How badly has the COVID-19 pandemic affected kids mental health? Mental Health America of Greater Houston recently held listening sessions with students, parents, teachers and administrators in the 28 Houston-area school districts that work with its Center for School Behavioral Health and what they heard was alarming.

According to Jamie Freeny, the centers director, K-12 students are now more frequently dealing with grief, family stress and isolation. Theres more clinginess, more self-harm, more cyber-bullying, more suicidal ideation, disrupted sleep and acting out. Kids are more frequently being diagnosed with anxiety, depression and stress-based diseases such as shingles.

Freeny, who has doctorate in public health, did her Ph.D research on childhood trauma. Here, she discusses specific ways that parents and other adults can help kids who are struggling.

I know that the Center for School Behavioral Help works to change systems in ways that help families. But could we talk about things that individuals can do to help the kids in their lives? For instance, what should a parent do if a 5-year-old clings to their leg and cries whenever the parent leaves the house?

Its really about assuring that little one that they are safe, that they are loved, and that you will be back. The clinging could be from a point of anxiety, not not knowing when they would see you next time, not knowing whats going to happen or whos going to keep them safe.

So you reassure them that you are there for them, that you love them, that you will be back and that they are safe. If youre leaving them at a day care or with a babysitter, make that connection. If the babysitters name is Mary, say, Mary is going to make sure you have food and make sure that youre safe. Then Ill come back after work.

Give them as much information as you can. With toddlers its difficult because they dont have the words to articulate feelings, nor can they understand time. But when youre dealing with kindergarten-age kids who are clingy, make a point of listening and validating them: I understand youre fearful. I understand youre upset. I understand youre scared.

Name the emotion. Tell them what it is so that they can start to articulate it: Mommy, Daddy, Im feeling scared. Or Im really worried.

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Its really important when talking with kids that we are aware of our own tone and body language. Oftentimes children pick up on that first. So if youre leaving and youre angry or frustrated, or maybe youre rushing because youre running late, the child may understand the mood as as something theyre causing. They might take your anger at a situation to mean that youre angry at them.

If you give them a hug and your hearts racing and youre breathing fast, more than likely their heart is going to race and theyll breathe faster as well. When you hug them, you want to be calm and present. Its really important that you are present, that youre looking at them and talking to them. Over time, if you do that consistently, they will start to understand, OK, Mommy is going to be back.

Then maybe youll see less of a that clinginess. But its not going to happen overnight, and its certainly something that you dont want to ignore.

A lot of parents are under huge stress too. Many are depressed or anxious. If Im a parent whos dealing with these issues, how do I insulate my child?

That is so important. The first thing that we do at Mental health America of Greater Houston is encourage people to take care of themselves. We cannot stress self-care enough.

Give yourself permission to take care of yourself, because if you dont prioritize your own health, no one else is going to.

Students work on their laptops as they attend virtual Houston Community College classes in the NHECHS Cafe at North Houston Early College High School Wednesday, Feb. 10, 2021 in Houston.

What does that kind of self-care look like? Are we talking a me-time bubble bath or what?

Self-care is any activity to help yourself come back to a state of balance and calm, and to be in the present. Self-care is not a luxury. Self-care is not something that only people with money can participate in. It doesnt have to be a luxurious bath with candles, and scented fragrances and oils. It doesnt have to be a trip to the spa. Self-care can simply be taking time to walk out to your garage, sit in your car for five minutes, and take some deep breaths.

Just to be away from my screaming child?

Just to be away from your screaming child. Or to be away from your significant other. Or be away from any other distractions, even the TV. Maybe youve been watching stuff about the George Floyd trial or voting rights, and it upsets you.

Whatever it is, remove yourself from it so that you can then focus, take deep breaths, and engage in mindfulness or prayer or whatever works for you. Its very important for you to do that. Its not selfish.

Some people find self-care in daily walks. Some people find self-care in listening to music or watching birds. Its very personal.

Its important that you model that kind of behavior for your children. If they see you taking deep breaths when youre angry or upset or anxious, or holding your stomach, or closing your eyes, they will start to model those behaviors as well. So not only are you doing something good for yourself, youre setting a good model for your family.

What if my kid is sleeping for hours and hours on end? What should I do then?

We tend to see that with older youth. In the teenage years, more sleep is not uncommon. But if theyre sleeping for long periods, like, over a week or two, that is certainly a red flag. Thats time for conversation.

Ask the teen, How are you feeling? Whats motivating you? What are your goals? What drives you every day?

