Twenty twenty-two is here, with all its possibilities and opportunities. You may be wondering how you will achieve all of your personal and professional goals this year. Your mental health in 2022 may hold the key to success. Read on for tips from Magellan Healthcare’s behavioral health experts to help you prioritize your mental health in the new year.

1. Spread out New Year’s resolutions over the year – At the beginning of the year, people usually try to accomplish too many resolutions all at once. They are quickly overwhelmed and give up. Instead, create a list of resolutions, or goals, to implement–one per month–over the year. Spreading out goals and focusing on one at a time will feel more consistent with lifestyle change than the usual New Year’s start and stop. – Candice Tate, MD, MBA
2. Plan things to look forward to – Having a daily routine is important for our mental health. It limits the chaos and helps us feel grounded. But it can get boring, especially during COVID-19 when we are closed in. Schedule things to look forward to for the upcoming weeks and months. Maybe schedule a day trip on a weekend, a few hours in the evening to watch a movie, or a phone/Zoom call with an old friend, make a reservation at your favorite restaurant or plan to place a delivery order. Choose things that make you feel good. – Linda Evans, MD, FAPA
3. Limit screen time and media exposure – Social media has been a much needed lifeline for so many of us during the pandemic, but it’s essential that we remember to limit our screen time and exposure to content that can be emotionally distressing or traumatizing. Make a habit of putting your mobile device down and stepping away from your computer to enjoy the people, plants or pets in your environment. Go outside, take a walk, and get some fresh air and sunlight. – Rakel Beall-Wilkins, MD, MPH
4. Learn that “no” is a complete sentence – You cannot pour from an empty cup. Saying yes to every request asked of you when you are already limited on time, energy or resources can increase stress levels. Putting your needs on the backburner is not healthy for you. Being a “yes” person sometimes equates to saying “no” to your own mental health. Recognize not only when to say no, but that you don’t have to feel guilty about it… It’s all about saying yes to you! – LaShondra Washington, MD, DFAPA
5. Measure something – Our perceptions often do not match the reality of a situation but picking something to measure that is related to a concern can help better align our perceptions to reality. And if the results of the measurements indicate that indeed perception and reality are aligned, then continued measurement, after an intervention, can determine the usefulness of the intervention on the measure. In other words, take steps to find out if what is bothering you is really a problem, and if it is, then make a change and reassess. – Louis Parrott, MD, PhD
6. Engage in journaling – Journaling is an effective way to manage stress and feelings. It can be cathartic to write about feelings and experiences. It is also a way to monitor your inner self and when it may be necessary to seek professional help. – Samuel Williams, MD, MBA, FAPA
7. Practice gratitude – Share gratitude with others and write three things you are grateful for every day. According to Jon Kabat-Zinn, PhD, an internationally known mindfulness advocate, we should ask ourselves three questions each day that relate to our relationships with family, friends, and co-workers: What have I received from __? What have I given to __? What troubles and difficulties have I caused? – Doris Lebischak, MD
8. Establish an attainable plan for regular physical activity and stick to it – Start with one or two days of exercise a week. Plan the days, times, and activities and commit to making it happen. Exercise is proven to reduce depression, anxiety, and negative mood.[1] – Greg Dicharry, CPRP
9. Consider expanding your exercise routine – As we age, our muscles must be challenged to maintain strength. Including strength training, stretching and physical activity that raises the heart rate in our workouts will have an immediate impact as well as long-term benefits for the body and mind. – Paula Hensley, MD
10. Eat a balanced diet with as many unprocessed foods as possible – Include colorful fruits and vegetables and prepare food in healthier ways like steaming and roasting rather than frying. If applicable, include children in meal selection and preparation, and eat at least one meal per day as a family. Try not to place food into strict bad and good categories, and understand that you are not–accordingly–bad or good depending on what you eat. It’s important to eat a balanced diet for your lifestyle. – Misty Tu, MD
11. Prioritize sleep – Push through busy schedules and life’s distractions to maintain eight hours of sleep each night and experience how it helps you think more clearly, feel better and be better able to creatively juggle the multiple demands of family, work, and beyond. – Barbara Dunn, LCSW, ACSW
12. Develop a cue that ends your workday – Whether it is pausing to watch the sunset, moving your body for 20 minutes, or ceremonially closing the door to your workspace, disconnecting from work to focus on rest, joy, or family responsibilities is a necessary way to prioritize mental health in 2022. – Dana Foglesong, MSW, NCPS, CRPS
13. Make sure to prioritize yourself – In a time when kids are home, work is piling up, and there is growing uncertainty in and outside of our homes, it’s unfortunately easy to get lost in all we have going on. But it’s vital we prioritize ourselves. Whether it’s going on a walk or other exercise, meditation, talk therapy, weekly dinner with friends or family… don’t ever forget to put yourself first because your mental health is wealth. – Yagnesh Vadgama, BCBA
14. Ask for help when you need it – Recognize that no one person can do everything. Family, friends, and neighbors can be great resources, so ask for what you need and offer help to them when you can. – Kathryn Kvederis, MD, DFAPA
15. Remember that you are not alone – One in five American adults has a mental illness and one in 18 American adults has a serious mental illness; one in six American youth has been diagnosed with depression.[2] Despite all of the glittery images we may see and our perceptions that others have it better, it’s likely that we have family members, friends, and co-workers who are right there with us when we aren’t feeling our best. – Keith Brown, MD

