On October 18th, Boston Children’s Museum welcomed Dr. Khadijah Booth Watkins, MD, MPH to host a discussion at its 108th annual meeting on a topic that has been on the minds of parents and caregivers for over 18 months now: How can I support the mental health of my child amidst the many challenges and disruptions of the Covid-19 pandemic?
Khadijah is the Associate Director of the Clay Center for Young Healthy Minds and the Associate Director of the Child and Adolescent Psychiatry Residency Training Program at Massachusetts General Hospital and McLean Hospital. She specializes in the evaluation, diagnosis, and treatment of psychiatric disorders in children, adolescents, and adults.
We hope this compilation of the information and recommendations Khadijah provided will serve as a helpful resource for you as you build strategies for supporting your child’s wellbeing through this very difficult time.
Stress—we all feel it
Stress didn’t begin with the pandemic. It was present in most of our lives long before March 2020, but was greatly exacerbated by the pandemic and so many concurring events like the reckoning on race, the polarization of the nation, the election, and natural disasters like wildfires and hurricanes.
For kids, a major difference between pre-pandemic and pandemic stress was their level of awareness. We were all at home with nowhere to go, and everyone was watching the news. Even very young children were aware of the many stressful events happening, even more so when parents and caregivers showed their own stress, which could be very difficult to hide given the amount of turmoil we were all dealing with.
“The cumulative effect began to mount for many kids and caregivers, and it was unrelenting,” Khadijah noted. “The entire family system was stressed. Kids, in particular, took an emotional toll.”
Kids and adults were and are still dealing with so many stressful emotions all at once:
· Grief and loss
· Anger and fear
· Lack of connection
· Uncertainty about their safety and their futures
Parents and caregivers suffered many additional stressors:
· The challenges of working from home and monitoring remote schooling
· Lack of support
· Housing insecurities
· Food insecurities
This level of stress can have serious effects, including poor sleep (and all the consequences that come with sleep deprivation, for kids in particular), poor nutritional patterns, difficulty regulating emotions, emotional eating, substance use, and medical problems including weaker immune systems.
Understanding all the consequences of pandemic stress, we all wonder what we can do to lessen its effects and support the wellbeing of our children.
How can we help our kids through all of these emotions while taking care of ourselves, too?
Put your oxygen mask on first before helping others. You can’t support your children’s mental health if you yourself are struggling. Though it is challenging with everything else on our plates, do your best to make sure you are engaging in self-care strategies that work for you, getting enough sleep, and eating well.
To support our children, the most important thing we as parents and caregivers can do is foster their sense of resiliency.
Resiliency is defined as:
Adapting well while maintaining personal and social stability in the face of adversity, such as trauma, tragedy, threats, family and relationship problems, serious health problems, financial stressors, or other significant sources of stress.
The key ingredients for developing resiliency include connection, awareness, wellness, healthy thinking, and finding meaning.
How can we foster resiliency in our kids?
· Facilitate connection with others, including a trusted adult
· Teach and model self-care
· Teach and model coping skills—things kids can do when they’re feeling stressed or overwhelmed
· Create opportunities for them to engage in problem-solving
· Ask “how” instead of “why” questions
· Allow kids to make mistakes
· Teach them how to label their emotions
It is extremely important to regularly engage in conversations with your child about how they’re feeling and what they are worried about. To make your child feel comfortable sharing, be as supportive and understanding as you can be during these conversations. Follow their lead and be mindful of your body language and facial expressions so that they don’t feel judged or criticized. And be honest—if they ask you questions you don’t know the answer to, tell them that.
“Kids mostly want to know we are doing all that we can to keep them safe,” said Khadijah. “These conversations will create a platform for kids to feel comfortable coming to you without being asked. They feel you can be supportive and understand.”
We can also be great examples of prioritizing self-care for our children. The pandemic has taught us how critical self-care is. It’s really a necessity, not a luxury. You can model self-care by doing activities together with your child that you both enjoy, being creative, exercising, enjoying nature—anything that works for you both.
“All kids want to spend time with their parents, even older kids who pretend they don’t,” Khadijah noted. “Quality time helps manage some of the stress and anxiety.”
For younger children, playing together with parents is also a powerful strategy to reduce stress, foster resiliency, and support wellbeing. “Play can mitigate toxic stress. It can help with learning, growth, and skills acquisition. When parents spend quality time with their children playing, it can really support their mental health,” noted Carole Charnow, Boston Children’s Museum’s CEO and President.
Common questions that parents and caregivers have about their child’s mental health
There were likely times throughout the last year and a half when you wondered at what point to become concerned about your child’s wellbeing. Begin by looking out for common signs that your child is struggling. Notice changes in your child’s behavior, including their appearance, declining performance in school, and lessened interest in athletics or hobbies. Notice if their sleep patterns, appetites, or moods are changing. Finally, notice if your child starts talking more frequently about their worries and fears.
When to worry (and not worry)
Certain levels of anxiety, stress, or depression are to be expected in kids facing so many challenges, but look out for certain signs that should spark concern—
· Prolonged periods of depression
· Isolating and withdrawing (they don’t want to come to the dinner table, watch TV with family members, call up their friends, participate in class, etc.)
· Behavioral concerns like outbursts or excessive tantrums
· Engagement in unsafe or risky behaviors
· Concerns for their safety
· Talking about death and dying
What should you do if you notice these signs?
The first step is to talk with your child. Start with open-ended conversations and move to specifics, following their lead. Then, reach out to other adults who interact with your children like teachers or coaches to find out if they’ve noticed changes in their behavior. And finally, seek support and guidance from a pediatrician or mental health professional.
Your child’s primary care provider can act as a gatekeeper to connect you with a mental health professional. Pediatricians may have a list of people or clinics that are taking new patients, but unfortunately, there is often a waitlist. Sadly, there is a major shortage of mental health providers throughout the United States.
This is when alternative resources can really help. There are many reputable online resources that provide helpful, up-to-date information for parents and caregivers on supporting children of all ages. You can find a list of these resources at the end of this blog post.
Along with wondering how to support your child’s mental health, you may also be concerned that your child won’t be able to catch up socially or academically after all this time lost. Finally, some great news: There’s no need to worry.
“Kids weren’t getting the education, but it’s not going to prevent them from learning it. They will continue to develop, and they will catch up,” said Khadijah.
With all of the consequences of the pandemic, there were some silver linings. This time at home provided people, especially kids and families, with the opportunity to recalibrate. We began noticing how overscheduled we’d been and questioning whether or not we were actually enjoying the things we were doing. We had the time to reevaluate our priorities and values—time that many families never had before. We also realized the importance of self-care, connection, creativity, and simply being present in the moment.
By helping them cultivate resiliency, spending time engaging in supportive and safe conversations about how they’re feeling, enjoying quality time together, modeling healthy coping mechanisms and self-care practices, and, when needed, seeking the help of a doctor or counselor, our kids will bounce back from this terrible time.
Resources for parents and caregivers on supporting children’s mental health:
Thank you so much to Dr. Booth Watkins and Dierdre Phillips, Managing Director of the Clay Center for Young and Healthy Minds, for joining us for this important and informative discussion. You can watch the full talk on our YouTube channel here.