Tips for parents and professionals

To be sure, Covid-19 changed a lot of things. One of which was doubling the average amount of screen time for American adolescents[1].

• Pre Pandemic: 3.8 hour per day
• Current: 7.70 hours per day

It is important that parents, teachers, counselors, and others who live and work with children and youth become familiar with the ever-changing digital landscape to provide timely guidance and support. The following information and downloadable tip sheet will give you a good foundation to get started.

Influence and Information

To understand the degree of influence of digital media on children, we must first understand the speed and scope of peer-to-peer information sharing in the digital age. Due to use of algorithms built to share information on a global scale instantly, it is often difficult to immediately curb the spread of misinformation and propaganda on the platforms. Algorithms are digital code built to recognize engaging content and then deliver that content to audiences to generate higher views. The algorithm does not distinguish positive or negative types of viral content. As content can be seen by adolescents and parents or professionals in the same general time frame, this provides the ability to prepare an appropriate response.

What it means to “Go Viral”

When a piece of content becomes widely shared, is referenced in other content, and begins to influence the social structure of its intended audience, the content is considered to have “gone viral.”

To give you an idea of how quickly content can reach worldwide audiences, here are the viral rates for Tiktok:

• > 500 views in the first .25/hr
• > 10k views in the first 4/hr
• > 250k views in the first 24/hr
• > 1 million views in the 48/hr

Empowering Viral Content[2]

Not all viral content is bad. Some viral content empowers adolescents to be the change they wish to see in the world. It’s important to understand that viral content can be positive and widely influential. Positive examples of viral content include:

• Student-led peaceful protests—In the spring of this year, high school students from Boston, Chicago, and other cities across the Northeast organized peaceful walkouts to protest the unsafe in person learning conditions amidst rising regional Covid cases. These students passionately demonstrated for the safety of their teachers and classmates to demand access to virtual learning. This was an excellent example of our youth being the young leaders of tomorrow.
• Neighborhood cleanups—Throughout 2020 lockdowns, a viral trend showcased individuals standing in front of an area with litter and trash visible. Dancing along with a selected audio, the creator would stitch a transition using choreography to a new scene where the area had been cleaned and the garbage bagged. These videos slowly became more dramatic over the summer as creators became more competitive, however the end goal was always environmental cleanup.
• “Show Your Talent” Challenge—The “Show Your Talent” challenge of 2021 featured an original creator issuing a challenge to others to “Show Your Talent”. This video garnered significant positive feedback and resulted in people of all ages showing talents.

Destructive Viral Content[3]

Viral content can also be destructive and damaging, influencing individuals to engage in behaviors that result in the loss of life, property, or safety. Examples include:

• “Silhouette” Challenge—The “Silhouette” challenge involves individuals dancing provocatively, often using a filter to showcase a millisecond long video of the individual either nude or barely clothed, viewed through a lens such a “Heat Filter”. This portrays a lewd image under the guise of it being safe due to the filter. However, these videos can be downloaded and the filter removed through the use of apps, allowing that content to be recirculated showing the real, unfiltered video.
• “Morning-after-pill” Challenge—The “Morning-after-pill” Challenge resulted from adolescents opening the plastic device used for a pregnancy test. Inside this plastic device is a silica tablet, meant to absorb moisture and maintain the validity of the test. Adolescents mistakenly thought this tablet was a free Plan B pill and ingested the tablet. This misinformation spread quickly, resulting in such a negative impact that manufacturers of the pregnancy tests released public statements educating the public about the silica tablets.
• “Devious Lick” Challenge—The “Devious Lick” Challenge started as individuals being dared to lick disgusting surfaces, such as the bottom of a sneaker, a toilet seat, or the bathroom door handle. However, this trend quickly escalated to damage of property, with multiple schools reporting damage. Damage included sinks being torn from walls, toilets broken, mirrors broken, and soap dispensers stolen.
• “Who Want Smoke” Challenge—The “Who Want Smoke” challenge hit our local schools the hardest. In November of 2021, a viral trend began using a specific audio on TikTok referencing gun violence. The image provided is taken from the viral video showing Clarksville students coming around a corner pretending to be holding a firearm aimed at the camera. Over 50 students were suspended for participating in this trend.

These types of viral content provide misinformation which can be harmful or dangerous.