As we sail into a bright new year, with 2021 in the rear-view mirror, let’s remember to prioritize ourselves and our mental health. We have all experienced the trials and tribulations of a tumultuous previous two years. If we have learned anything, it’s that our mental health in 2022 is what will keep us strong and poised for happiness and success.

Visit MagellanHealthcare.com/BH-Resources for free information and tools to address mental/behavioral health needs and spread awareness to reduce stigma. Stay tuned here and on our calendar for updates on our virtual events throughout the year.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470658/

[2] https://www.samhsa.gov/data/release/2020-national-survey-drug-use-and-health-nsduh-releases

We made it through Thanksgiving – hopefully emotionally unscathed. But for many, managing mental health during the holidays is not easy. Whether you deal with anxiety for months leading up to the holiday, your family is plagued with arguments or more subtle discomfort during get-togethers, and/or you are mourning the loss of a loved one and have an empty seat at the table – the holidays can be tough. In fact, in a 2021 survey, 44% of Americans said that preparing for the holidays is stressful and 39% said that family gatherings during the holidays are stressful.[1]

Holiday anxiety

Anxiety is defined by the National Institutes of Health as “a feeling of fear, dread, and uneasiness.”[2] And why might we feel anxious leading up to what one might consider a wonderous and magical occasion, such as Thanksgiving or a December holiday, with our family? The reasons are endless. It could be a difficult family member we are not looking forward to seeing. It could be that we are not feeling particularly good about ourselves and want to face others. Maybe we are hosting a holiday gathering and worried about getting everything done in time, how much everything will cost and whether everyone will have a good time.

We are barraged with media images of what the perfect holiday looks like, and we may sometimes feel pressure to be happy and festive and live up to expectations.

When we dread an upcoming holiday, it puts a damper on more than merely just that day or specific gathering, but the days, weeks, or even months leading up to it. It is almost like the reverse of excitement or anticipation. But whether we are excited or anxious about something, the actual event often does not live up to our expectations. In the case of holiday anxiety, if we can remember that it may actually end up being better than we think and simply try not to care as much, our anxiety time may be reduced. We can let go of others’ expectations of us and do what truly makes us happy.

Family arguments during the holidays

Yes, most families argue – even during the shiny holidays and behind the scenes of the happy pictures we post on social media. And just when our typical bickering was not enough, our country has become increasingly divided, and it has seeped into our very own families. There are things we can do to prevent the arguments and deal with them in a healthier way when they occur.

You have probably heard the phrase “communication is key.” A lot has changed over the past couple of years and continues to change at a rapid pace. We may think we know how a loved one would like to celebrate the holidays, for example. But their preferences, and our own, may have changed just like so much else has changed.

It’s a good idea to initiate respectful conversations – early in the holiday planning process – with our family and friends to understand where they are coming from on certain issues. It can be a way to identify the topics that should be off-limits during the upcoming holiday gathering and prevent arguments.

