent Research and Education (CARE) to address growing youth mental health crisis. May 5, 2020. https://www.prnewswire.com/news-releases/total-brain-partners-with-center-for-adolescent-research-and-education-care-to-address-growing-youth-mental-health-crisis-301052755.html (11 May 2020).