The number of children in our nation who urgently need mental health services has steadily been rising for the past decade and is spiking during the pandemic. In October of this year, a coalition of the nation’s leading pediatric health experts, representing more than 70,000 doctors, issued a joint statement declaring that the child mental health crisis has become a national emergency. The statement highlights the serious toll that isolation, ongoing uncertainty, fear, and grief during the pandemic are taking on U.S. children and teens. Pediatricians and child and adolescent psychologists and psychiatrists are reporting significantly more kids with anxiety, depression, eating disorders, and suicidal thinking over the past year. This joint statement was echoed in early December when the U.S. Surgeon General issued a rare public advisory in a 53-page report noting that the pandemic significantly intensified mental health issues that were already widespread by the spring of 2020.
Data shows that we have some of the highest rates of mental illness in California. This grim reality is compounded by having the fewest mental health care professionals per capita in the state. During the pandemic, professionals here have been seeing a significant increase in children presenting for services coupled with increasingly serious symptoms. The Office of Student Services at Fresno County Superintendent of Schools reports a doubling of referrals in the last 2 months alone to 600 children per month.
Not only is there a surge in teenagers showing up in emergency rooms, alarmingly, the number of children in mental health crisis under the age of 13 is also significantly on the rise. This mental health crisis is hitting children of color especially hard. As of June 2021, over 140,000 children had lost a caregiver to COVID-19. Given the disparate mortality rates suffered by minorities, these losses hit children of color particularly hard. A recent study in the Journal of Pediatrics reported that, when compared to white children, Native American children were 4.5 times more likely to have lost a primary caregiver, Black children were 2.4 times more likely, and Hispanic children nearly twice as likely.
Teachers across the Central Valley are reporting a growing number of children from Pre-K to early grades arriving at school with dysregulated behaviors that cause chaos in the classrooms. The symptoms exhibited—high activity levels, aggression, tantrums, limited eye contact, restricted play choices, or being stuck obsessively on a tablet, for example—may be mistaken for autism but may actually be rooted in developmental reactions to early trauma. Mental health starts early. Babies learn to form relationships; and to manage, and express emotions and to build confidence and learn. The complex issues underlying the historical rise in the deterioration of children’s mental health have been accelerated by the alteration of family dynamics during the pandemic. Parents are too often overwhelmed by isolation, ongoing financial uncertainty, lack of affordable housing, work demands, fear, and grief and are unable to calm and regulate themselves let alone respond consistently to the needs of their children. Each of us, in our traumatized nation, especially the low income and people of color, is holding high levels of stress which has resulted in a decrease of social and emotional health. This is especially true for our children.
In searching for ways to deal with this crisis there are two distinct strands to consider, both of which are essential—Prevention and Treatment. Especially effective in the realm of prevention are early services beginning pre-conception to age 5. The Fresno Cradle to Career (C2C)
Blueprint for Funding and Advocacy points out that “a child’s healthy development is dependent on many factors including their interactions with adults, living conditions, learning opportunities, access to health care, and, beginning in the womb, experiences of stress and trauma,” and makes a series of recommendations as to how to achieve this. Robust support for the implementation of the
0 to 5 Blueprint would do much to disrupt the causes of early trauma.
Currently treatment for mental illness is greatly hampered by a variety of factors with two of the biggest being lack of funding to support existing and new programs coupled with a significant shortage of professionals. As we seek to develop and strengthen our treatment services we should pay attention to the growing body of research related to Adverse Child Experiences (ACE) that is leading us to understand that the best therapies include body movement and the expressive arts—music, dancing, drumming, art, etc. The Fresno County Trauma and Resilience Network is leading a collaborative effort with partners from multiple sectors– health, social services, community-based organizations, government, early care and education, child welfare, and the legal/justice system—to comprehensively build ACE awareness community wide.
Fortunately there are some new resources coming in. The Biden administration announced in August plans to invest nearly $85 million in funding for mental health awareness, training and treatment for children. In addition to the federal dollars Governor Newsom signed several bills last year to help improve access to mental health services and substance use disorder services.
Navigating the bewildering world of multiple agencies, programs and services can be challenging. Valuable sources of help are:
All4Youth is a collaboration between Fresno County Department of Behavioral Health and the Fresno County Superintendent of Schools for children ages 0-22 who are experiencing difficulties that affect them at school and at home. It is an integrated system of care that, with one call, will give all youth and their families access to behavioral health services at school, in the community, or in the home
211 is a 24/7 call center provided by United Way for help on a wide range of issues, e.g. mental health, housing, rent payments, employment and education, income, food and meal assistance, legal assistance, health and dental care, substance abuse programs, transportation, and more.
1-800-273-8255
Provides help for students in Crisis as well as the Teen and Youth Help Hotline.
More information available at TeenLine.org
In Community,