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Hundreds of Suicidal Teens Sleep in Emergency Rooms. Every Night.

Hundreds of Suicidal Teens Sleep in Emergency Rooms. Every Night.

by | Jun 9, 2022 | Blog

With inpatient psychiatric services in short supply, adolescents are spending days, even weeks, in hospital emergency departments awaiting the help they desperately need.

NYTimes,  May 8, 2022, By Matt Richtel, Photographs by Annie Flanagan, Matt Richtel spent more than a year interviewing adolescents and their families for this series on the mental health crisis.

On a rainy Thursday evening last spring, a 15-year-old girl was rushed by her parents to the emergency department at Boston Children’s Hospital. She had marks on both wrists from self-harm and a recent suicide attempt, and earlier that day she confided to her pediatrician that she planned to try again.

At the E.R., a doctor examined her and explained to her parents that she was not safe to go home.

“But I need to be honest with you about what’s likely to unfold,” the doctor added. The best place for adolescents in distress was not a hospital but an inpatient treatment center, where individual and group therapy would be provided in a calmer, communal setting, to stabilize the teens and ease them back to real life. But there were no openings in any of the treatment centers in the region, the doctor said.

Indeed, 15 other adolescents — all in precarious mental condition — were already housed in the hospital’s emergency department, sleeping in exam rooms night after night, waiting for an opening. The average wait for a spot in a treatment program was 10 days.

The girl and her family resigned themselves to a stay in the emergency room while she waited. But nearly a month went by before an inpatient bed opened up.

The girl, being identified by her middle initial, G, to protect her privacy, spent the first week of her wait in a “psych-safe” room in the emergency department. Any equipment that might be used for harm had been removed. She was forbidden to use electronics — to keep her from searching the internet for ways to commit suicide or asking a friend to smuggle in a sharp object, as teens before her had done. Her door was kept open night and day so she could be monitored.

It was “padded, insane-asylum-like,” she recalled recently in an interview. “Just walls — all you see is walls.”

She grew “catatonic,” her mother recalled. “In this process of boarding we broke her worse than ever.”

Mental health disorders are surging among adolescents: In 2019, 13 percent of adolescents reported having a major depressive episode, a 60 percent increase from 2007. Suicide rates, stable from 2000 to 2007, leaped nearly 60 percent by 2018, according to the Centers for Disease Control and Prevention.

G’s story describes one of its starkest manifestations of the crisis. Across the country, hospital emergency departments have become boarding wards for teenagers who pose too great a risk to themselves or others to go home. They have nowhere else to go; even as the crisis has intensified, the medical system has failed to keep up, and options for inpatient and intensive outpatient psychiatric treatment have eroded sharply.

Nationally, the number of residential treatment facilities for people under the age of 18 fell to 592 in 2020 from 848 in 2012, a 30 percent decline, according to the most recent federal government survey.The decline is partly a result of well-intentioned policy changes that did not foresee a surge in mental-health cases. Social-distancing rules and labor shortages during the pandemic have eliminated additional treatment centers and beds, experts say.

Absent that option, emergency rooms have taken up the slack. A recent study of 88 pediatric hospitals around the country found that 87 of them regularly board children and adolescents overnight in the E.R. On average, any given hospital saw four boarders per day, with an average stay of 48 hours.

“There is a pediatric pandemic of mental health boarding,” said Dr. JoAnna K. Leyenaar, a pediatrician at Dartmouth-Hitchcock Medical Center and the study’s lead author. In an interview, she extrapolated from her research and other data to estimate that at least 1,000 young people, and perhaps as many as 5,000, board each night in the nation’s 4,000 emergency departments.

“We have a national crisis,” Dr. Leyenaar said.

This trend runs far afoul of the recommended best practices established by the Joint Commission, a nonprofit organization that helps set national health care policy. According to the standard, adolescents who come to the E.R. for mental health reasons should stay there no longer than four hours, as an extended stay can risk patient safety, delay treatment and divert resources from other emergencies.

Yet in 2021, the average adolescent boarding in the E.R. at Boston Children’s Hospital spent nine days waiting for an inpatient bed, up from three and a half days in 2019; at Children’s Hospital Colorado in Aurora in 2021, the average wait was eight days, and at Connecticut Children’s Medical Center in Hartford, it was six.

