Why Children's Mental Health Has Become a National Emergency

COVID-19 may not have made a huge impact on children’s physical health, but its ripple effects have wreaked havoc on their emotional wellbeing. That’s why leading medical groups recently declared a national emergency in child and adolescent mental health.

The joint statement from the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association notes that children’s mental health has been worsening over the past decade. Rates of childhood depression and anxiety have steadily climbed, and suicide is the second leading cause of death among people between 10 and 24 years old.

But with the stress of the pandemic continuing to exacerbate these problems, experts say children’s mental health is now in crisis. Here’s why.

Pandemic Stress Harms Children

When you zero in on the numbers, it’s easy to see why experts are sounding the alarm on the worsening state of children’s mental health. 

Nearly a third of parents say their child has worse mental or emotional health now than before the pandemic. Anxiety and depression among youth around the world have doubled their pre-pandemic rates. And emergency department visits for suspected suicide attempts among teen girls in the U.S. jumped a whopping 51% early in the pandemic, compared to 2019.

Experts say that sweeping lifestyle changes during pandemic proved immensely stressful for children.

“During the pandemic, children have faced so many challenges. In the best circumstances, youth have experienced some degree of isolation and disrupted learning,” says Stacy Doumas, MD, chief of the division of child and adolescent psychiatry at Jersey Shore University Medical Center.

Teens especially have struggled with the disruption to everyday routines and the lack of social interaction with peers, says Sarah Edwards, DO, Assistant Professor and Medical Director for the Children & Adolescent Psychiatric Unit at the University of Maryland Children’s Hospital.

“Teens have the developmental task of separating from their parents and becoming more independent. They are supposed to be building relationships outside of their family, and the pandemic interfered with this,” she explains.

Another factor in children’s worsening mental health is the stress their parents and caregivers have experienced during the pandemic. It can be a huge emotional blow for a young person to watch “the person who is supposed to be their rock collapse due to COVID-19,” notes Ilan Shapiro, MD, FAAP, medical director of health education and wellness at AltaMed Health Services.

“Seeing how worried they are about finances, to see them go without, and experience hunger due to job loss is devastating,” he explains.

Deaths of Parents and Caregivers

The rising rates of children facing orphanhood further compounds the youth mental health crisis. More than 140,000 kids experienced the death of a parent or grandparent caregiver between April 1, 2020, and June 30, 2021. Such a significant loss can have a major impact on a child’s mental health and overall wellbeing, both in the immediate aftermath and over the course of their lives.

Dr. Edwards notes that the circumstances surrounding the deaths of many parents and caregivers to COVID-19—including the sudden passing and inability for family to speak or visit with them in the hospital—can put kids at risk of childhood traumatic grief.

“This is when a child is not able to accomplish typical tasks of bereavement because of a traumatic stress reaction they are having,” she says. “These youth are not able to move past the traumatic nature of how their loved one died, they have scary thoughts and memories about the way the caregiver died, and they may avoid memories or talking about the caregiver.”

When a caregiver or parent dies, children may also experience disruptions to their housing, school, financial stability, and emotional support network. That, in turn, can have a tremendous impact on their mental health, says Dr. Doumas. 

“In general, children who have experienced parental loss are not only at a higher risk for many mental health issues such as depression, anxiety, somatic complaints, and post-traumatic stress disorder, they may also have long-term negative outcomes impacting academic success, sexual risk behaviors, and self-esteem,” she says.

It’s important to note that children of color have experienced disproportionately high rates of caregiver deaths to COVID-19 compared to their white counterparts. As time goes on, that could contribute to worsening disparities among communities of color, which often lack access to mental health resources.

“We need to make sure that if there's another pandemic, that there are safety nets in place and more support for the vulnerable communities that need it the most. We need to do more to protect the future of our country,” says Dr. Shapiro.

Advocating for Children’s Mental Health

In response to children’s mental health emergency, the White House has put out a new resource with evidence-based recommendations for ways to support kids’ wellbeing. But this is just the first step of many that need to be taken to help children heal from the trauma of the pandemic, experts say.

“In order to best address the youth mental health crisis we need an ‘all in’ mentality. Government organizations [at the] local, state, and national [levels]; healthcare providers; schools; and parents must work together to improve the wellbeing of our youth,” says Dr. Doumas. 

Increasing funding of mental health support will be key in reducing disparities among children of color, says Dr. Shapiro.

“We need appropriate funds for mental health resources in communities in color. We need more conversations with policy makers on addressing the needs of school-aged children and a pipeline to produce more pediatric mental health experts,” he says.

Healthcare organizations can also take additional measures to improve children’s emotional wellbeing.

“Healthcare organizations can improve access to telemedicine, integrate with pediatrics, provide trauma-informed care, and meet acute mental health needs of youth,” says Dr. Doumas.

But while we wait for improvements on the large-scale, parents and caregivers can begin helping kids on the individual level now, by getting them mental health support when they need it.

“Mental health treatment works,” says Dr. Edwards. “We are resilient and we can treat childhood mental health conditions and prevent future symptoms and challenges.”