NASHVILLE, TN – The Surgeon General issued a warning last week about a mental health crisis among American youth. Dr. Vivek Murthy said children are suffering more depression and attempting more suicides since the arrival of COVID-19.
“Even before the pandemic, an alarming number of young people struggled with feelings of helplessness, depression, and thoughts of suicide — and rates have increased over the past decade,” Murthy said.
According to the Centers for Disease Control and Prevention (CDC) the number of children visiting emergency rooms with mental health issues increased beginning in April 2020 and remained higher through October.
The CDC found that “compared with 2019, the proportion of mental health–related visits for children aged 5–11 and 12–17 years increased approximately 24% and 31%, respectively.”
California has a behavioral health safety net in place and the number of children experiencing a mental health crisis there has increased dramatically.
“Having students away from school and the social and emotional support in school exacerbated the mental health crisis but when children come back to school we actually see higher rates of crisis,” said Michelle Doty Cabrera, Executive Director, County Behavioral Health Directors Association.
Cabrera said that children are not simply little adults. They need different resources and sometimes require different clinical approaches. “Children and teenagers often rely on the adults in their lives to help them seek care,” she said.
Cabrera noted more Black children and youth are served in California’s specialty mental health system. It’s different than the regular health model.
“Studies show individuals are more likely to being misdiagnosed with schizophrenia as opposed to other mood disorders if they are Black,” she said.
“We know the pandemic has had pretty significant impact on alcohol and drug use,” she said.
A Rand study found a 40% increase in heavy drinking by women during the pandemic. Opiate-related deaths have increased by 29% and 64% of them were caused by fentanyl that is laced into street drugs. More young people are dying, unaware of how deadly street drugs can be.
California has invested $4.4 billion into health initiatives that include funds for more school-based services, mobile medical teams, and early psychosis programming.
KidsData tracks children’s health and wellbeing on 57 different topics in California.
There was already concern about the increase of mental health issues among young people leading up to the pandemic.
“We could expect that with the beginning of the pandemic mental health would only be more challenging for youth and this is, in fact, what we have seen,” said Dr. Lori Turk-Bicakci, KidsData Senior Program Director. It is a non-profit think tank and health data resource.
Their research shows many California children and youth are suffering mental issues such as depression, anxiety, and eating disorders.
“There has been an increase of prevalence and intensity of mental health issues,” Turk-Bicakci said. Overdoes deaths of 15-19-year olds have increased dramatically. (see chart).
From April 2020 to October 2020, ER visits for mental health issues increased 31% among 12-17-year olds; went up 24% for 5-11 year olds; the visits by 0-4-year olds did not change much. Attempted suicides among girls increased by 51% and 4% among boys.
Dr. Tonya Wood is Director of Clinical Training at Pepperdine University and a practicing psychologist. She is past president of the California Psychological Association.
“Some 2018 data found Black children between 5-12 are about twice as likely to die by suicide as White children of the same age,” Wood said.
Depression and suicides among Black youth have been increasing at an “alarming” rate for two decades. Woods ticked off some of the reasons: adverse childhood experience like loss or separation from family, abuse, experience of racism and discrimination, as well as lack of access to care.
“The red flags that we traditionally use to assess for suicide and depression may look very differently in a black youth. So rather than sadness or hopelessness, Black males, in particular, may express irritability and anger. Depression is often expressed more through physical or health complaints–so talking about feeling tired or fatigued or having aches and pains,” Woods said.
She said COVID-19 just exacerbated those vulnerabilities and risk factors for suicide and depression among Black youth. COVID disproportionately affected African Americans with more severe health outcomes.
“And that medical impact was felt not only by adults but by youth, as well, who were two and half times more likely to be hospitalized than White youth and five times more likely to die from COVID.
So in addition to grappling with the grief and loss of loved ones, Black youth, rightfully, also experienced an increased fear and anxiety about their own health and well-being,” Wood said.
She noted that with the COVID shutdowns families lost income, and experienced increased anxiety about finances. They had food insecurity and increased exposure to abuse and trauma. The political unrest surrounding the George Floyd protests last summer also brought more stress into the lives of Black youth.
Wood cited the work of author Robert Hill. Hill’s book, The Strength of Black Families, talked about the strategies African Americans have historically relied upon for strength and resiliency to survive in American society. They include strong kinship bonds, a strong work ethic and personal motivation to succeed, as well as a strong religious orientation.
“The move to distance learning and social isolation, and shelter in place, it stripped away the very tools that Black families and youth have historically leaned upon to survive,” she said.
Wood said the cost of getting mental health care was a barrier to seeking it. And so was the lack of Black therapists who only make up 4% psychologists in the U.S.
“In my own practice I probably had a ten fold increase of referrals specifically from people of color who were seeking a therapist of color and were having a very hard time finding one,” she said.