Emergency-department boarding has risen at small, rural hospitals, too, with “no pediatric or mental health specialists,” said Dr. Christian Pulcini, a pediatrician in Vermont who has studiedthe trend in the state. “There is one clear conclusion,” he told the Vermont legislature recently. “The E.D. is not the appropriate setting for children to get comprehensive, acute mental health services.”

Doctors and hospital officials emphasize that adolescents should absolutely continue to come to the E.R. in a psychiatric emergency. Still, many emergency-room doctors and nurses, trained to treat broken bones, pneumonia and other corporeal challenges, said the ideal solution was more preventive care and community treatment programs.

“Frankly speaking, the E.D. is one of the worst places for a kid in mental health crisis to be,” said Dr. Kevin Carney, a pediatric emergency room doctor at Children’s Hospital Colorado. “I feel at a loss for how to help these kids.”

The challenge was evident one day in late February when Dr. Carney arrived for his shift at 3 p.m. The children’s hospital has 50 exam rooms in its emergency department, which fill with patients who have gone through an initial screening and need further evaluation. By midafternoon, 43 of the rooms were full, 17 of them with mental health cases.

“It’s breathtaking,” Dr. Carney said as he stood in the hallway. “Forty percent.”

On clocking in, Dr. Carney had inherited a block of 10 exam rooms from a doctor who was clocking out. “Seven are mental health issues,” Dr. Carney said. “Six are suicidal. Three of them made attempts.”

The adolescents who were deemed to be at physical risk to themselves or others could be readily identified: Their exam room doors were open so they could be monitored, and they wore maroon-colored scrubs instead of their own clothes. No shoelaces, belts or zippers.

Throughout the day, staff members at the hospital had called eight inpatient facilities in the region, looking for available slots in treatment centers where the 10 young boarders, as well as 17 other adolescents boarding at three smaller Colorado Children’s Hospital campuses around the state, could be placed.

One of the adolescents waiting in Aurora, a Denver suburb, was a 16-year-old who had been stabilized after attempting suicide and who needed a residential treatment spot. “But there are no beds,” Jessica Friedman, a social worker, said she had told the family.

“I have eight or nine conversations like this a day,” Ms. Friedman, standing in the hallway, told a reporter; so far that day she had had only two. “This is actually a good day.”

Standing nearby, Travis Justilian, a nurse and the interim clinic manager in the emergency department, said the flood of boarders “is crushing our staff.” He added, “We’re fixers and we’re sitting here doing nothing but watching them watch TV.”

Colorado is struggling with the same shortage of services that has hit hospitals nationwide. The state has lost 1,000 residential beds serving various adolescent populations since 2012, according to Heidi Baskfield, vice president of population health and advocacy for Children’s Hospital Colorado. The state closed one 500-bed facility, Ridgeview, which served at-risk young people, in 2021 because of instances of poor quality and abuse. Another facility, Excelsior, closed its 200 beds in 2017 because reimbursement rates were not high enough to support ongoing operations, the chief executive officer said at the time of the closing.

A major cause, Ms. Baskfield said, was the low reimbursement rates paid by Medicaid, the state insurance program. From 2006 to 2021, the daily Medicaid rate in Colorado allotted roughly $400 for a therapeutic residential bed — “less than some families spend to send their kids for a night to sleepaway camp,” Ms. Baskfield said.

The low rates also accounted for some of the quality issues, she said; it was hard to hire experienced staff. (In the past year, Colorado has raised its reimbursement to $750 per day by using money from the American Rescue Plan, but new beds have yet to open, and that source of money is temporary.)

Lisette Burton, chief policy and practice adviser for the Association of Children’s Residential and Community Services, a nonprofit advocacy group, noted that, nationally, the closure of facilities and the loss of beds was the result of many factors, including a well-intended, decades-long effort to keep foster children and other children out of institutional settings. But the intended substitutes — more nimble and specialized treatment options — were never funded and remain largely unavailable, she said.

Then came the pandemic, amplifying labor shortages and introducing social-distancing and quarantine guidelines that reduced the capacity for patients. “Demand went up, supply went down,” Ms. Burton said. “Now we’re in full-blown crisis.”

