COVID-19 took a population of young Americans already reeling from a variety of mental health challenges and “exacerbated the unprecedented stresses young people already faced,” according to a public advisory issued by U.S. Surgeon General Vivek Murthy, MD.
“Since the pandemic began, rates of psychological distress among young people, including symptoms of anxiety, depression, and other mental health disorders, have increased,” the advisory said. “Recent research covering 80,000 youth globally found that depressive and anxiety symptoms doubled during the pandemic, with 25% of youth experiencing depressive symptoms and 20% experiencing anxiety symptoms.”
Before the pandemic began in America in March 2020, roughly one in five children in the U.S. aged 3 to 17 reported a mental, emotional, developmental, or behavioral disorder, according to the report. It went on to say that since the pandemic started, there have been unmistakable signs mental health among young people has suffered even more. For instance, in early 2021, emergency department visits in the U.S. for suspected suicide attempts were 51% higher for adolescent girls and 4% higher for adolescent boys compared with the same time in early 2019.
The surgeon general is not the first to point out COVID-19’s mental health impact on this population. In October, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association declared a “national state of emergency” in children’s mental health.
Nor is Texas immune to the problem. And like most states, it has a shortage of mental health professionals, which means mental health care frequently falls on primary care physicians like pediatricians and family physicians, says Donald Murphey, MD, an Austin pediatric infectious disease specialist and chair of the Texas Medical Association’s Council on Science and Public Health.
“If you’re seeing a broad diversity of kids, then there’s lots of stress, and you’re doing a lot more mental health in the course of normal work in pediatrics,” he said.
While the pandemic has created numerous problems, the mental health challenges young people face typically are preventable and treatable, the surgeon general’s advisory says, pointing out that they are resilient and typically can move on in healthy ways after a disruptive event.
“According to more than 50 years of research, increases in distress symptoms are common during disasters, but most people cope well and do not go on to develop mental health disorders,” the report said.
It also spelled out several steps physicians and other health care professionals can take to help. They can:
- Recognize that prevention is the best treatment for mental health challenges, and implement trauma-informed care principles and other prevention strategies to improve care for all youth, especially those with a history of adversity.
- Routinely screen children for mental health challenges and risk factors, including adverse childhood experiences.
- Identify and address the mental health needs of parents, caregivers, and other family members.
- Work with community partners as well as people in schools and in child welfare, juvenile justice, and similar institutions to provide mental health services.
- Build multidisciplinary teams to implement services tailored to the needs of children and their families.
- Enlist children and families as partners and engage them in all stages of decisionmaking, from screening to treatment.
As health care leaders, physicians also can focus the public’s attention on mental health issues among youth, Dr. Murphey says.
“The other thing we can do is educate the community about these issues – suicide prevention, adverse childhood events, the loss of caregivers, and the fact that there are mental health resources out there,” he said. “If they see issues out there, talk to their physician, and get a referral and work on treating that.”
Dr. Murphey also encourages physicians to use the Child Psychiatry Access Network (CPAN), a program created by the Texas Legislature in 2019 with TMA’s support. CPAN provides pediatricians and family physicians across Texas free telemedicine-based consultation and education on behavioral health for children in primary care. Physicians can call CPAN and typically get professional advice in minutes.
CPAN is part of the Texas Child Mental Health Care Consortium. The consortium also oversees Texas Child Health Access Through Telemedicine, which uses telemedicine to help behavioral health specialists assess elementary through high school students with mental health needs. Likewise, the consortium funds expansion of the psychiatric workforce, child and adolescent fellowship programs, and improved mental health research.