Benefits to Consider

It is critical to practice the language of the digital age on a daily basis. Linguistics is evolving at an unprecedented rate. This may create opportunities to connect with children and adolescents that were not previously available. Other benefits include:

For the Professional:

• Becoming more familiar with ever-changing digital landscape
• Understanding the evolving linguistics of the digital age child
• Faster and stronger rapport building

For the Child/Adolescent:

• Providing opportunity for discussion on current trends and topics
• Creating an environment for authentic growth and self-reflection
• Establishing a sense of trust and safety

Due to using this best practice, Magellan Federal counselors at Fort Campbell were aware of the “Who Want Smoke” trend prior to its arrival to local schools. This allowed the opportunity to have preemptive support for adolescents. Through this support, adolescents were able to have authentic conversations about the trend, its meaning, and how it could impact them.

Sites to Search

To stay on top of digital trends, we recommend actively searching the following media channels:

• Local news source
• Facebook
• Other social media platforms
• Tiktok
• Reddit
• Twitter
• Instagram

Pro Tip: Ask the adolescents where they spend their time online. Populations will differ by region and age group. It never hurts to ask!

Article originally published on MFed Inform. Visit to download free tip sheet.

[1]   Nagata JM, Cortez CA, Cattle CJ, et al. Screen Time Use Among US Adolescents During the COVID-19 Pandemic: Findings From the Adolescent Brain Cognitive Development (ABCD) Study. JAMA Pediatr. 2022;176(1):94–96. doi:10.1001/jamapediatrics.2021.4334

[2]   Alfonseca, Kiara. Jan 14 2022. Students walk out over COVID-19 in-person learning conditions in schools. https://abcnews.go.com/US/students-walk-covid-19-person-learning-conditions-schools/story?id=82265171

[3]   Quinlan, Keely. Nov 23, 2021. Over 50 students suspended for viral TikTok video at West Creek High in Clarksville. https://clarksvillenow.com/local/over-50-students-suspended-for-viral-tiktok-video-at-west-creek-high-in-clarksville/

More than half of the world’s population–4.55 billion people–currently uses social media.[1] Of children in the U.S., 84% aged 13-18 and 38% aged 8-12 use social media.[2] We spend an average of 2 hours and 27 minutes each day on social media.[1] 

Whether we need it or not, it’s safe to say that social media isn’t going anywhere anytime soon.

In our recent webinar, “Addressing the effects of social media on kids,” we learned that 90% of the participants believe the overall impact of social media on their kids is negative. While many parents are concerned about their children’s use of social media and how it’s affecting their mental health, there are things we can do to protect them.

In this post, we will cover behaviors to watch for in a child who may be struggling due to effects from social media, as well as tips and resources to help in moderating their social media use.

Signs that social media may be negatively impacting a child​

In our webinar during Mental Health Month, 94% of participants expressed worry that social media is impacting their child. If you find yourself in a similar situation, trust your gut and watch for any of the following, which could be signs of an unhealthy relationship with social media.

1. Isolation–Do you find that your child is spending a lot of time alone and on their phone, computer or other device? Are they avoiding in-person time with friends and family?
2. Poor mood after exposure–Does your child seem happy or unhappy after they’ve been on social media? Try to get a sense of their mood during or just after social media use.
3. Irritability or angry outbursts–Does their anger seem misplaced or are they exhibiting these behaviors for seemingly no reason?
4. Doesn’t want to go to school–Does your child seem to dread going to school each day, or are they actively trying to get out of it? Talk to your child to get an understanding of why they may be avoiding school.
5. Falling grades–Are you noticing bad test scores or falling report card grades? Pay close attention to negative grade fluctuations which could be a reflection of more than just how much studying and learning is taking place.
6. Decreased interest in offline activities–Are they participating less in activities they have always enjoyed or showing little interest in new activities, such as sports, arts and crafts, and other hobbies?
7. Headaches or upset stomach–Do they seem to have more frequent complaints about not feeling good? Reoccurring physical health conditions can manifest from stress and mental health challenges.
8. Deteriorating mental health–Are you noticing that your child just doesn’t seem like their normal happy self? Talk to your children each day about their feelings and be cognizant of any signs of depression, anxiety or mood changes.

Helping your kids have a healthy relationship with social media

If you notice any of the above signs in your children, it may be a result of negative impacts from their use of social media. Set your kids up for success with these proactive tips and resources for when there may be a problem.