During these early conversations and when we’re all together for the holidays, our family members may inevitably do or say something that rubs us the wrong way. At that moment, our reaction will set the course for what comes next. As our feelings come together to form that reaction, why not assume goodwill and the best intentions of the offending person. It may be that their actions and comments reflect the way they feel about themselves and not the way they feel about you.

With so much to disagree about these days, there is also a lot we can agree on. Try to focus on the latter, agree to disagree when possible, and assume that others are coming from a place that is genuinely meaningful to them.

Grief and missing a loved one during the holidays

The pandemic has taken so much from us, including the lives of precious loved ones. The holidays have always been a difficult time to bear when we cannot share them with a lost family member or friend. During this holiday season, you can uphold and honor memories of those you have lost in many ways: Look through photographs of the person and reminisce about holidays of the past; do things you used to do with a lost loved one during the holidays, like cooking or baking a certain recipe, a craft, or decorating; and journaling or talking with others about your feelings.

It can be hard to move on without a person we love, but they would want you to be happy. We will always have their memories during the holidays and beyond, as we carry on with old and new traditions.

We can all agree that it has been another tough year. But we have endured, and it is time to let go of expectations and focus on our mental health during the holidays and how the holidays can be a time to do what makes us happy, spend quality time with those who are important to us and cherish the memories of those we have lost.

Visit MagellanHealthcare.com/Holidays for additional information and resources on holiday emotional wellbeing and how to find peace and moments of joy with family and friends this holiday season.

[1] Collage Group Holidays and Occasions Survey, May 2021

[2] https://medlineplus.gov/anxiety.html

Candice Tate, MD, MBA, serves as a medical director at Magellan Healthcare. Dr. Tate’s treatment philosophy includes a strong physician-patient therapeutic alliance and safe, responsible medication management. Dr. Tate joined Magellan in 2017. She has years of experience in psychotropic medication management for a variety of psychiatric conditions in inpatient and outpatient settings. During her graduate medical training, Dr. Tate was extensively trained in psychodynamic psychotherapy and was supervised by experienced psychoanalysts. She is also familiar with cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and dialectical behavior therapy (DBT). Dr. Tate graduated from the University of Tennessee Medical School in Memphis and completed her graduate medical education in General Psychiatry at Northwestern University’s Feinberg School of Medicine in Chicago, IL. Dr. Tate is a board-certified psychiatrist by the American Board of Psychiatry and Neurology.

The holidays can be a joyous time—a time to spend with family and friends, reflect, and be thankful. Yet, for many people, the holiday season can bring on the blues, including feelings of anxiety, stress, worry, and sadness. These feelings may even be worse for those who have experienced divorce, lost a loved one, or are living far away from family and friends.

The holiday blues

A 2014 survey conducted by the National Alliance on Mental Illness (NAMI) found that the holidays contribute to feelings of sadness or dissatisfaction. Of those surveyed:

• 63% reported there was too much pressure
• 57% stated they had unrealistic expectations
• 66% reported experiencing loneliness
• 50% were unable to be with loved ones
• 55% found themselves remembering happier times in the past contrasting with the present
• 68% reported feeling financially strained

While the holiday blues are different from mental illness, it can lead to clinical anxiety and depression. It is important that we do not ignore these feelings, especially as we all continue to deal with changes wrought by the COVID-19 pandemic but deal with them in a proactive and healthy manner.

Tips for beating the holiday blues

1. Throw guilt out the window. Try not to put unreasonable pressure on yourself to be happy or enjoy the holidays and avoid overanalyzing your interactions with others. Give yourself an emotional and mental break this holiday season.
2. Be realistic and try not to expect the “ideal” holiday. Keep expectations for the holiday season manageable by not trying to make the holiday “the best.” Be truthful to yourself and others about what you can and cannot do. And remember, nobody has a perfect holiday or perfect family.
3. Give to others. Volunteering somewhere, like a soup kitchen, food bank, children’s group home or facility for the elderly can fill you with feelings of love and pride. You will spend time with others and immerse yourself in the true spirit of the holiday season.
4. Stay connected. Schedule phone calls or virtual gatherings with your favorite folks where you can open gifts together, sing songs and reminisce. Spending time with those who love and value you can be very comforting and help ground everyone involved.
5. Acknowledge the past yet look toward the future. Change is a constant part of life. If your holidays are not like they used to be, it is OK. Cherish the memories and remember everything does not have to be like past holidays for you to enjoy the season.
6. Make a budget. Budgeting at the start of the season for holiday shopping and expenses is one of the most effective ways to alleviate stress. It helps prevent accidental overspending and allows you to manage expectations.