On that February day in Colorado, one inpatient bed finally opened up. It happened to be in the 12-bed inpatient ward of Children’s Hospital Colorado, just a few minutes’ walk from the E.R.

The ward’s hallways are wide, the walls painted light green and the lighting bright, to instill a feeling of comfort and calm. Each bedroom has windows looking outside and, next to the door, a glass panel enabling hospital staff to discreetly peer inside.

In a small communal room, four adolescent girls in maroon scrubs sat on blue chairs and couches. One listened to headphones and sang aloud to the soundtrack to “Encanto.” Another worked on a jigsaw puzzle of the sea. Two others chatted with a counselor.

The emergency department “is just a collection of rooms where patients are expected to stay in their rooms and comply with rules,” said Lyndsay Gaffey, director of patient care services at Children’s Hospital Colorado. In the inpatient ward, she said, the aim instead was to stabilize patients by having them work through trauma, receive therapy and interact with peers.

But they must be closely watched here, too. When a reporter rested a pen on a countertop, a staff member swept it up. “You cannot have this here unless it is on your person,” she said. “If a patient walks over and grabs it, it can basically be used as a weapon.”

In severe cases of mental distress, emergency-room doctors can compel an adolescent to board in the E.R. until inpatient services become available, however long that takes. Often, parents opt to return home with their child, to try to manage there while waiting for a treatment opening. But that option requires family and doctors alike to work through a difficult question: Is the adolescent safe to go home?

In early February, a 12-year-old boy, J, was struggling toward an answer at the emergency room of the Highlands Ranch campus of Children’s Hospital Colorado. (He is being identified by his first initial for privacy reasons.)

He had arrived that morning with his mother, after she discovered that he had been searching the internet for ways to commit suicide. Over the course of his day in the E.R., he was asked several times how safe he felt to go home. The mother recounted one exchange:

“Do you think you can go home?” the doctor asked.

“What’s the other option?” J asked.

“You’d be in the emergency room.”

“I can go home with my mom,” J said. “But if I feel like I’m going to kill myself, what do I do?’”

“You’ll come back to the emergency room,” the doctor replied.

J’s mother took him home and “hid every medicine and every knife,” she said. J wanted to get help and asked her that first night: “So can I start tomorrow?”

No, his mother told him, he’d have to wait. Sixteen days went by before a spot for J opened in an intensive treatment program. She watched her son around the clock. “It was the scariest two weeks of my life,” she said.

For adolescents like G, who stayed in the emergency room of Boston Children’s Hospital last spring, the experience can be wrenching.

G lives in a Boston suburb with a teenage brother, father and mother. The family has a history of anxiety and depression, the mother said, but G had been a happy and adventurous child. In middle school she started talking back and acting somewhat obsessively, behavior that her mother figured was typical for a teenager.

What G’s mother did not know was that her daughter had been cutting herself for two years, since seventh grade, before the pandemic began. “I cut with literally anything I could find — hockey cards, pipe cleaners, paper clips, anything,” G said. She described the self-harm as a “coping mechanism” to deal with inner pain. She hid the activity “with sweaters, hoodies, foundation.”

As the pandemic set in, G withdrew, and her grades fell. “Then came April 29,” her mother said. “We had a life before April 29 and a life after April 29.”

That day, she picked up G at school for a routine visit to the pediatrician. As G got into the car, her mother saw the marks on her wrists.

At the emergency room, G told the medical team she had tried to overdose a few weeks earlier and had regretted the next morning that she was still alive. In the exam room, she noticed a container of hand sanitizer. “I told them, ‘I’m thinking about drinking this,’” G recalled.

Admitting to her pain and self-harm provided her “with kind of a little bit of relief,” she said. “After two years of cutting and trying to kill myself, I was finally going to get some help. But I didn’t really get help.”

That first night, she was moved for safety reasons to a room that contained just a bed and, for her mother, a rollaway. With the door open, sleeping was difficult. “A sitter was literally staring at my kid,” G’s mother said. “It felt demoralizing.”

Mother and daughter played Uno, Go Fish, checkers and Connect Four. G, anxious and awake, received Ativan on three of the next four nights, then was prescribed Trazodone for chronic anxiety.