1. Talk about the risks, traps and dangers and keep an open dialogue–It’s critical to help your kids understand the realities of social media. Talk with them about adult predators who pose as friends their age, how all of the happy pictures of friends and even strangers don’t show the whole picture, and how negative comments can be deeply hurtful and follow the person who posts them forever.
2. Set up parental controls and monitor activity–Find helpful resources with these guides:

• Tom’s Guide, “The best parental control apps for Android and iPhone 2022”​
• Common Sense Media, “Parents’ ultimate guide to parental controls”

3. Balance screentime and face-to-face time with family and friends​–Despite the negative impacts, there is also much positivity that can come from social media. While it may be easy to get sucked in, as social media is designed to do just that, it’s important to remind your kids about all that the real world and people around them have to offer.
4. ​​Post and seek out positive content–Explain to your kids that we can all help to keep social media a positive place by being respectful in our comments and understanding of different perspectives. Help them understand that they should seek out social media interactions that make them feel good about themselves and provide a healthy sense of connection with others.
5. Encourage good sleep​ and exercise–​We’re not usually at our most active when on social media. We must encourage our kids to keep up their physical activity, which will benefit their physical health and mood. A healthy sleep routine will also provide benefits for kids in all aspects of their lives, and it’s important not to let social media interfere with sleep.
6. Utilize resources on cyberbullying:

• StopBullying.gov, “Prevent cyberbullying”​​
• Substance Abuse and Mental Health Services Administration (SAMHSA), KnowBullying mobile app​
• UNICEF, “Cyberbullying: What it is and how to stop it”

7. Model good behavior–Just like kids, parents and caregivers are susceptible to having an unhealthy relationship with social media. Remember these tips when balancing your own on- and off-screen time because your kids are watching.
8. Seek professional help​ when needed–If you suspect that your child is struggling, reach out to their doctor or mental health professional for support and treatment options.​

For many parents, today’s digital world is very different from the one in which they grew up. Navigate this ever-changing environment with your kids and keep an open dialogue about the realities of social media beyond the glitz and glamour that appears on the surface, as well as alternative sources for contentment, inspiration and social connection.

Learn more about social media and kids

Find the recording of our webinar, “Addressing the effects of social media on kids,” where I, along with other children’s behavioral health experts, address this important issue and answer audience questions here.

Additional webinar resources:

• AACAP Social media and teens
• CDC data and statistics, children’s mental health​
• SAMHSA 2020 National Survey of Drug Use and Health Youth Mental Health Trend Tables​
• December 7, 2021, HHS press release on the Surgeon General’s Advisory addressing the youth mental health crisis
• October 19, 2021, AAP-AACAP-CHA declaration of a national emergency in child and adolescent mental health​
• ​Social Media Today, “The history of social media [Infographic]”​
• Journal of education and health promotion,“Effective use of social media platforms for promotion of mental health awareness”​
• ​Journal of technology in behavioral science, “Social media and mental health: benefits, risks, and opportunities for research and practice”​
• ​World Psychiatry, “Youth mental health: risks and opportunities in the digital world”​
• Journal of technology in behavioral science, “Social media and mental health: benefits, risks, and opportunities for research and practice”​
• Journal of youth and adolescence, “Exposure to social media racial discrimination and mental health among adolescents of color”​
• World Psychiatry, “Youth mental health: risks and opportunities in the digital world”​
• American Psychological Association, “Social networking’s good and bad impacts on kids”​
• Mayo Clinic, “Tween and teen health”​
• WebMD, “Teens on social media too much? What experts want you to know.”​
• Cleveland Clinic, “Effects of social media on children”​
• Experian, “7 ways to protect your kids on social media”​
• Family Education, 5 ways social media affects kids’ mental health (and how parents can help!)

[1] Statusbrew, “100 social media statistics you must know in 2022 [+Infographic]”

[2] Common Sense Media, “The Common Sense Census: Media use by tweens and teens, 2021”

It was hard enough for kids without social media. Many of our older readers will remember… We compared ourselves to others, but it happened mostly in-person at school or events, or when we consumed one-way media like TV or magazines. While it could be hurtful, we still got a break at home, while riding in a car, or for much of the rest of the day, as we didn’t have smartphones. We became the subject of gossip, but we had the benefit of an imperfect “grapevine” that took longer to spread information, and likely, we didn’t even always hear about it. And we played the popularity contest, but we could never be sure just who were the winners and losers.

We’ll dive into these issues in this post and you can learn more by watching a recording of our webinar, “Addressing the impacts of social media on kids,” here.