You might find that they dont have any motivators. They may be tired of this whole pandemic and want to sleep it away. When you are asleep, you dont have to worry about other people and socializing and bullying and what you look like and you know, all this stuff. So we should definitely recognize changes in sleep patterns as a red flag for stress or mental health concerns.

Then talk to the teen and help them set up some structure, make a plan. It might be, Every day at 11:30, were going to take a walk together. Every day at noon, were going to eat lunch together.

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Its important to ask that teenager, What is something you can look forward to? and then try to to fit that into the daily or weekly schedule. Its really difficult to get out of bed if you dont have anything to look forward to, or if you think the day is just going to drag on and not going to be a good day.

You also want to get to the root of the problem. Are they sleeping more because theyre tired of school? Or is it because theyre physically tired? Maybe its boredom: Extreme boredom was a huge topic of conversation during our listening sessions, and that can also drive a person to just want to sleep.

Ask open-ended questions. Why do you think that youre sleeping more these days? Listen. Just listen to them. Dont try to fix the problem. Dont try to come up with solutions. Listen and validate their concerns. Validate their emotions. If they say, You know what, Im tired of all this, and I just want to sleep, validate that.

Say something like, You know what? I am too, and we are going to get through this together. I can understand why you feel fearful or tired or uncertain or unmotivated. We all struggle with that at times. What can we do to move forward? Because this isnt healthy.

Dont make it about you, the parent, and what your expectations are not in that moment when theyre sharing with you. Be open and listen. You can come back later and set those expectations. But really work with them. Engage them in that conversation and engage them in planning a solution.

That general approach can work for a lot of problems with children and teens. It can pertain to teens who are not eating at all, or else overeating.

It can also pertain to children and teens who are complaining of headaches every day. Youd say something like, This is new. So tell me, what are you thinking about before this headache comes on? Or What are you doing before this headache hits? What are some things that we can do to that might alleviate that?

A stuffed animal with a mask is pictured in this file photo.

The self-harm behaviors are especially alarming. If my kid is cutting themselves or chewing their fingernails until they bleed, what could I do?

Again, start with showing your concern, not bringing it up as a punishable behavior but showing empathy and listening, I cant stress how important listening is. Oftentimes, we listen to respond. Especially if its our loved one, we want to fix the problem, move forward and sweep it under the rug or dismiss it. But thats just not what works well.

For me, those behaviors are hard to fathom. Why do kids do that?

Well, its not too difficult to understand if we remember that a teens brain is still developing. Theyre trying to understand their emotions and how to respond to them. And sometimes, when it comes to painful emotions, the go-to coping mechanism is to do whatevers going to get rid of that pain. For some youth, and for some adults, its exerting pain elsewhere: I am transferring this pain that Im feeling from embarrassment, shame, fear or whatever it is, to something that I can control. I cant control x, y or z, but I can control how often I cut. I can control the feeling.

I wont say thats always the crux of self-harm, but its a component. Thats why a lot of kids engage in substance abuse smoking, drinking, other forms of substance abuse. It helps release the pain.

Thats why its crucial for parents, mentors and educators to talk about healthy ways of coping and to help them understand that we can work through these temporary issues in other ways. Dont dismiss whats driving the behavior, and dont assume that you know whats driving the behavior.

At the beginning of this pandemic, we were like, Oh, children are so stressed out about wearing a mask and about social distancing. Well, not necessarily. Children were stressed out because they couldnt see their friends, they couldnt go to school, and they couldnt go outside and play.

So its really, really, really important that when we are observing these behaviors that we dont ignore them, we dont make assumptions, and we approach with empathy and concern. Its okay for parents to say that they may not know what to do themselves.

You may walk in on a child cutting themself, or see a childs burn marks on their legs or scratch marks on their arms. The approach then is to listen and to understand.

And know that there is help available. I wouldnt open up the conversation with, I see youre cutting. Im gonna send you to a psychiatrist. Thats not how that conversation should go.

Listen first. Then maybe, This has helped me understand why. I really feel bad for you. I hate that youre experiencing this. What can I do to help? I may not know the best next steps, but lets think about talking to a therapist. Or lets think about reaching out to your doctor. Because I want you to remain safe, and I want you to to be able to cope in more healthy ways.

Lots of kids have been stressed out by the same world events that are stressing out adults: By all the COVID deaths, or the election, or the deaths of George Floyd or Brianna Taylor. How can we talk about those things with kids?