Want more tips for beating the holiday blues?

Visit the Magellan Healthcare holiday emotional wellbeing website for resources to help you find peace and moments of joy this holiday season here.

Men, women, and children. Black and white. Rich and poor. Depression affects Americans from all walks of life, regardless of age, gender, race, ethnicity, and socioeconomic status. In fact, the Centers for Disease Control and Prevention estimate that one in thirteen of us is living with depression.[1]

• In 2019, nearly 13 million U.S. adults and 2.7 million U.S. adolescents had at least one major depressive episode with severe impairment in the past year[2], including:
  • Almost 10% of females and 6.0% of males[3]
  • Approximately 15% ages 18-25, 9% ages 26-49, 5% ages 50+[4]
  • About 7% Hispanic or Latino, 9% White, 6% Black or African American, 5% Asian, 4%[5] Native Hawaiian/Other Pacific Islander, 9% American Indian/Alaskan Native[6]
• About 31% of Americans in poverty and almost 16% of those not in poverty report having been diagnosed with depression [7]

Recognizing signs of depression

Depression is often referred to as a silent illness. Many people who suffer from depression secretly struggle and never seek help. Signs and symptoms of depression include:

• Low mood or increased irritability
• Feeling empty or numb
• Loss of energy or motivation
• Loss of interest in regular or recreational activities
• Feelings of guilt, restlessness, hopelessness, worthlessness or fear
• Sleeping too much or too little
• Changes in appetite or eating behavior
• Poor concentration
• Suicidal thoughts

If you or someone you love is experiencing any of the common risk factors and warning signs associated with depression, online or in-person depression screening is the first step toward improved mental health and wellbeing.

Benefits of depression screening

Screening is a valuable tool in the identification and treatment of depression. One of the most common screening tests for depression is the Patient Health Questionnaire (PHQ). Early identification and treatment of depression can:

• Slow its progress
• Improve your physical health
• Prevent years of suffering
• Decrease the risk of death by suicide
• Place you on the path to a happier, healthier life

Visit here to complete the PHQ-8. Once you complete the assessment, be sure to review your results and any recommendations with your doctor.

Who should take a depression screening test?

The U.S. Preventive Services Task Force recommends screening for depression in the general adult population, including pregnant and postpartum women. Although anyone can develop depression, regardless of their age, ethnicity, or background, depression is more common among people who:

• Have a family history of mental illness
• Have another mental health condition, like anxiety
• Struggle with a substance use disorder, like drug addiction or alcoholism
• Recently experienced a stressful life change or traumatic event

However, anyone who has any signs of depression should take a depression screening test.

Screening and treatment

While screenings are not a professional diagnosis, they do point out the presence or absence of depressive symptoms and can indicate if a referral for further evaluation is needed. You should see your doctor or a qualified mental health professional if you experience five or more depression symptoms for longer than two weeks or if the symptoms are severe enough to interfere with your daily routine.

Proper treatment of depression has been proven to effectively reduce depressive symptoms, decrease the risk of relapse and recurrence, and decrease emergency department visits and hospitalization rates.

Learn More

Visit Magellan’s Behavioral Health Resources page to learn more about depression and other mental health conditions.

If you’re in crisis or have suicidal thoughts, seek help immediately. Please call 1-800-273-8255 (National Suicide Prevention Lifeline) or call 911 and ask for help, or go to your nearest emergency room.