Kids’ self-image and social media

Social media makes it easy—and even entertaining—to endlessly scroll through the latest and greatest images of our friends, celebrities, and perfect strangers. We get to see the best of everyone all the time. If any one of our friends isn’t posting their best on any given day, we’re seeing someone else who is posting their best. This can put undue pressure on our kids to attain perfection, as they are developing their self-image and self-esteem.

For kids, and us all, there is tremendous value in limiting the time we spend on social media and understanding that what we see there isn’t usually the full picture. Social media can provide a great sense of connection with others, along with many other positive impacts, but life outside of it can be refreshing and cleansing when we focus on all that we have and want to do.

Social media and cyberbullying

It’s a lot easier to be mean to someone when you’re not doing it to their face. With social media, not only is it easy for a bully to target another child from behind the protection of their screen, but they can do so publicly for classmates and the world to see and weigh in with opinions, or even just a “like,” on the matter. This ruthlessness can be humiliating and overwhelming for the victim, and lead to serious mental health concerns.

As our kids’ gossip and squabbles naturally pervade and have the potential to be broadcasted instantaneously on social media for all to see, let’s talk to them about leaving the negativity off of social media and focusing on positive messages that will ultimately reflect better on us all. If your child is a victim of cyberbullying, find resources at https://www.stopbullying.gov/cyberbullying/prevention and learn more in our webinar on May 11.

Our kids’ popularity, quantified

Our kids’ popularity is now quantified and displayed on social media. They have a number of followers, and every time they post, it’s assigned a number of likes and comments. Is this environment creating additional pressure for our kids to be liked and drive up their social stats at the risk of harming their mental health in the process?

While we can’t make a direct correlation with kids’ use of social media, we know the prevalence of depression among adolescents aged 12–17 has steadily increased–and more than doubled–from 8% in 2010 to 17% in 2020, and that certain demographic groups have been disproportionately affected, including girls, of which the prevalence of depression has increased from 11.9% in 2010 (4.4% among boys) to 25.2% in 2020 (9.2% among boys).[1]

We know our kids are much more than the number of likes they receive on a social media post. It’s important that we talk to our kids about what is really important and build up their self-worth through meaningful activities that stimulate their learning and interests, and help others.

On May 11 Magellan Healthcare hosted a webinar, “Addressing the effects of social media on kids,” for Mental Health Month with former Magellan child psychiatrists, Dr. Keith Brown and Dr. LaShondra Washington, and Senior Director Children’s Healthcare Barbara Dunn, and Creator of Magellan Youth Leaders Inspiring Future Empowerment Greg Dicharry. Watch a recording of the webinar at https://www.magellanhealthcare.com/event/addressing-the-effects-of-social-media-on-kids/.

[1] SAMHSA 2020 National Survey of Drug Use and Health, Youth Mental Health Trend Tables

In the midst of a national children’s mental health crisis, families are doing the best they can to assess how well their children are coping with increased stressors from the pandemic and figure out what to do if it seems they are having difficulty. Psychotropic medication is among the options to consider when indicated. However, over the years, children and adolescents with behavioral health challenges have generally been prescribed an alarming number of medications. This high prescription rate, paired with questions about the appropriateness of the diagnoses used to justify the drugs’ use, has raised many concerns among families, practitioners, and youth advocates alike. Prescribing medication to treat children’s mental health conditions can be appropriate, but parents, caregivers, and practitioners need to fully understand the risks and monitor their use.

In this post, we will contemplate these issues and draw on knowledge from Magellan Healthcare’s recently updated clinical monograph, Appropriate Use of Psychotropic Drugs in Children and Adolescents, which highlights evidence-based research on the use of psychotherapeutic agents in children and principles for optimal children’s psychopharmacotherapy practice.

Considerations for treatment with medication for children’s mental health

When families consider medication as an option to treat a child’s mental health condition, Magellan’s monograph offers the following to contemplate:

The practice of evidence-based medicine for children and adolescents requires health professionals and child welfare advocates to engage in a careful assessment of the risks and benefits of using psychopharmacological treatments while addressing serious concerns of over-diagnosis and overtreatment in this vulnerable population. As attention to these issues has grown, a strong undercurrent of anxiety and confusion exists about whether the use of psychotropic agents to remove undesirable impulses and behaviors of children may affect their neurological development, personality, character, and temperament. Suspicions exist that over-diagnosis and overtreatment are driven by a supply-induced demand created by pharmaceutical companies and medical providers.