Boarding night after night in an emergency department can overwhelm some adolescents, said Dr. Amanda Stewart, an emergency room pediatrician at Boston Children’s. One day this February, she was treating an infant with a respiratory infection when she heard screaming. It came from a 12-year-old boy with attention-deficit disorder and autism who had threatened suicide and was boarding down the hall.

“Other patients started escalating,” Dr. Stewart recalled. “One of them, across the hall, started hitting her head against the wall.” The girl, 15, had entered the E.R. after a suicide attempt and had been calm until that point.

Dr. Stewart said that some teens tell her that boarding in the emergency department intensified their suicidal urges. “I’ve heard that from kids many times,” she said, recalling that they will say: “‘I’m not going to tell you next time, because it means I’m going to have to come here again.’”

Dr. Patricia Ibeziako, a child psychiatrist at Boston Children’s Hospital, said that adolescents do, in fact, receive some treatment while boarding in the emergency department, including basic counsel aimed at “crisis stabilization” that is “all geared to safety.”

“Boarding is not a great thing, but it’s still care,” Dr. Ibeziako said. “We’re not just putting a kid in a bed.”

May 7 arrived — G’s eighth day in the emergency ward — and still no inpatient beds were available in the region. But a bed did open in the hospital, upstairs in the pediatric medical unit; this room had a window and a private bathroom, and a caregiver who watched G around the clock.

She “was very, very, very depressed and dejected,” her mother recalled. “She didn’t even cry anymore.”

Finally, 29 days after G arrived, a bed was located for her at an inpatient facility in an outlying suburb. She spent a week there but did not find the experience all that helpful.

“We learned the same coping skills over and over,” she said. Over the summer, she worked a fast-food job, but she continued cutting herself, she said, and did a better job of hiding it.

In the fall, she told a counselor at school that she planned to kill herself; she was quickly re-admitted to the same inpatient unit, given priority as a former patient, and spent two weeks there. When her stay ended, G went into an intensive outpatient program. But a counselor there told her mother that G needed more intensive care because she had described a plan to kill herself.

“They told me, ‘This kid is on fire, she’s too acute to be here,’” G’s mother recalled. This time, the family went to the emergency room at a different Boston-area hospital, Salem Hospital, where G boarded only one night and, this time, was lucky to get a bed in that hospital’s inpatient unit, where she spent three weeks, until mid-October.

G’s mood these days is “better than it was, but it still sucks,” she said recently. And, she added, “I’m better at covering things up more.”

“Once people ask you a question, ‘Do you feel suicidal,’ you have to say nope,” she said. “You can’t tell them anything or they’ll send you to the hospital.”

Matt Richtel is a best-selling author and Pulitzer Prize-winning reporter based in San Francisco. He joined The Times in 2000, and his work has focused on science, technology, business and narrative-driven storytelling around these issues. @mrichtel

 

The Guidance Center’s Work “Beyond Our Walls”

The Guidance Center’s Work “Beyond Our Walls”

by | May 27, 2022 | Anton Media, Blog, In The Media

By Kathy Rivera, published in Anton Media, May 27, 2022

North Shore Child & Family Guidance Center is known throughout Long Island as the preeminent mental health organization for youth and families, providing individualized, culturally sensitive therapeutic services that serve to bring hope and healing to those experiencing mental health challenges. For nearly 70 years, the Guidance Center has been listening to your needs and concerns, and responding swiftly and compassionately. Since May is Mental Health Awareness Month, we wanted to share with you some important information on our offerings. 

As we told you in our April Anton column, we shifted to a hybrid model of service within days of the pandemic’s beginning, seeing clients both in person and via a secure telehealth platform. 

But if you picture the work of the Guidance Center as taking place only inside our three buildings or via a virtual platform, with a counselor and client sitting in an office or communicating via a smartphone or computer, think again. Many of our innovative programs happen beyond our walls, in places that range from state parks to schools to homes. 

The Guidance Center’s Wilderness Respite Program, now in its 23rd year, provides a unique opportunity for at-risk adolescents to put down their tech devices and participate in hikes and other nature activities that help them gain confidence and make lasting friendships. 

