When Things Aren’t OK With a Child’s Mental Health – The New York Times

Dr. Spinks-Franklin suggested a free downloadable ebook about coronavirus for children, put out in collaboration with the American Psychological Association. “I actually read that with one of my patients through our online call,” she said. “She was just so anxious about coronavirus and we read the book together.” Afterward, she said, “she was able to articulate how much she learned from the book and what she can do and what her family can do to keep them safe.”

If you’re worried about your child, you may need some guidance in finding help in this changing landscape of remote therapy and tele-mental health. “Often I’ll tell people to start with their pediatrician, they often have a sense of what’s available, and recommendations around mental health providers,” Dr. Vinson said. “Insurance companies have really lowered barriers around providing tele-mental health services,” she said.

The summer may be a good time to look for a therapist if a child is struggling; as the school year picks up, schedules may fill. Talk to your child’s primary care provider, talk to the school, consider reconnecting with a counselor or therapist who has seen your child before. If your child is already taking a medication — for anxiety, for attentional issues, for depression — talk to the doctor who prescribed it to see if an adjustment is indicated.

Remote mental health may be harder with young children, Dr. Kaslow said, though many therapists are finding ways to be really creative, asking children to show their favorite toys and how they play with them, and to talk about their home environments and how they’re feeling.

Dr. Vinson said that for many children with mental health problems, symptoms have gotten more severe. “If they were anxious, they’re more anxious, if they were depressed, it’s harder, if it’s schizophrenia, the voices went up.” Her own work as a child and adolescent psychiatrist has increased, she said, with children needing more help during the pandemic.

“Parents need to take their children seriously,” Dr. Spinks-Franklin said. “This is a very stressful time for adults and children, and we don’t want to disregard it when a child tells us how stressed they are, how worried they are.”

Cindy Liu, a clinical psychologist in the departments of pediatric newborn medicine and psychiatry at the Brigham and Women’s Hospital and the director of the developmental risk and cultural resilience program, said that in a setting in which we are all now accustomed to thinking of the risks of viral infection, it’s important to consider “stress contagion” and the risks to those who are most vulnerable, and to families at higher risk because of structural racism and socioeconomic disparities.

“Stress in families can be quite contagious as well,” said Dr. Liu, an assistant professor at Harvard Medical School. Quarantined together, she said, children are exposed to parental stress, but also get to witness “how parents cope and regulate their stress.” And racial minorities may have less access to mental health services, she said, and to other supports to help parents cope themselves, and help their children through.

Dr. Kaslow, past president of the American Psychological Association, said that amid all the stresses of the pandemic, there have been positive experiences for many children, with strong family bonds and unusual amounts of time together. “Be sure the balance of your interactions with your children are about love, positive nurturance and fun,” she said. Even with the responsibilities of overseeing remote learning, she said, “loving warm interactions need to take precedence” over struggling with them about behavior, or about schoolwork. “When children feel connected, they’re going to learn better, do better, stay on track,” she said.

“Having a kid struggling right now in no way means you’re not a good parent,” Dr. Kaslow said. “It’s not a reflection on your love for them — it’s an unprecedented time.”

Dr. Vinson said she is encouraging families “not to take for granted the things that sound simple — sleep, movement. I talk to all my families about movement, exercise, nutrition, and really protecting those things, because you need your brain at its best while you’re dealing with all this stress right now.”

Dr. Perri Klass is the author of the forthcoming book “A Good Time to Be Born: How Science and Public Health Gave Children a Future,” on how our world has been transformed by the radical decline of infant and child mortality.