[1] https://www.cdc.gov/tobacco/campaign/tips/diseases/depression-anxiety.html

[2] https://www.nimh.nih.gov/health/statistics/major-depression

[3] https://www.nimh.nih.gov/health/statistics/major-depression

[4] https://www.nimh.nih.gov/health/statistics/major-depression

[5] https://www.nimh.nih.gov/health/statistics/major-depression

[6] https://www.nimh.nih.gov/health/statistics/major-depression

[7] https://news.gallup.com/poll/158417/poverty-comes-depression-illness.aspx

Among those who experience a mental health illness, more than half do not receive treatment.[1] The 2019 National Survey on Drug Use and Health reveals no treatment was received by:

• 90% of the 20.4 million individuals aged 12+ who have a substance use disorder (SUD)
• 55% of the 51.5 million individuals aged 18+ who have any mental illness (AMI)
• 35% of the 13.1 million individuals aged 18+ who have a serious mental illness
• 90% of the 9.5 million individuals aged 18+ who have a co-occurring SUD and AMI
• 57% of the 3.8 million individuals aged 12-17 who have had a major depressive episode

In fact, what we’ve seen in our data is that 60% of patients who are admitted to inpatient care were first seen in a primary care setting within 6-12 months of the admission and the mental health condition was either missed or not addressed.

Through effective screening for mental health conditions on your own or through a physician or mental health professional, it is possible to identify problem areas and get help, so you can live a happier and healthier life.

Mental health self-screening tools

Magellan Healthcare provides links to reputable, free self-assessments of behavioral/mental health, substance use and more.* Once you complete an assessment, be sure to review your results and any recommendations with your doctor.

• Addiction(CAGE-AID)
• Alcohol consumption (AUDIT-10)
• Anxiety (GAD-7)
• Bipolar disorder
• Child depression (CES-DC)
• Child trauma (CTS)
• Depression (PHQ-8)
• Drug abuse (DAST-10)
• Eating disorder (SWED)
• Insomnia (ISI-7)
• Obsessive compulsive disorder (OCD) (Y-BOCS)
• Pain (PEG-3)
• Parent mental health
• Postpartum depression
• Post traumatic stress disorder (PTSD) (PC-PTSD)
• Psychosis (PQ-B)
• Youth mental health

*Note these are links to outside websites that are not monitored by or affiliated with Magellan Healthcare. If your screening results indicate you are at high risk, call 911 or go to the emergency room immediately.

We encourage you to watch a recording of our webinar, “Depression is more than just a rough patch,” and find additional resources addressing depression at MagellanHealthcare.com/Mental-Health.

[1] https://www.samhsa.gov/data/sites/default/files/reports/rpt29392/Assistant-Secretary-nsduh2019_presentation/Assistant-Secretary-nsduh2019_presentation.pdf

Behavioral health is an important indicator of a society’s overall wellbeing, as it interacts closely with physical health. Unfortunately, most individuals do not receive the behavioral health treatment they need. Fear of treatment, shame, and embarrassment keep many from seeking care. More than one-third of Americans live in areas lacking mental health professionals.[1] Fifty percent of individuals who receive a behavioral health referral do not follow through or have only one visit.[2] Collaborative care addresses these problems by providing physical and behavioral health care in the primary care setting.

What is collaborative care?

Collaborative care is a specific type of integrated care developed at the University of Washington’s AIM Center that treats common mental health conditions, such as depression and anxiety, that require systematic follow-up due to their persistence. Based on principles of effective treatment of chronic illness, collaborative care focuses on defined patient populations tracked in a registry, measurement-based practices, and treatment to target. Trained primary care providers and embedded behavioral health professionals provide evidence-based medication or psychosocial treatments, supported by regular psychiatric case consultation and treatment adjustment for patients who do not improve as expected.[3]

Principles of collaborative care

Developed in consultation with a group of national experts in integrated behavioral health care in 2011 with the support of the John A. Hartford Foundation, The Robert Wood Johnson Foundation, Agency for Healthcare Research and Quality, and California Healthcare Foundation, five core principles define collaborative care and should inform every aspect of implementation to ensure effective collaborative care is practiced.[4]