Nature takes a leading role in our two Organic Gardens, located at our main headquarters in Roslyn Heights and our Marks Family Right from the Start 0-3+ Center in Manhasset. By weeding, seeding and tending to the crops, kids blossom as they learn important skills such as self-confidence, cooperation and responsibility.

The Guidance Center also has a Nature Nursery, where our youngest clients use all their senses as they touch pinecones or paint on an outdoor “canvas.”  The textures, sounds and sights help children explore their creative sides and learn skills to help cope with difficult feelings.

In addition to therapy, our Latina Girls Project incorporates monthly outings to places such as theaters, museums and more. These trips boost the teens’ confidence and sense of independence and help them discover the larger world. In 2019, the trips expanded to include outings for boys that also have been a huge success.

Students from 5-21 who’ve had a hard time succeeding in school have a great alternative with our Intensive Support Program (ISP), held at three Nassau County B.O.C.E.S schools. There, they receive academic help and counseling, with therapists on site to help them flourish emotionally and academically.

We also work in Westbury high school and middle school with our Teen Intervene and Too Good for Drugs programs, designed to prevent substance and alcohol use. 

For children and teens who need our help but can’t come to our offices, the Guidance Center provides intensive in-home therapy with our Clinical Care Coordination Team (CCCT). CCCT aims to lessen acute symptoms, restore clients to prior levels of functioning, and build and strengthen natural supports. Through CCCT, our goal is to reduce unnecessary emergency room visits, hospitalizations and residential placements.

Our Coordinated Children’s Services Initiative (CCSI) supports families with the coordination of services in their homes and communities, identifying and accessing resources, providing advocacy and helping children and families gain the skills and tools needed to be self-sufficient.

Through our Family Advocate Program, parents who have been through mental health crises with their own children are trained to offer peer support for families by joining them at special education meetings, offering support groups and providing many other resources. 

In addition, we have enhanced services to the clients in our Diane Goldberg Maternal Depression Program by adding yoga classes and self-care outings.

As you can see, the Guidance Center is always thinking “outside the box,” creating innovative programs that meet the needs of the community and enhance the therapeutic value of all our services. We are here for you!

Bio: Kathy Rivera, LCSW, is the Executive Director/CEO of North Shore Child & Family Guidance Center, Long Island’s leading non-profit children’s mental health organization. To get help for your child or to support the Guidance Center’s lifesaving work, call (516) 626-1971 or visit www.northshorechildguidance.org.

How to talk to kids about the Texas school shooting

How to talk to kids about the Texas school shooting

by | May 26, 2022 | In The Media, Newsday

Newsday, By Beth Whitehouse, May 26, 2022, featuring Kathy Rivera, Executive Director/CEO, North Shore Child & Family Guidance Center

Click here to watch a powerful video posted with this article.

“Am I safe?” 

That may be the first reaction of school-aged children when they hear about Tuesday’s mass shooting at Robb Elementary School in Texas that left 21 people dead. “Most children want to know, ‘Am I going to be OK? Are you going to be OK? Is this going to happen to me?’,” said Mary Pulido, executive director of the Manhattan-based New York Society for the Prevention of Cruelty to Children. 

Long Island social workers and psychologists offered advice for parents: 

See what your child knows. Ask if they’ve heard any news that they want to talk about, and if so, what they heard, advised Kathleen Rivera, executive director and CEO of North Shore Child and Family Guidance Center, with offices in Roslyn, Manhasset and Westbury. “Let the child use their own words to tell their own story. Sometimes you need to know what you’re working with before you can take proper action,” she said. Correct misinformation and talk to them in ways appropriate for their age. 

If you think they haven’t heard about the shooting, you may wonder whether you should bring it up. While you know your child better than anyone, experts generally suggest introducing the topic. With cellphones and TV ubiquitous, chances  are if they don’t hear about it from you, they will hear about it from someone else when you aren’t there to help them manage their reaction, Rivera said. You don’t need to be detailed, experts said. Kids understand the concept of good and evil.

Emphasize that many people work every day to keep them safe. Tell them, “Days, months, and years have gone by when you are OK and adults have protected you,” said Don Sinkfield, vice president of The New Hope Mental Health Counseling Services in Valley Stream. Outline in concrete terms that it’s your job to protect them, and that many people — from the President of the United States to their local police department to their individual teachers — are protecting them as well, experts said. “You can’t promise them something that is false — ‘it will never happen again,’” Rivera said. But remind them that their school has plans for how to keep them safe; you could review those plans, but don’t contradict the school’s protocol, experts said. 

