Mental Health

Mental Health, Children, and the Challenges of 2020 and Beyond

February 25, 2021

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Written by Beth Links Torwekar, M.D. and Deidre Burton, M.D. 

Last year was one of high stress for both adults and children. From health concerns caused by a global pandemic to protests across our country fighting against social injustice and a very intense Presidential election, 2020 was a year of constant challenge. But our work didn’t stop with the end of the year: These challenges continue into 2021.  

As pediatricians, for a long time, we have been taking care of kids with different medical problems—from broken bones to constipation and pneumonia, to more serious chronic conditions like asthma, diabetes, and developmental delays.  

But over time, the needs of our patients and their families have changed. Many of the children and families we treat also need mental health support and access to behavioral health resources. 

Events in our community have made feelings of sadness and anxiety more intense compared to any previous time. One out of three high school students have reported being unhappy or depressed in the past 10 months. 

How can we help our children thrive during such difficult circumstances? As parents, one of the most important things is to remain kind to yourself and your children. But there are other things to keep in mind, too. They are:

Mental Health in the time of COVID-19

Signs of stress

  • Acknowledge the stress that children are facing. Let them know they are not alone. Above all, listen.  
  • Answer your children’s fears honestly. 
  • Realize that children respond to stress differently depending on age and temperament. 
  • Respond to each child specifically; acknowledge feelings and help them talk about them: “I see you are afraid. Let’s talk about it.” 
  • Young children may show developmental or social problems, including struggles with sleeping, eating and toileting. 
  • School-aged children may withdraw, act out or show physical issues, like stomach pain, headaches, fatigue, and sleeping troubles. 
  • Adolescents may be sad, withdrawn, anxious or less interested in doing activities. 

When to seek help 

For concerning symptoms, seek help from your primary care provider or a behavioral health specialist. Your pediatrician is available to perform initial screenings and can help develop a plan for additional assessment and treatment if needed. Our community children’s hospital is available to assist in emergency situations. 

  • Children experiencing weight loss, large mood swings, or alcohol or drug abuse should be seen by a provider. 
  • Withdrawal from relationships, poor academic performance, neglect of personal hygiene and loss of interest in activities may be signs of sadness or anxiety that need to be addressed. 
  • Children who express suicidal thoughts should be evaluated. 

Building connections 

  • Help your children connect with people you both love and continue to find opportunities to celebrate everything that’s good in life.  
  • Cultivate gratitude 
  • Identify some of the “wins” of the pandemic. 
  • Each day reflect on something good that has happened and something that your children are looking forward to. 
  • Be intentional and creative about connections 
  • Use technology for virtual bake-offs, board game tournaments, remote movie nights. 
  • Put on a mask and go outside. 
  • Help your children connect with other children in their classrooms so they don’t miss the opportunity to make new friends. 
  • Dream about the future with your children 
  • Plan a family vacation. 
  • Itemize things that your children want to do with friends or schoolmates or family members. 
  • Encourage your children to keep playing the sport or activity they love; get ready for the time they can play it with others.  
  • Practice self-forgiveness. There have been so many changes to daily life and our lives have been disrupted. We may experience physical and mental illness despite our best intentions.

This past year will be seen by history as one of challenges that will linger for a long time. For the well-being of our children and families, we must adjust expectations. Recognize when you and those you love need help and take every opportunity to connect creatively. Celebrate small accomplishments.  Gratitude and joy can be cultivated during difficult times.  

References and Resources 

AAP Interim Guidance on Supporting the Emotional and Behavioral Health Needs of Children, Adolescents, and Families during the COVID-19 Pandemic—Teens & COVID-19: Challenges and Opportunities During the Outbreak—Mental Health During COVID-19—Talking to Children about Tragedies and Other News Events 
Children’s book about COVID—”Julie and the Evil Queen” by Beth Links Torwekar 

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