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The pandemic is taking a devastating toll on the mental health of children and families

Topics in Health: Lessons From The Field

The pandemic is taking a devastating toll on the mental health of children and families

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(Photo by Nenad Stojkovic via Flickr/Creative Commons)
(Photo by Nenad Stojkovic via Flickr/Creative Commons)

Teresa, an 8-year-old girl in Washington, D.C., was struggling emotionally during the coronavirus pandemic. Her father had been gunned down in 2019, and amid the isolation of lockdowns and remote learning, she started cutting herself over the summer. But once her mother put her on camera during a video call, the little girl was more interested in showing me her favorite picture book than discussing her mental health. 

“I feel sad,” Teresa said quietly. That was about as much as she would say. 

Not that I could blame her. Why would a third grader want to divulge her feelings to a total stranger, over the phone no less? 

Reporting on children’s mental health presents challenges of age, privacy and emotional maturity. Even when journalists have the data to quantify the nature and scope of traumatic experiences, elementary school students are not the easiest to interview. And the public health constraints of the coronavirus pandemic made those conversations with families even more difficult. 

Before the pandemic, the process was rather straightforward. I was often able to meet in-person with students and their parents, as well as educators, getting to know them at their homes or schools. But safety precautions around COVID-19 created unprecedented institutional and personal barriers for fostering those relationships. 

Amid the spring lockdowns, data was already emerging to show that communities of color were being disproportionately impacted by COVID-19, exacerbated by long-standing racial and economic disparities. I wanted to explore how young Black and brown children were handling the grief and loss, and how the pandemic was affecting their lives. 

As I reported the story for The New York Times, it soon became clear that COVID-19 was only one of the perils many of these youth and their families feared. As the summer progressed, the Black Lives Matter protests, along with surging community gun violence, underscored the layers of trauma afflicting many of the communities most impacted by the pandemic. Unfortunately, most of the data on youth mental health focused on the pre-pandemic era, with few gleanings during or after the spring lockdowns. 

Even in normal times, mental health data largely quantifies the most tragic incidents: emergency room visits, self-harm, suicide. The underlying complexities that might explain why are rarely recorded in spreadsheets. And with many city schools closed during the pandemic, even educators were unsure exactly how students were coping with the pressures of distance learning and upended home lives. Government agencies were also hampered in collecting such information, though some officials whom I spoke to seemed less interested in sharing what they did know, and more concerned with framing their efforts in politically beneficial talking points. 

By the autumn of 2020, the toll on youth mental health was becoming devastatingly clear. Between March and October, according to data from the Centers for Disease Control and Prevention, there was a 24% spike nationwide in mental health-related emergency room visits among children between the ages of 5 and 11, and a 31% rise among those between 12 and 17, compared with the same period in 2019.

Dr. Adelaide Robb, the head of the psychiatry and behavioral sciences division at Children’s National Hospital in Washington, D.C., told me that compared to 2019, the hospital saw an increase last fall in minors being hospitalized for suicidal ideation, as well as for overdoses. The overdoses were so severe, she said, patients needed a high level of medical intervention and stabilization before they could be moved to the psychiatric floor.

In many low-income communities, however, long-standing fear of the authorities sometimes prompts families in crisis to avoid contacting the police during emergencies. Judith Sandalow, the executive director of the Children’s Law Center, which annually helps more than 5,000 at-risk children and families in Washington, D.C., told me that such families must contend with not only the pandemic, but a systemic suspicion among case workers that can culminate with family separation, despite parents’ best efforts. While middle class parents are generally trusted to make good decisions for their children, often “society and government agencies don't trust low-income parents to make the same kinds of choices,” she said. 

The coronavirus deepened the inequities in seemingly mundane yet powerful ways. Throughout the lockdowns and social isolation of the pandemic, middle class families found a salve for their mental health by taking walks. Yet many of the Law Center’s clients are scared to go outside, and have been stuck in cramped, poor housing conditions, Sandalow said. For families living in poverty and desperate to feed their children, the lack of access to coping outlets as simple as a daily walk only worsened the stress they were under. “Parents were trying to figure out so many different problems that they couldn't even focus on their kids’ schooling,” Sandalow said. 

During my reporting, I heard this stress in emotional interviews with single mothers who were trying to protect their children even as the social services that could normally provide assistance were closed, overwhelmed or out of reach. 

“You have to struggle with the question of ‘Do I leave my kids in the house by themselves, or do I go to work so we have something to eat,’” one mother told me.  

Another mother broke into tears as she recounted the mountain of paperwork burying her small table. Much of it was related to an ongoing custody case involving her ex-husband, whose years of physical abuse she described in harrowing terms. Meanwhile, she was feeling “overloaded” by the emotional needs of her children in their home, which was in a Washington, D.C. neighborhood plagued by gun violence. One of her sons frequently had nightmares about being shot, and the children went into “panic mode” whenever they heard the sound of nearby gunshots: turning off the lights, checking locked doors, dropping to the ground. 

Even seeing police officers in the neighborhood was traumatizing for her children, she said, recalling how her 5-year-old son started screaming when he noticed a police car behind them during a recent drive: “Mom I don't want them to lock you up, I don’t want them take your life, I don’t want them to take me away,” she recounted him yelling. 

Ultimately, I ended up including different quotes and interviews in my reporting. But those chilling insights helped illuminate the myriad difficulties low-income parents and their children face during the pandemic, and highlighted just how much harder it will be for them to heal emotionally after the nation returns to a normal that had left them traumatized to begin with.

Announcements

As public health officials like to say, "COVID-19 isn't done with us." And journalists know that we're not done with COVID-19. Apply now for five days of stimulating discussions on the pandemic's disproportionate impact on people of color -- plus reporting and engagement grants of $2k-$10k and five months of mentoring while you work on an ambitious project.

Are you passionate about helping journalists understand and illuminate the social factors that contribute to health and health disparities at a time when COVID-19 has highlighted the costs of such inequities? Looking to play a big role in shaping journalism today in the United States? The USC Center for Health Journalism seeks an enterprising and experienced journalism leader for our new position of “Manager of Projects.” 

 

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