Ensuring that our kids are all right

We are just starting to understand the effects the past two years have had on the mental health of children and youth. Helping our students with mental health disorders requires understanding the scope of the issue, combating outstanding myths, connecting children with treatment, supports, and services, and building strong support networks for all our young people.

Pediatric health providers have cited escalating rates of mental health challenges tied both to the COVID-19 pandemic and the on-going struggle for racial justice. And in late 2021, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association joined together to declare a National State of Emergency in Children’s Mental Health.

Mental health issues may be less obvious than physical ailments. Occasional emotional distress, anxiety, stress, and depression are normal experiences for all children and youth, and it can be difficult to distinguish between the behaviors and emotions that are related to typical child development and those that require extra attention and concern.

According to the Mayo Clinic, warning signs that a child may have a mental health disorder include:

• Persistent sadness — two or more weeks
• Withdrawing from or avoiding social interactions
• Hurting oneself or talking about hurting oneself
• Talking about death or suicide
• Outbursts or extreme irritability
• Out-of-control behavior that can be harmful
• Drastic changes in mood, behavior or personality
• Changes in eating habits
• Loss of weight
• Difficulty sleeping
• Frequent headaches or stomachaches
• Difficulty concentrating
• Changes in academic performance
• Avoiding or missing school

The American Academy of Pediatrics indicates that the stress, fear, grief, isolation, and uncertainty related to COVID-19 has likely increased the number of American children that have at least one mental health disorder. School closures, social distancing, loss of health insurance, disruptions in medical care, and the loss or change in primary or secondary caregivers are all contributing to rising rates of mental health concerns in children.

Indiana Youth Institute’s Mental Health Spotlight, which details Indiana specific data, reports that in 2020, the rate of Indiana students in grades 9 through 12 having felt sad or hopeless for two or more weeks in a row in the prior year were higher than for such youth nationally. Eighty-three Hoosier youth and young adults ages 10 to 19 died from suicide that year, and nearly 1 in 5 tenth grade Hoosiers reported considering attempting suicide, a higher rate than national averages.

In addition to our students with preexisting mental illness, those who are Black or Latino are at particular risk, having been more likely to contract COVID-19 or to have lost friends or family members. Inequities arising from structural racism have contributed to disproportionate impacts on children from communities of color. We need these historically marginalized students to receive a level of services matching their needs.

Responding to the increased mental health needs of our children and youth calls for action at the local, state, and national levels. The following strategies aim to increase mental health prevention, diagnosis, and treatment:

• Debunk the myths. Childhood mental illness is not caused by personal weakness or poor parenting. Children and youth cannot overcome mental health problems through willpower, nor will they grow out of their disorder.
• Ensure children, from infancy through adolescence, can access evidence-based mental health screening, diagnosis, and treatment to appropriately address their mental health needs, with particular emphasis on meeting the needs of under-resourced populations.

• Promote culturally grounded clinical practice. Communities can provide trainings and share resources to best help local clinical practitioners become more culturally aware and thus more culturally responsive in their practice.
• Improve access to technology to assure continued availability of telemedicine to provide mental health care to all populations.

• Foster increased access to comprehensive school-based mental health services, including clinical strategies and models for payment.
• Strengthen emerging efforts to reduce the risk of suicide in children and adolescents through prevention programs in schools, primary care, and community settings.
• Build and sustain community-based systems of care that connect families in need of behavioral health services and supports for their child with evidence-based interventions in their home, community, or school.
• Address longstanding workforce challenges in child mental health and intensify efforts to recruit underrepresented populations into mental health professions.

It is imperative that we understand and work to reduce the barriers of stigma and access to mental health care. Just as with physical illnesses, keys include ensuring children and youth in need can receive appropriate screening and treatment. We would not ignore a child’s physical ailment, and it is time that we consistently take the same approach to their mental health.

Find more data and information about the well-being of Hoosier children, Indiana’s overall child well-being rankings, and impacts due to COVID-19 at iyi.org/indiana-kids-count-data-book.

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About the Indiana Youth Institute :

For over three decades, Indiana Youth Institute (IYI) has supported the youth services field through innovative trainings’, critical data, and capacity-building resources, aiming every effort at increasing the well-being of all children. To learn more about IYI, visit www.iyi.org, follow us on Facebook or Twitter.