On the pandemic’s hidden frontline, children and teens struggle with the mental stress

While children and adolescents generally are spared physical harm from COVID-19, many are feeling deep mental stress because of school closures and the isolation brought on by the pandemic.

In Raleigh, Jennifer Birch and Jessica Sparrow are working on this largely invisible frontline of the pandemic. Birch is a therapist specializing in children and adolescents. Sparrow is a Raleigh psychiatric nurse practitioner who prescribes drugs for children and adolescents struggling with anxiety and depression. The two often coordinate their work.

Birch told me the number of children she counsels has doubled since March and “all of it is pandemic related.”

And as the number of her clients increases, the mental strain they are experiencing is getting worse. “I’m seeing a lot of self-harm, cutting, suicidal thoughts,” she said.

Sparrow used to see children with attention deficit disorder and other learning disabilities improve with medication. Now she is also seeing young patients without those issues who can’t keep up when all their classes come through a computer screen.

“I can count on one hand the number of kids I see who are doing well, by that I mean passing,” she said. “A lot of these kids have to learn in a face-to-face environment and all of a sudden they are put in a position of a lot of self-motivated learning.”

Sparrow said she often hears her young patients say, “I’m not keeping up academically. I’m so far behind, what’s the point? Mom’s so mad at me.”

Birch encounters the same. “What I’m seeing most is this overwhelming feeling of despair,” she said “This the first time that they haven’t been successful because they are really good students.”

Along with the academic challenges, Birch said students, especially those in high school, are coping with lost social contact and missing the rites of school – homecoming, dances, football games, proms, graduation.

School systems were not wrong to end in-person classes at the start of the pandemic, Birch said. She considers the closures a reasonable response to a public health crisis. But she does fault schools for the abruptness of the action.

“I really got upset with the way Wake County did it,” she said. “None of the kids knew when they left the building that was going to be the last time they would see their teachers. There was no closure. There was this upheaval. Book bags are still at the school.”

She added, “There were so many different ways they could have handled this. Yes, keep (students) safe and think about their mental health.”

This wave of mental stress is swamping an already inadequate network that cares for mentally and emotionally troubled children. Birch said, “Across the board, the wait time to get in with a psychiatrist is months.”

With not enough psychotherapists readily available and psychiatric care hospitals fully booked, Sparrow is prescribing drugs for anxiety and depression earlier and more often.

“I’ve had to be quicker to manage things with medications than I would usually because there are just not enough providers for the amount of therapy that’s needed,” she said. “I try to avoid medications, but it’s too risky when someone is going to have to wait eight weeks to see a psychotherapist.”

Sparrow notes that many children from less well-off families can’t afford private mental health care and are struggling with the pandemic’s stress on their own. “That’s another layer out there that I haven’t seen,” she said.

Schools will see it soon enough. Children cut off from school and coping with strained family situations are not going to snap back once children file into schools again. Many students will need extra attention with academics and with the challenge of emerging from a sudden and prolonged removal from their school environments.

Prospects for such extra help aren’t good. School counselors, nurses and teachers were in short supply before the pandemic. The state legislature and school districts will need to do much more for children if getting back to school is going to also mean getting back to normal.