Addressing the shortage of children’s mental health professionals

Another consideration for parents and families is the shortage of professionals providing specialized mental healthcare services for children. Mental healthcare for children is often initiated at the pediatrician’s office, Magellan’s monograph provides the following insights:

Given the significant national shortage of child psychiatrists, there remains a realistic need to rely on primary care clinicians to perform screenings of children for mental health disorders and treat uncomplicated ADHD, anxiety, or depression. However, the problem of follow-up care and ongoing monitoring of mental health problems in pediatric primary care is a matter that must be addressed.

Principles for optimal use of medication to treat children’s mental health

The American Academy of Child and Adolescent Psychiatry published the Practice Parameter on the Use of Psychotropic Medication in Children and Adolescents to promote the appropriate and safe use of medication to treat children’s mental health by emphasizing the best practice principles that underlie medication prescribing. These principles, as highlighted in the monograph, are as follows:

Principle 1: Before initiating pharmacotherapy, a psychiatric evaluation is completed.

Principle 2: Before initiating pharmacotherapy, a medical history is obtained, and a medical evaluation is considered when appropriate.

Principle 3: The prescriber is advised to communicate with other professionals involved with the child to obtain collateral history and set the stage for monitoring outcomes and side effects during the medication trial.

Principle 4: The prescriber develops a psychosocial and psychopharmacological treatment plan based on the best available evidence.

Principle 5: The prescriber develops a plan to monitor the patient, short and long-term. Clinicians should use standardized, objective measures to measure the efficacy of pharmacologic interventions.

Principle 6: Prescribers should be cautious when implementing a treatment plan that cannot be appropriately monitored.

Principle 7: The prescriber provides feedback about the diagnosis and educates the patient and family regarding the child’s disorder and the treatment and monitoring plan.

Principle 8: The child’s assent and parent’s consent are completed and documented before initiating, and at important points during, medication treatment

Principle 9: The assent and consent discussion is focused on the risks and benefits of the proposed and alternative treatments.

Principle 10: Medication trials are implemented using an adequate dose and for an adequate duration of treatment.

Principle 11: The prescriber reassesses the patient if the child does not respond to the initial medication trial as expected.

Principle 12: The prescriber needs a clear rationale for using medication combinations.

Principle 13: Discontinuing medication in children requires a specific plan.

We encourage you to learn more about medication to treat children’s mental health in the full clinical monograph and Understanding and Meeting the Needs of Children and Adolescents at High Risk: Foundations of a Model, which highlights evidence-based prevention and treatment approaches for problematic behaviors and various types of behavioral health challenges in children and adolescents, here. Both provide valuable insights and information to support the critical behavioral health needs of our nation’s children.

This article is part two of our discussion about the impacts on mental health and the war in Ukraine. Click here to read our tips for adults. 

Information on the war is continually changing. The youngest viewers, children, are watching and may experience the fear and stress associated with images from the war in Ukraine.

To add to the stress and concern, this global crisis comes on the heels of being exhausted and socially isolated by the pandemic. The following are some tips to help children that are impacted or stressed by the Ukraine situation.

Listen to children. Children hear and see things. This can be especially frightening if they have a parent deployed. It is important not to force them to talk. Find alternative ways to communicate with children such as drawing or playing with toys.

Calm conversation. It is important for parents to be calm when talking to their children about Ukraine. Parents need to be careful not to be the source of a child’s anxiety. Parents are encouraged to check-in and ask their children how they are doing.

Answer children’s questions. Support and acknowledge what your child is saying and their potential fears. Reassure your child but do not make unrealistic promises. Answer questions and help in separating fact from fiction.

Provide support. Do not let children watch the images of violence on television. Children who have experienced trauma may need extra attention. Some children may not want to talk about the event. It is okay if they would rather play or be outside.

Limit exposure to media and social media. Limit the exposure to graphic violence on media. For older children, watch the news with the child and then talk about how the child is reacting to what they are seeing.

Maintain a normal routine. Encourage the daily routines such as homework, sports, activities to continue.

Watch for changes in mood. Some children show their reactions in nonverbal ways. Watch for anger, physical symptoms, mood changes, or withdrawing from usual activities and conversations.

Many of us can now say we have experienced the trials and tribulations of parenting during a pandemic. We have attempted to juggle full-time work and regular household duties, along with being a full-time teacher or daycare worker and entertainer for our kids. While we’re all doing the best we can in taking on these new and challenging roles, some parents and caregivers may be wondering about their child’s mental health after they have missed out on so much and dealt with new stress and uncertainty – certainly as many of us know that our own mental health has been affected.