Don’t have the conversation at night. A lot of parents connect with their children at bedtime. That may not the best time to broach the topic, said Laurie Zelinger, a child psychologist in private practice in Cedarhurst who spent 19 years as an elementary school psychologist in the Oceanside School District. “If you have a child who is particularly anxious or sensitive, have the conversation early in the day,” she advised. Give them a chance to absorb the information and ask questions. 

Keep children away from constant news. “Please turn off the TV, stop the social media apps,” Rivera said. “Stay present with your child.” 

Be conscious of your own reaction and how you are expressing it. “It can have a trickle-down effect,” Rivera said. This shooting happened on the heels of the mass shooting in a supermarket in Buffalo, so adults are feeling vulnerable as well. “We didn’t have a chance to recalibrate,” she said. 

If your child is afraid to go to school and really needs a day to stay home for a day, that may be OK. “Right after a tragic event, kids can have acute stress. You want to be able to help kids resurrect a feeling of safety, and they will feel safer at home,” said Zelinger, who is also the author of the children’s book, “Please Explain Anxiety to Me” (Loving Healing Press, 2014). 

This is not a “one and done” conversation. “As a parent, you have to do a temperature check on your child,” Rivera said. They might be OK today, but not tomorrow. Parents should look to community resources, she said. “We are a phone call away.”

Make the Most of Moving with an Autistic Child

Make the Most of Moving with an Autistic Child

by | May 20, 2022 | Blog

By guest blogger Jenny Wise

Having a child on the autism spectrum brings about an array of emotions. You have your good days and bad days. You probably already know that certain experiences, like moving, require careful consideration and understanding. If you need pointers to help make your upcoming move as smooth as possible, spend a few minutes reading the following guide presented by North Shore Child & Family Guidance Center.

Make the Experience a Positive One

Your child may struggle with change, especially sudden changes. Let your kid know as soon as you can that you’re planning to move. Introduce the subject calmly. Explain to your child why you’re moving and how wonderful the experience can be. Incorporate your child in the moving process as much as possible, such as by helping pack boxes. 

Research the Market

Before you start looking for a house in Roslyn Heights, research your target market. Discover how much the average home costs.

Use this information to determine how much you can spend on a home. Look into grant programs that may help you with the cost of home modifications for children with autism.

Consider choosing a house with a fenced-in yard, or think about hiring a fence installer to add one. Make sure you look at schools and parks in the area, too.

Make a Calming Space for Your Child

You’re probably already experienced a number of meltdowns during your time parenting your autistic child. These emotional outbursts are a reaction to too many stimuli.  

By creating a calming space in the new house, your child will have an area they can go to when the world becomes too much.

Think about your child’s sensory needs. You’ll more than likely want light-blocking curtains. Walls should be a light color, nothing too bold, dark or bright. Gather a collection of sensory toys, such as water beads or fidget toys. 

Declutter and Clean 

As you’re in the process of moving, make sure you’re decluttering and cleaning as you go along. You’ll make life simpler by reducing clutter. Not only can clutter make you feel overwhelmed, but it can also affect your child negatively as well.  

As you sort through the items, get rid of duplicates or anything you haven’t used in a year. If you notice something has collected dust, it’s probably safe to toss it. Consider taking photos of nostalgic items rather than keeping them all. 

If you notice you have an upholstery stain that you’ve unsuccessfully battled using store-bought cleaners, contact a professional upholstery cleaner to contend with the blemish. You’ll reduce your stress so you can focus on your child, you, and the move.

As you’re searching for an upholstery cleaner, look online for reviews to compare. Choose a few that have the highest ratings and schedule meetings. Make sure you discuss your needs and get quotes. Ask for referrals from previous clients. As a general rule, you should avoid companies that use all-in-one cleaners.  

By following some of these tips, your child will have a much easier time moving—and so will you!Bio: Jenny Wise created Special Home Educator as a forum for sharing her adventures in homeschooling and connecting with other homeschooling families. She has been homeschooling her four children for many years now, including her youngest daughter Anna who is on the autism spectrum.

