The coronavirus pandemic has not only wreaked havoc on the physical well-being of Americans across the country, but it has also exacerbated mental and behavioral health struggles for people of all ages, especially children. At a time when so many families are grappling with financial hardships and health concerns, the mental health of young people has taken a considerable hit, experts say.
“It really threw routines and regular life into sort of a crisis for everyone,” said Dr. Tami Benton, psychiatrist-in-chief at Children’s Hospital of Philadelphia during an Aug. 11 webinar hosted by U.S. News & World Report. “If you were already struggling prior to the pandemic, things just became much more difficult.”
Benton spoke on a panel discussion alongside Tim Robinson, chief executive officer of Nationwide Children’s Hospital in Ohio. The two hospital leaders explored the ways that children’s hospitals are working to improve and adjust to the mental health needs of young people in the midst of the ongoing pandemic.
School closures and the uncertainty related to reopening schools this fall have played a significant role in mental health challenges among young people. Many of them have continued to struggle with the rapid transition to online learning and the lack of in-person social interaction with friends, teachers and others outside of the home. Although parents often shared the same struggles and concerns, it has been difficult for many of them to be available enough to help their children process what they have been experiencing and assist teachers with virtual learning.
“So much of the support for the kids comes through the schools,” Benton said. “By losing the school connections, kids lost the opportunity to utilize those resources that exist in schools.”
CHOP, Nationwide Children’s Hospital and other pediatric institutions made a fairly quick transition to telehealth, which has been helpful in continuing to provide adequate mental health care to children throughout the pandemic so far, Robinson and Benton said. But going into the new academic year, partnerships between hospitals and schools will be just as crucial to ensure that the proper interventions kids need extend to the classroom.
At CHOP, for example, clinicians have been helping advise families on decisions regarding school and child safety. They are also partnering with teachers to work on stress management and the maintenance of their own physical and mental health through psychological first aid training and virtual group education so that, by extension, educators are well equipped to help their students and identify those who are struggling.
Additionally, many hospitals are working to monitor population health and provide necessary community-based services in proximity to schools. In its community of Columbus, Nationwide Children’s has a program called Partners for Kids, which delivers coordinated care to more than 325,000 children per year within the south central and southeastern regions of Ohio. Schools have been an important partner for the program, serving as an access point for the hospital to reach many kids in its area. However, the pandemic has been a major disruptor, and the road to getting back to normal has been challenging, Robinson said.
“There’s still just uncertainty of how different school systems are going to show up,” Robinson said. “But once they do, if they are in-person, it’s going to be a completely different experience.”
Another challenge children’s hospitals are facing is a reckoning with longstanding racial and socioeconomic disparities in health care. Low-income communities and minority populations have been heavily impacted by the COVID-19 pandemic at disproportionate rates in several areas, with mental and behavioral care for children being no exception.
“On a more personal level for a lot of clinicians … I think they learned where the disparities existed within our own practices in our own community,” Benton said. “And the dual pandemic of racism was highlighted at the same time.”
Hospitals like CHOP have, in some cases, gone beyond the threshold of traditional care to address the housing and food insecurities of patients and families, whether it be providing technology or supplying food and groceries.
The need for more awareness of the social determinants of care has also been a key focus. For example, at Nationwide, the Healthy Neighborhoods Healthy Families initiative has focused on revitalizing high-need neighborhoods of Columbus in order to best support the health and wellness of children and their families for over a decade.
“We’ve affected over 300 homes with providing affordable housing” and implementing “strategies for workforce development,” Robinson said, in addition to working with schools on education programs.
Though the need for mental health services for young people has increased due to the pandemic, children’s hospitals have suffered significant financial strain. Hospitals have received some support through the federal CARES Act, signed into law in March, but not much of that is meant specifically for investments in mental health care.
“The challenge has been that most of the mechanisms have been Medicare-based, and there are very few 65-year-old children,” Robinson said.
According to Robinson, there is significant return on investment in addressing mental and behavioral health. He noted Tuesday that 50% of adults identify mental health issues by the age of 14, so investing in addressing those needs could go a long way toward ensuring tremendous return for communities and the country as a whole.
“It’s just an area that has been underprioritized, I think, by our society more broadly,” Robinson said. “It’s an area that we all have to advocate for.”