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‘It’s heartbreaking for me to see my kids like this’: Children, parents and providers grapple with impact of pandemic on mental health
Morning Call - 1/24/2021
Jennifer Ortiz said that over the course of the pandemic she has watched as the mental health of her two daughters, Isabella Hartnett and Gianna Bright, declined.
Ortiz, of Allentown, said her daughters have preexisting mental health conditions: Both have attention deficit hyperactivity disorder, and Isabella, 6, has oppositional defiant disorder, a condition in which defying authority is chronic.
Isabella has been acting out — ignoring her teacher during virtual class, playing with scissors, cutting her hair, running out into the street and throwing tantrums any time she is told no.
“Due to some of the statements she was making and things she was saying in one session, the therapist came out and said, “You need to take this child to the emergency room for an immediate psychiatric evaluation,’” Ortiz said.
Meanwhile, the single mother said 8-year-old Gianna’s self-confidence has plummeted as she’s struggled with virtual-only classes and fallen behind on schoolwork.
“She thinks that she is not smart. She thinks that she is dumb, because she’s very behind in a lot of her studies,” Ortiz said. “Her mental health has declined and my own personal mental health has declined because of it — it’s heartbreaking for me to see my kids like this.”
Ortiz and her daughters are not alone — for many the pandemic has proven to be mentally trying. There has been a marked uptick in the number of children experiencing feelings of stress and depression, and some of the services in place to treat them are finding it difficult to meet the demand.
KidsPeace, the Lehigh Valley nonprofit specializing in children’s mental and behavioral health, is turning away troubled kids for lack of room.
“There probably hasn’t been a day that’s gone by, except maybe Thanksgiving, that we haven’t had to deny admission because there’s just more referrals than we have the space to take care of,” said Dr. Matthew Koval, executive vice president and chief medical officer for KidsPeace.
KidsPeace has limited the capacity of its inpatient centers to allow for adequate social distance, Koval said. Patients became sick with COVID-19 and units had to quarantine, further limiting the number of kids that can be admitted. Then staff get sick and have to quarantine, limiting admissions further.
Katherine Matonis, KidsPeace’s director of Pennsylvania community programs, said outpatient services have also been in high demand.
Koval said that for many people the pandemic is a chronic stressor, a constant presence as opposed to acute stressors that are one-time occurrences. He said about half of new admissions cite the pandemic and its effects as major factors.
The exact source of stress varies from child to child, he said, but some have cited virtual-only education, being stuck at home, social isolation, sickness or death in their family from COVID-19, or economic and financial hardship in their home as reasons.
But the young people admitted to KidsPeace aren’t just stressed. An increase in the number of serious mental health events among children appears to also be backed up by data from the Centers for Disease Control and Prevention on emergency rooms.
A CDC report released in November shows the average number of ER visits for mental and nonmental health reasons was high at the beginning of 2020 but declined once the pandemic hit the U.S. in mid-March. However, the proportion of ER visits for mental health reasons rose during the pandemic, especially among those age 12 to 17. During the first 11 weeks of 2020, mental health visits per every 100,000 emergency room visits were at 1,162, but from week 12 to week 42 this increased to 1,673. This proportion was also higher than the rate for weeks 1 through 42 of 2019.
Fathima Wakeel, a Lehigh University professor who is leading a study on the mental health effects of the pandemic, said there is no precedent for something like this in modern history. Because of this, she said there is not much research to help predict the full psychological impact the pandemic will have.
Wakeel said researchers have collected anecdotes and data on how the pandemic has effected the mental health of children, teens and adults. However, she said it will be some time before the long-lasting mental health effects of the pandemic are fully understood.
The available scientific research is limited but some studies and surveys conducted in the U.S. and abroad suggest a dramatic impact upon the mental health of children.
An article published by Psychiatry Research in August reviewed some available studies, and says that research has shown that for children confined at home, virtual-only education is associated with uncertainty and anxiety. It also says some children cooped up at home become more clingy, attention-seeking and more dependent on their parents due to the long-term shift in their school routine.
For children with neurodevelopmental, behavioral or emotional disabilities like autism, ADHD or cerebral palsy, the shift in life and school routines, as well as the loss of some resources, pose disproportionate hardship, the article states. These children may also have greater difficulties following instructions, understanding the complexity of the situation the pandemic has created and doing their own work independently.
Milagros Canales, of Allentown, can confirm the research. She said that for her adopted son Robert Ramos, 13, who has a moderate intellectual disability, the pandemic posed a series of challenges beyond what he was used to experiencing. Besides his intellectual disability, Robert also has intermittent explosive disorder, which is characterized by episodes of impulsive, aggressive, violent behavior as well as angry verbal outbursts, post-traumatic stress disorder and oppositional defiant disorder.
She said that though Robert is capable of verbal communication, due to his disability he has difficulty expressing himself and this causes him to act out. Canales said that under normal circumstances it is difficult to explain to the boy what he should or shouldn’t do, but it’s only been harder under the pandemic.
“He didn’t understand why we had the curfew and everything else — he just couldn’t handle it, it was hard for him. He doesn’t want to wear a mask, he just doesn’t understand the risks associated with it,” Canales said.
She added that Robert did not take well to virtual learning either and she couldn’t get him to do his schoolwork online.
Because of the pandemic, it also proved difficult for Canales to get Robert access to the educational, mental and behavioral health services he needed. She said her son needs people to be there working with him in-person, and social distanced measures like virtual counseling were not helpful.
“That’s the part that was the struggle for me,” Canales said. “I just kept feeling that I was losing support. I kept feeling that nobody understood what I was going through. And believe me, I had the people. I got [Lehigh County] Children and Youth Services involved. I had people in my corner that were willing, more than willing, to come and help me, but they couldn’t get in, they couldn’t get in because of COVID.”
However, Canales said in October she was finally able to get Robert enrolled at the Bradley Center in Pittsburgh, where he is getting the mental health and educational health services he needs.
Morning Call reporter Leif Greiss can be reached at 610-679-4028 or email@example.com.
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