Mental Health Matters in the Month of May!

Sanjivan V. Patel, MD, FAAP

Sanjivan V. Patel, MD, FAAP

Sanjivan Patel, MD, FAAP
Chairman, Department of Pediatrics
Wyckoff Heights Medical Center

Christian McCartney-Melstad, DO, PGY1
Department of Pediatrics
Wyckoff Heights Medical Center

May is Mental Health Awareness Month and an excellent reminder to pediatricians to consider the mental health of their patients and their families at every visit.

This is even more important than usual, given the enormous disruptions caused at all levels of society by the COVID-19 pandemic.  Schools have been closed, children have been isolated with their families, and social activities have been cancelled or changed.  Families may be under enormous health, financial, and interpersonal stress.  Amidst all of these adjustments, mental health can become particularly vulnerable.

For young children, parents can adopt some simple steps to help children deal with these new fears and anxieties.

  • Talking with your child and ascertaining what they know about the coronavirus and COVID-19 can be a good place to start.
  • Answering their questions and reassuring them in an age-appropriate manner may ease their concerns.  Even if you don’t know the answers, voicing the child’s concerns may ease their anxiety.
  • Help your child understand that it is natural and normal to worry about these changes, and that everybody does.
  • Don’t try to protect or shield your child from news or current events.  The child may hear other, less-accurate information from their friends or online.
  • Be mindful that you model behavior for your child; if you exhibit anxiety or fear, they will perceive this.  Adults may need to be more thoughtful in how they express their emotions.
  • Teach your child that they are unlikely to become seriously ill, and that if they are sick, you will take good care of them.  Tell them what kind of support you have in case you get sick.
  • Help your child learn how to take proactive steps to protect themselves.  Practice handwashing, mask usage, and discuss the importance of social distancing.
  • Maintain as much normality in your lives as possible.  Try to keep some of your old, familiar routines.  This will help your child feel safe and stable.
  • Devote quality time to your child.  This can be challenging when everyone is at home together all day long, but it creates a space for gentle reassurance and an opportunity for them to voice their concerns informally.
  • Help your child think about actions they can take to feel safer.  Encourage them to pursue hobbies and relaxation.
  • Your child may want more close contact with you and feel more than usually anxious about separation.  Be prepared for more physical contact than usual.

School-aged children may have different concerns.  At this age, they may begin to take more comfort from facts. Parents can discuss some more of the science behind the disease with these children, and use informative graphs and figures to greater effect.  These kids can also be taught to distinguish truth from rumor, especially when considering anonymous or internet sources.  As with younger children, don’t try to disguise or conceal information: they’ll either get their information from you or from their friends.

Older children’s social needs are also more sophisticated.  Until it is possible to see their friends in person or return to school, consider setting up video calls or play dates.  Even short interactions can serve to maintain connections and decrease loneliness and social isolation.  Scheduling such calls in advance or making them part of the home school routine can help preserve a sense of predictability in the child’s life.

Teenagers’ needs are different than those of the younger or school-aged children, of course.  They may feel especially isolated as social distancing cuts them off from their friends.  The loss of milestone events like proms, graduations, and organized sports can be particularly difficult for them.

For teens, create a schedule that accommodates their online learning requirements.  Be flexible and allow “down time” and privacy.  Share the information that you receive from reputable sources and talk about how the can do their part to help slow the virus’s transmission by social distancing and practicing good hygiene.

Parents need to look after themselves, too!  Adults should take advantage of their social networks and healthcare resources to get the support that they need to best care for their kids.

Beyond these simple steps, we have identified several resources that pediatricians can use to help their patients and their families to understand the illness, the changes in their daily lives, and the importance of maintaining healthy habits in this time of uncertainty.

Organizations like ProjectTEACH provide many resources for pediatricians and their patients of all ages.

COVIBOOK” is a free PDF book downloadable in many languages that addresses young children’s emotions and explains the virus and its spread in simple language.

For older kids, “Coronavirus: A Book for Children” (also a free PDF) discusses the basic science behind the virus and its transmission, and specifically addresses the stress and difficulty of the social changes that children are dealing with, like staying home and not seeing their friends and family members.

There are abundant resources available online for parents, too.  The AAP’s own website is an excellent place to start.  Other AAP resources, like the “Information for Families” webpage, add even more information. For comprehensive children’s mental health resources, parents can visit NYU Langone’s “COVID-19 Mental Health Resources for Families” website, the American Psychological Association’s page, or American Academy of Child and Adolescent Psychiatry’s resources.  Even mainstream publications like the USA Today have offered helpful advice.

Of course there are many, many other resources available online; many are of dubious quality.  With so many options, pediatricians can help their patients’ families by recommending high-quality, evidence-based information sources.