• Patient-centered team care—Primary care and behavioral health providers effectively work together using shared care plans that include patient goals. Being able to receive both physical and mental health care in a familiar location provides patients with comfort and reduces duplication of assessments. Increased patient engagement often leads to a better health care experience and improved patient outcomes.
• Population-based care—Care teams share a specific group of patients that are included in a registry. The registry is used to track patients and ensure that no one falls through the cracks. Patients who do not show improvement are outreached, and behavioral health specialists offer caseload-focused consultation.
• Measurement-based treatment to target—Each patient’s treatment plan includes personal goals and clinical outcomes that are measured using evidence-based tools, such as the Generalized Anxiety Disorder scale on a routine basis. If patients do not improve as expected, treatments are adjusted until clinical goals are met.
• Evidence-based care—Patients receive treatments with sound research evidence to support their efficacy in the treatment of the target condition, including various evidence-based psychotherapies that have proven effective in primary care, such as problem-solving treatment, behavioral activation, and cognitive behavioral therapy, and medicines.
• Accountable care—Providers are responsible for and receive reimbursement for the quality of care and clinical outcomes, not just the volume of care provided.

Collaborative care has been proven to double the effectiveness of depression care, improve physical function, and reduce health care costs. Magellan Healthcare’s evidence-based Collaborative Care Management product, enabled by NeuroFlow, provides care management and psychiatric consults for primary care patients and augments physical health providers’ staff with Magellan staff to facilitate integrated physical and behavioral healthcare. Learn more here.

[1] https://usafacts.org/articles/over-one-third-of-americans-live-in-areas-lacking-mental-health-professionals/

[2] https://aims.uw.edu/collaborative-care

[3] https://aims.uw.edu/collaborative-care

[4] https://aims.uw.edu/collaborative-care

Think back to New Year’s Eve, Tuesday, December 31, 2019. Maybe you had big plans that night to ring in the new year, or maybe you were spending a quiet evening at home. In either case, you probably had expectations about 2020 and hopes that it would be happy, healthy and prosperous…

Fast forward a couple months to February, 2020 when we began hearing more about a new coronavirus, COVID-19, originating from Wuhan, China that had made its way into the United States and was beginning to spread.

Changes caused by COVID-19

We started to see our world and our lives drastically change, experiencing loss and grief in several forms. For many of us, there were no more commutes to work, as we began to work from home if we were lucky enough to keep our job. There was no more getting the kids off to the bus stop or waiting in the drop-off line, as schools closed and switched to a virtual learning environment.

Parents lost the luxury of being able to fully concentrate on their jobs, as they were forced to take on the roles of teacher or daycare worker and daytime entertainer for their kids. Kids missed out on receiving the first-class education they depended on to feel prepared for the next school year or even college.

Healthcare workers risked their lives and those of their family to care for the people who were getting sick from COVID-19, worried they had been infected and wanted to get tested, or needed regular healthcare. Essential workers in grocery stores, post offices, public transportation, and other industries also became heroes as they continued to come to work to keep the country running, despite fearing for their own health and lives.

And there wasn’t a roll of toilet paper or paper towels to be found.

Social isolation

Across the board, we didn’t get to spend precious in-person time with our extended family and friends because we were doing our part to bend the curve and stop the spread of COVID-19. We didn’t get to go to the gym and may have fallen behind in our physical fitness. Our kids didn’t get to participate in their beloved sporting or other extracurricular events. Medical procedures were cancelled. Vacations were cancelled. Weddings were cancelled. Graduations were cancelled. Everything was cancelled.

Our dreams and plans were put on hold.

COVID-19 mental health toll

We certainly couldn’t have imagined this would be how the year would start off and end. Spring, summer, fall and winter, and all that comes with each, did not happen the way we have all become accustomed to for our entire lives.

And while we have done our best to adapt, the grief and loss of loved ones, financial security and social normality we have experienced over the past year has taken its toll on our mental health.

Where to go from here

We encourage you to watch a recording of our webinar “Coping with grief and loss during COVID-19” with Paula Hensley, MD, Magellan Healthcare senior medical director; Sagar Makanji, PharmD, Magellan Rx vice president, clinical strategy and programs; and Mark Santilli, PharmD, Magellan Rx senior director, clinical strategy and programs, as they share knowledge and tips for persevering after grief and loss due to COVID-19 and answer audience questions.

For additional COVID-19 resources from Magellan Health, click here.

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.