Children's Hospitals Today - Summer 2022 - 14

FEATURE / PANDEMIC
What the stats say
Continued from page 13
CHT: Let's talk about
functional closures and
the effect they're having.
RUBIN: We're not doing
virtual school anymore,
but a lot of kids are
missing extended periods
of time. Kids who may
have been exposed to
COVID are still asked
to quarantine in many
locations. So, people are
coming in and out of the
classroom. There's also a
lot of absenteeism on the
staff. You might have kids
sitting in a classroom,
but if substitute teachers
aren't teaching them,
that's a problem. There's
still a lot of disruption.
CHT: What should
children's hospitals be
doing now?
RUBIN: We're in a
different phase of this
pandemic. The epidemic
we're dealing with now
is around children's
well-being and behavioral
health. That starts
with getting kids back
to their routine and
accepting the risk that
COVID-19 introduces
in the classroom. It
brings a significant
challenge in terms of
building community and
school-based resources,
taking advantage of the
relationships between
public health and school
districts, and trying to
build a system that grants
kids access to different
levels of services based
on their needs.
It may feel like life is inching toward normal,
but data on kids' and teens' mental health
continue to show negative trends. " Despite
the return to in-person school, which many
people felt would boost kids' mental health,
we're not seeing declines in depression or
suicide, " says Jami Young, Ph.D., associate
chair of research at Children's Hospital
of Philadelphia, Department of Child and
Adolescent Psychiatry and Behavioral Sciences.
Young says her team has been struck by
the data, which show mental health concerns
seem to be worse this year than they were last
year. " Particularly as this pandemic moves
forward, we're continuing to see increased
rates of depression, anxiety, suicide and eating
disorder risk amongst our teens, " she says.
Huszti is seeing the stats jump in CHOC's
emergency department: visits for mental or
behavioral health concerns increased 41%
from July 2019 to March 2022 and visits for
medically unstable children with eating
disorders increased 94%. Huszti says CHOC's
outpatient mental health clinic is receiving
about 200 referrals a month-a record high-
and the age of suicide and suicide ideation is
getting younger. " We're seeing more mental
and behavioral health concerns, and it's more
acute, " Huszti says. " Clinicians like myself who
have been practicing for decades are saying
they've never seen anything like this.' "
Young says school counselors are telling a
similar story. " One of them said they had done
more suicide assessments in this past year
than in the last five years combined, and that
they're doing at least one, if not more, every
day, " she says. " It's important to recognize the
role schools play in promoting access to school
mental health services and recognize that kids
need these services even more. "
These observations suggest that, while
children's hospitals were in crisis mode during
the height of the pandemic, now is the time to
shift to supporting longer term prevention,
surveillance and community interventions.
And schools continue to be an area of
opportunity where children's hospitals can
build partnerships to achieve these aims.
Despite a return to in-person school, we are not seeing declines in
depression or suicide. -Jami Young, Children's Hospital of Philadelphia
The importance of community
Jill Haak Bohnenkamp believes in the power
of community and low-cost, high-impact
mental health promotion activities in the
schools. She says even the smallest of gestures
and moments can have a tremendous effect-
like a bus driver or teacher who provides a
student with a warm greeting, an administrator
who is supportive, or a community event
welcoming caregivers into the classroom to
see what kids are learning. " We need to make
sure we're doing things to support strong
teacher-student-caregiver relationships, " says
Bohnenkamp, Ph.D., assistant professor at
the National Center for School Mental Health,
14
CHILDREN'S HOSPITALS TODAY Summer 2022
Division of Child and Adolescent Psychiatry,
University of Maryland School of Medicine.
" We have not had as much of those things
because of the pandemic, and they are critical
pieces that build a student's academic, social
and emotional competencies. "
Recent CDC research shows that this
kind of personal connectedness has lasting
effects. Youth who feel connected with the
community at school and the family at home
are as much as 66% less likely to experience
health risk behaviors related to sexual
health, substance use, violence and mental
health in adulthood.
Children's Hospitals Today - Summer 2022

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