(Part 3 of a 4-part series)
In this installment of "Coping During COVID-19," Psych Congress Steering Committee member Julie Carbray, PhD, FPMHNP-BC, PMHCNS-BC, APRN, discusses aspects of the COVID-19 pandemic which may have long-term mental health consequences for children and adolescents.
Dr. Carbray is Clinical Professor of Psychiatry and Nursing, University of Illinois at Chicago, and Administrative Director, Pediatric Mood Disorder Clinic, Pediatric Brain Research and Intervention Center, Department of Psychiatry, Chicago, Illinois.
"Coping During COVID-19" is an initiative designed to provide content and connection to mental health clinicians during the global pandemic.
Read the transcript:
There are a few aspects of this pandemic that we expect may result in some long‑term negative effects for children and adolescents.
The first is that their academic environments have been significantly changed. What this means is that with online schooling, parents trying to step in as teachers and instructors, and children, particularly those who have special education needs, are being challenged with trying to continue to learn when they're distracted. Distracted by the stress of the world. Distracted by things like not seeing their friends and the unknowns that the pandemic presents. We expect that there may be some long‑term outcomes in relation to their learning that will be problematic down the road.
In addition, several of our kids have been impacted by this pandemic personally, as well. They've had family members that have been sick. They have had exposures that they have been navigating. They may have lost family members to this pandemic.
For some of our children, they've experienced multiple losses that were unprecedented in their lives. For some of our children, that may bring back previous losses that they've had. Their inability to process one loss after the next may have some downstream effects on their coping and on their mental health outcomes over time.
We need to be mindful of those loss experiences, as well.
The social isolation during quarantine has actually been looked at as being most problematic for long‑term outcomes across adults and children and adolescents. I think it's hit children most significantly because kids play in groups. During this time, kids really haven't been able to hang out in groups, to go to playgrounds.
If they're out exercising, they haven't been able to do things like play basketball, team sports, things that are the fabric of childhood and of adolescence. In addition, there's been some rites of passage that, in particular, our teenagers have not yet begun to experience. Things like dances, or prom, or graduations, or even sitting at lunch with their favorite friends.
I've been hearing a lot from my families that I'm working with. A lot of fears about when we do return to school, what will things be like. Do I have to start all over? Will I still have the social connection that I had with new friends that I made?
We don't know. There's a lot of fear associated with when the pandemic is over, because we all know it will be over, although sometimes there's a question—how long will it be over?
We all know that it will be over. When it's time to reintegrate into the social fabric of a child's life, what will that be like? We really don't know.
Our hope is that this time of isolation, loneliness, a disconnect from a child's social fabric will not have longstanding mental health effects, but that's the fear of this time right now, is that with that loneliness, that isolation that quarantine brings, combined with losses of family members.
In addition, family members who have been essential workers who've been working all throughout the quarantine and have been less available to their children and adolescents because of their need to work.
Add one more thing, and that is financial strain that families may be experiencing due to job loss, unemployment. It's really thrown a lot of our families into a spin.
The long‑term outcome will be mediated by how resilient these families are, what is their access to support, and availability of others that might surround that family, to be able to help that family during this time.
We can only remain hopeful that the silver lining will be that there will be more support services in place because we expect there to be fallout after this pandemic.