If you’re worried about your child’s mental health or noticing any issues, read on for tips and knowledge shared by Magellan’s Linda Y. Evans, MD, FAPA, child psychiatrist and medical director, and Greg Dicharry, CPRP, youth empowerment director.

Children behavior changes

Changes in your child’s behavior may be a sign of mental health difficulties that should be closely monitored. Depending on the age of your child, stress can manifest in different ways. Toddlers and young children aged 2-6, may show signs of regression and lose the ability to do things previously learned, like toilet training. School-aged children and teenagers may show a disinterest in going to school and/or begin to see falling grades. The most common symptom in teenagers is irritable mood. Kids of all ages may experience vague body complaints, like a headache or belly ache, changes in sleep or appetite, difficulty concentrating, loss of pleasure in activities previously enjoyed, and withdrawal from social interactions.

Often, even the child may not recognize these symptoms as the result of mental health issues. It is important for parents and caregivers to be a barometer for behavioral or other changes in their children – as they may be the first to notice – to be able to identify if their mental health may be suffering. When parents keep the lines of communication open, allowing their kids to share their thoughts and feelings, they are better equipped to identify any troubling signs of childhood depression, anxiety or other mental health conditions.

The child’s primary care physician (PCP) also plays a role in screening for mental health concerns and can be a good first point of contact if parents are seeking additional help. With the shortage of child psychiatrists and mental health professionals trained to work with children in our country, PCPs are increasingly adopting a model of collaborative, or whole-person, care to screen and treat children for mental health issues before they get worse because of potentially waiting long periods to see a specialist.

Interrupted school and family routines

While there’s not much we can do about changing work, school and social arrangements due to the pandemic, it’s important to consider the stability of our kids’ environment and instill predictability in their lives to the extent that’s possible.

Additionally, there are many things that parents and caregivers can do to keep their kids content and engaged amid the chaos and unprecedented change we’re all experiencing. To make up for lost in-person social time with friends and family, virtual meetups can be scheduled. That could be a fifteen-minute Facetime call with grandma and grandpa every Wednesday night at 7:00, or a periodic Zoom/interactive video game gathering with friends. Parents can also take time with their kids away from the screens to play a board game or do a project to make home-time more fun. Exploring and supporting your kids’ passions is a way to get them involved in activities that will bridge the gaps of interrupted routines and help prevent negative mental health outcomes.

Family stress affecting children

We have all been affected by the drastic changes, uncertainty, loss and isolation caused by COVID-19. And it’s not hard for our own stress and worry to be noticed or even absorbed to some extent by our kids. While we’re focusing on our family’s well-being, it’s important to practice self-care and recognize that our own mental health is of paramount importance. Having healthy caregivers is an essential component in the normal development of kids.

When parents are navigating divorce and co-parenting arrangements during COVID-19, it can be even more difficult to filter out the negativity for our kids, especially when parents have different points of view about things like in-person vs. virtual learning, the vaccine and mask wearing. Although it can be difficult to share your kids with an ex-spouse, it’s important to remember they need both of their parents. When parents work together for the benefit of their children and keep the focus on them, the impacts of divorce can be mitigated. Implementing a flexible custody arrangement during COVID-19 is also encouraged; for example, if the child wants to see a parent when it’s not their day for visitation, it might be beneficial to the child to honor their request.

To alleviate stress and some of the burden, parents and caregivers can consider connecting with others who understand the struggles and support each other. They can look for parent support groups in their communities.

Back to school and bullying

For kids who experience any level of social anxiety, the transition back to school, or even a new school, from the comfort of home may be more difficult. While some kids may be happy to get right back to the in-person learning environment, a gradual adjustment may work better for others.

Teachers can be especially helpful in ensuring that children are adjusting well and that a child withdrawing from the group is noticed. When the teacher has a trusting relationship with students, they can initiate conversations to try to understand how a child is doing and if their emotional needs are being met. The teacher’s insights are critical for parents and caregivers who cannot be with their kids at school.

Parents and teachers should be especially sensitive to look for bullying and have a zero-tolerance policy for kids being cruel to one another. Children must understand that bullying is unacceptable, as it can lead to serious and disastrous consequences for those who are targeted.

