Staying calm, vigilant can help mitigate COVID-19 effects on children’s mental health, experts say

Mobeen Rathore

The ongoing COVID-19 pandemic will likely present mental health challenges for children, according to child health experts who participated in a live panel discussion organized by Newswise.

Mobeen Rathore, MD, chief of the department of pediatric infectious diseases and immunology at Wolfson Children’s Hospital, said in a teleconference that public health interventions, including social distancing and avoiding large public gatherings, must remain in place regardless of individual mental health effects; however, health care providers and parents can mitigate these effects on children by remaining calm.

“Children are very quick to understand if their parents or health care providers are anxious,” Rathore said. “This is an adverse childhood experience. Many of these kids are not going to be seeing their pediatricians for obvious reasons, but whenever we have an opportunity to interact with our patients, we have to ask them questions: How are you doing? How can we help?”

A particular concern during the current outbreak environment is the management of screen time, Rathore said. Although the American Academy of Pediatrics recommends limited screen time for young children, the current circumstances might make such limits challenging for parents to enforce. Encouraging children and their parents to play board games or seek out activities not involving a screen may reduce negative outcomes, according to Rathore.

More severe and life-threatening mental health challenges potentially could arise, according to Robert Franks, PhD, president and CEO of Judge Baker Children’s Center.

“Increased stress and risk factors can contribute to challenges such as depression and suicidality, so this is something that we should definitely be watching for,” Franks said during the teleconference. “The advice I typically give parents, which is even more important now, is you know your kids better than anyone else. When you see changes in their behavior that are significant, such as in their sleeping or eating patterns ... these are times when you should really engage your child and have conversations with them.”

Franks noted that although clinicians might not be able to offer in-person assistance to these patients, many insurance companies, as well as Medicaid, have waived access restrictions to receiving telehealth. Thus, parents can call their insurance or Medicaid provider to be linked with a clinician who can then perform a screening of the at-risk child.

“Today, in my own practice, we had zero face-to-face visits,” Rathore said. “We had all telehealth visits, and we can [use them to address] mental health and [offer] counseling.”

Rathore noted that some insurance providers and states do not cover telehealth, so clinicians and mental health providers should advocate for payments for the provision of telehealth-provided mental health services.

According to Franks, for children in vulnerable populations, such as those from economically disadvantaged backgrounds or those who experience abuse at home, school is often the safest place.

“When they’re not in school, they’re going to be exposed to a much higher level of community risk factors,” Franks said. “The idea that we’re going to have a generation of children for a period of time who are going to be subject to a higher level of risk is real. When we come out of this, hopefully, we’re going to have to really invest in mental health services and supports to try to offset some of those adverse effects that this generation of kids is experiencing.”

Laurie Theeke, PhD, FNP-BC, GCNS-BC, FNAP, professor of nursing at West Virginia University, said clinicians and parents should ensure that children are avoiding negative coping strategies.

“Be vigilant [and look] for negative coping strategies, like vaping, smoking or substance use,” Theeke said. – by Joe Gramigna

Reference: Newswise. COVID-19 expert panel: Children's health, mental health, and education during the coronavirus outbreak. Available at: https://www.newswise.com/articles/covid-19-expert-panel-children-s-health-mental-health-and-education-during-the-coronavirus-outbreak-monday-march-23-at-2-pm-edt-media-invited-to-attend-and-ask-questions. Accessed March 24, 2020.

Disclosures: Healio Psychiatry could not confirm relevant financial disclosures at time of reporting.