Responding to the Crisis in Children’s Mental Health

Responding to the Crisis in Children’s Mental Health

by | May 5, 2022 | Anton Media, Blog, In The Media

By Kathy Rivera, published in Anton Media, April 27, 2022

As of this writing, while COVID-19 cases have been inching up, most experts say that we have moved into a new phase of the pandemic, where the disease, while still dangerous, is less deadly than previous strains. In addition, preventative measures and treatments have advanced far beyond the early days of the crisis, when so little was known.

Certainly, that is news we’ve all been hoping to hear for more than two years, but there is another crisis that shows no signs of abating: the epidemic of mental health issues spurred by long-term social isolation, anxiety, illness, financial insecurity and other challenges. 

While all of us have been impacted, the reality is that children, teens and young adults have experienced the losses surrounding COVID-19 in deep and potentially long-lasting ways. Numerous studies have reported sharp increases in rates of depression, anxiety, loneliness and suicide attempts. In addition, the number of U.S. children who have a lost a parent or other caregiver to COVID-19 is estimated to exceed 200,000.

In a first-of-its-kind study of youth mental health during the pandemic period, released on March 31, 2022, the Centers for Disease Control and Prevention reported a dramatic increase in emotional and psychological trauma in kids and teens. More than a third of high school students said they experienced poor mental health during the pandemic, with 44% reporting they felt “persistently sad or hopeless.” One in five considered suicide, and nearly 10% made a suicide attempt. 

The CDC also reported that, during the first seven months of lockdown, hospitals experienced a 24% rise in mental-health-related emergency visits for children aged 5 to 11, and a 31% increase for those aged 12 to 17.

Sadly, these statistics came as no surprise to the team of clinicians at North Shore Child & Family Guidance Center (the Guidance Center).

From the early days of the pandemic, we have been flooded with calls from hospitals, emergency rooms, urgent care centers, parents, schools and others desperate for help as they saw those statistics come to life.

At the Guidance Center, we’ve provided therapy to children—some as young as three years old—who are experiencing deep grief from the loss of a parent or other loved one. Many are grieving a loss of hope and confidence about their futures. Others are in dire financial situations born of pandemic job loss. All lost fundamental things that we used to take for granted: the ability to be with friends, go to school, celebrate joyous occasions, participate in extracurricular activities and have confidence that we were safe in the world. 

Even if the pandemic disappeared tomorrow, the mental health effects would not disappear with it. Unfortunately, we cannot expect our children to simply get over what has been such a profoundly difficult, scary and uncertain time.

Despite these gloomy predictions, parents need not succumb to hopelessness. You have a vital role to play, and it’s one that can make all the difference in helping your children survive and even thrive despite the challenges of the past two years.

First, be on the lookout for signs of emotional distress. Is your child or teen isolating themselves, even though they are allowed to be with others? Have their sleeping or eating patterns changed? Have their grades dropped dramatically? Have they lost interest in the things that used to make them happy? Are they more irritable than usual? Have they turned to substances to improve or numb their moods?

Don’t assume that they will tell you they’re struggling. Ask them how they are feeling. Assure them that it’s normal to be feeling sad, scared and even angry in the face of all they’ve experienced. And tell them there is absolutely no shame in asking for professional help. Tell them, it’s OK not to be OK.

The Guidance Center has been serving the community for nearly 70 years, and we are here during this time. We never turn anyone away for inability to pay, and we promise to see urgent cases within 24 to 48 hours through our Douglas S. Feldman Suicide Prevention Project and our Fay J. Lindner Foundation Triage and Emergency Services. We offer individualized, culturally sensitive treatment via telehealth, in person or a combination of both, depending on the needs of the family.

Children are not little adults. They have specific needs that are best addressed by mental health professionals who are specially trained to help young people. They are also resilient, and with the proper support, they will overcome the challenges brought on by the pandemic. We all will.

Bio: Kathy Rivera, LCSW, is the Executive Director/CEO of North Shore Child & Family Guidance Center, Long Island’s leading non-profit children’s mental health organization. To get help for your child or to support the Guidance Center’s life-saving work, call (516) 626-1971 or visit www.northshorechildguidance.org.