In general, what kids need for healthy development is a stable routine, predictability, a safe environment and healthy parents or caregivers. COVID-19 has disrupted all of these conditions, leading to increased mental health disorders and interrupted development. There are many things that parents and caregivers can do to nurture their child’s mental health and address what they need for healthy development. We encourage you to explore Magellan’s following resources for additional information and support:

• Mental Health Month website for comprehensive tips and resources to support yours and your family’s mental health.
  • Be sure to check out the recording of our webinar, How are your kids doing? under “Previous events”
• Understanding and Meeting the Needs of Children and Adolescents at High Risk: Foundations of a Model clinical monograph highlighting evidence-based research on the prevention and treatment of problematic behaviors and various types of behavioral health challenges in children and adolescents.
• Stay Home for MY LIFE virtual youth fest, featuring inspirational speakers, uplifting entertainment, fun activities and more, taking place on the 4^th Thursday of each month, from 6:00 – 7:30 p.m. ET, for youth and young adults who have experience with mental health, substance use, juvenile justice and foster-care-related issues, as well as professionals and caregivers across the country.

By: Linda Y. Evans and Greg Dicharry

Before the COVID-19 pandemic started wreaking havoc on various aspects of our “normal” lives, including our mental health, 1 in 6 children aged 2-8 years in the United States was diagnosed with a mental, behavioral or developmental disorder.[1] While these children have endured the impacts of drastic changes over the past year, so too have others who did not previously have a mental health diagnosis; some children have been newly diagnosed with a mental health condition as a result of COVID-19. When considering how to nurture the mental health of our children during a pandemic, we must understand their pre-pandemic mental state and monitor how they are coping.

Children diagnosed with a mental health condition before COVID-19

For children who experienced mental health challenges before COVID-19, the pandemic may have imposed new complications. In many cases, before COVID-19, families practiced a routine in their daily lives, which helped everyone manage their feelings and behaviors. When routines changed – kids were no longer going to school, adults were working from home, or not at all, and in-person interactions with friends, extended family, and even doctors were cut off – that familiarity and rhythm, and the associated therapeutic effects, were lost. Another part of the pre-pandemic routine for many children with a mental health diagnosis was the special help received by trained teachers and therapists in schools. While this support could be a vital lifeline, it was completely cut off for the kids who depended on it. Other treatment options, through primary care and other outpatient settings, also dwindled due to office closures caused by COVID-19. As a result, an increasing number of children were seen for mental health-related care in emergency departments (EDs). From mid-March to October 2020, the Centers for Disease Control and Prevention reported an increase in the proportion of mental health-related ED visits among children aged 5-11 years (24%) and 12-17 years (31%) compared with the same period in 2019.[2]

Serious mental health impacts for children as a result of COVID-19

Children and youth who started off 2020 without a mental health diagnosis may not have ended the year in the same way, as newly developed depression and other mental health conditions were caused by the pandemic. A CDC report on mental health, substance use, and suicidal ideation during the COVID-19 pandemic shows that while 11% of adults seriously contemplated suicide in June 2020, the same was disproportionately reported by young people aged 18 to 24 (26%).[3] The serious effects on younger children include delays in social and emotional development, as their brains are forming amidst irregular human activity. In some cases, when parents weren’t adjusting or handling the increased stress and uncertainty well, maltreatment in the form of child neglect or abuse has resulted.

Negative mental health consequences of COVID-19 for all children

Because of COVID-19, all children are coping with unprecedented change and loss. Children feel the family stress of economic hardships, health concerns, social isolation, exhaustion, bereavement, and worsening mental health and substance use. And children have stressors of their own. When healthy outlets, like school, sports, and social engagements, are lost, that energy may become more negative and unproductive. The impacts of missed once-in-a-lifetime childhood events, like birthdays, graduations, and family vacations, may not even be fully realized until later in life. Children and youth may also experience their own anxiety and stress about what the future looks like.

The state of mental healthcare for children

There have always been barriers for children to access mental healthcare. Among them are stigma, availability, misinformation, and lack of information. While these factors impact access to care for adults, as well, they may be more pronounced for children. Parents are afraid or do not want to accept that their child is affected by a mental illness. There is a shortage of child and adolescent psychiatrists and therapists trained to work with children in our country. In addition, many parents and caregivers are misinformed about child psychiatric services that are meant to improve a child’s mental state, and not necessarily their behavior, although the latter may be a secondary effect.

With the pandemic, parents may be so preoccupied that they cannot see potential conditions in their children. The advent of a pandemic has stretched an already thin system of specialized mental healthcare for children at a time when it may be needed the most. And misinformation continues to plague our news sources and social media.

Where to go from here

There are many things that parents and caregivers can do to support and nurture their child’s mental health. We encourage you to learn more in a recording of the webinar, “How are your kids doing?” where I was joined by Greg Dicharry, CPRP, youth empowerment director, to share knowledge and our years of experience working with children to improve mental health and wellness and answer audience questions.

[1] https://www.cdc.gov/childrensmentalhealth/data.html

[2] https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a3.htm

[3] https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm

For our kids, disruptions caused by the COVID-19 pandemic are likely more than just that – temporary inconveniences, varying in severity, until life goes back to “normal.” Besides missing out on once-in-a-lifetime events, like graduations, birthdays and other milestones – at least in a way they would traditionally be observed – regular human interactions, part of social and emotional development, have changed. While adults may be experiencing a serious blip on the radar, children may be experiencing an interruption in brain development and/or lack the ability to fully cope in this unchartered territory.

In this post, we will contemplate these issues and draw on knowledge from Magellan Healthcare’s recently updated clinical monograph, Understanding and Meeting the Needs of Children and Adolescents at High Risk, which highlights evidence-based prevention and treatment approaches for problematic behaviors and various types of behavioral health challenges in children and adolescents.

As we think about the significance of childhood development, the following points from Magellan’s monograph provide insights:

A growing body of scientific information has confirmed the importance of the first five years of life, when the ongoing construction of brain architecture impacts youth social and emotional development, the ability to learn new behavior and skills, and how the youth evolves into adolescence.

Advances in neuroscience have contributed new understanding of adolescent development. During adolescence, the brain experiences a period of major development comparable to that of early childhood.

With much changing in our kids’ lives and environment – virtual schooling, modified in-person play arrangements with friends and reduced time with extended family – the responsibility falls on parents and caregivers, as it always does, to ensure their child’s wellbeing and adjustment. Magellan’s monograph offers the following to ponder:

While genes determine when specific brain circuits are formed, experiences actually shape their formation and are fueled by a self-initiated, inborn drive toward competence. This phenomenon depends on appropriate sensory input and stable, responsive relationships whereby adults respond to a child’s natural reaching out for interaction.

However, when parents are under unprecedented stress and often just trying to make ends meet, attending to their child’s increasing needs can understandably be overwhelming. In addition to the role of parent and full-time employee, many adults have taken on the additional roles of teacher, daycare worker and entertainer, to name a few. In some cases, however, a parent’s struggles may lead to neglect of their children. Magellan’s monograph highlights the following of child neglect:

While child abuse is more widely acknowledged and publicized, child neglect is, in fact, the most common type of child maltreatment, which frequently goes underreported. Expanding on the earlier discussion of impaired brain development, it is now understood that lack of stimulation and necessary care early in life may cause children to remain in a state of “hyperarousal” (i.e., constantly anticipating threats and/or experiencing dissociation) rather than a normal state of attentive calm. This phenomenon leads to a decreased ability to benefit from social, emotional and cognitive experiences and results in other psychosocial consequences. Together with insecure attachments, this state of hyperarousal can significantly affect normal growth and development.

Many parents are also managing their own mental health conditions and substance use disorder during the pandemic, which adds to the impact of what children and adolescents are experiencing themselves. The monograph outlines the risks for children of these parents:

There are many serious risks to children and adolescents who have a parent or both parents with mental illness. The American Academy of Child and Adolescent Psychiatry (AACAP) calls attention to the strong genetic predisposition in children for inheriting bipolar disorder, an anxiety disorder, attention deficit-hyperactivity disorder (ADHD), schizophrenia, alcoholism or other SUD, or depression. Recent studies have also demonstrated delayed brain development in young children of depressed mothers. Further, the AACAP notes the additional stress that mental illness places on a marriage and parenting abilities of the couple, and the risks that stem from an inconsistent, unpredictable family environment that can contribute to psychiatric illness and developmental delays in children.

It’s also appropriate to consider the older children and young adults who may lack the ability to cope with increased stress and instability. Magellan’s monograph calls attention to recent research:

A CDC report on mental health, substance use and suicidal ideation during the COVID-19 pandemic shows that while 11% of adults seriously contemplated suicide in June 2020, the same was disproportionately reported by young people aged 18 to 24 (26%).

During these difficult times, we’re all doing the best we can. And we know that brighter days are on the horizon. Until then, and always, as we’re helping ourselves and our children through, let’s remember that “information is power,” as they say. To that effect, we encourage you to learn more in our full children’s clinical monograph here.