Knowledge is power. Knowledge is key. The more facts that you have, the better prepared you can be to answer certain questions. That means doing some research, understanding whats happening not just what youre seeing in social media or what your friends or co-workers are saying, but really getting to the facts and then talking to your children using those facts. The most important thing that we can do is teach children to listen and to learn and to be respectful, but always to go back to the facts.

Try to explain things in ways kids can understand. So when you talk about a protest with a small child, you could say, You know how I might tell you to stand up to a bully that you see at school? Or how, if you and your friends want to have pizza at school every Friday, you might get together and make some signs. You might go talk to your teacher. You might go talk to the principal and say, Hey, we want to have pizza every Friday. Thats what protests are: Protests are recognizing changes that need to happen.

And youll want to talk about whats driving the protests that they recognize mistreatment of a group of people, that the protests are a way of speaking up about it.

When we talk about racism, oftentimes the question I get is, Whats the appropriate age to talk about that? Research tells us that between the ages of 4 and 5, children pick up and act on differences in skin color.

Its really important that those conversations start at home. You introduce skin color and race as something that is different about how a person looks, but thats the only thing it is: Its just a difference in skin color. You can say, Look at all the beautiful skin colors! and figure out ways to celebrate those differences.

That way, when children are up against other diversity issues, such as meeting a child in a wheelchair or somebody that is missing a limb, they meet them with a positive curiousness, rather than downplaying them or degrading them because they dont look the same.

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Remember to check your own biases. When we talk about race, or when we talk about the elections and the different Republican and Democrat parties, whatever side of the aisle that you are on, think about how you are talking about the people that are on the opposing side. When we talk about racism and discrimination, think about how you are describing people of other races and ethnicities.

If you were I dont know at the post office, and you dropped a piece of mail, and a Black man picked it up, be mindful of how you describe that. Is it necessary to say Oh, a Black man helped me instead of some nice man picked up a piece of mail for me?

Your body language and nonverbal cues are very telling there. Theyre as important as your words. Children pick up on that.

Those things are difficult to catch. Were not always conscious of them. Its just natural. Its happened in our families for so many years. But its crucial that we try because children pick up on those nuances. Be intentional about making those changes.

When children are asking questions about what theyre seeing on TV, asking, Why are adults so angry?, take the time to engage in those conversation. Applaud them for paying attention and asking. Often children are dismissed, so when things come up later on in life, they are scared to say something about it. Or they go to their social media, or they to their social group and try to figure out whats happening.

You really want them to come to you. As the parent, as the caregiver, as the educator, you want them to come to you. So you can start with being open and being honest, and and not being punitive.

Fifth grader Victoria Thomas uses her laptop to work on math at William Lloyd Meador Elementary School in Willis on Sept. 8.

With some mental-health challenges for instance, suicidal ideation after Ive had that first hard conversation with my kid, I am clearly going to want outside help. How do I get that? Where do I find it?

Try your childs school, your primary-care doctor, and resources such as Mental Health America of Greater Houston. NAMI, the National Association on Mental Illness, and the Hogg Foundation in Houston both provide information on mental illness. Those are great resources to to have in your back pocket.

For a young child, Sesame Street has some really great lessons on how to talk about race and racism, and how to talk about the elections, and how to talk about depression or anxiety, how to talk to a child whose parent is struggling with a mental illness.

The more that we talk about depression or anxiety or schizophrenia, the more normal these things will be. We can start to dismantle some of the stigma thats related to them.

People that struggle with mental illness are not bad people. Theyre not more violent. Theyre not scary. Theyre no one to be feared. We need to make sure that when we talk about mental illness, that were talking about it just like were talking about somebody who breaks their leg, or somebody who has a heart attack. The brain is just a part of the body, like the arms and the feet and legs. Mental illness is just another part of physical health.

Children experience stress and fear when somebody leaves or dies. They may cry. Those times are opportunities to talk about how to cope with emotions, so that in the future, those things dont advance to mental illness. We can teach kids early and intervene early so that they dont become adults struggling with depression or anxiety.

Check your own biases, your own thoughts, your own feelings and your own experiences, especially when it comes to things related to mental illness, illness, and suicidal ideation. Some of those words and behaviors may be a emotional trigger for you, because of your own experience. Maybe this is something that happened to you when you were younger, or you had a loved one who had those experiences. Understanding and checking that first, before you respond, is crucial. You dont want to take any anger or fearfulness or uncertainty from your own past experiences and pass them on to that child. Thats not their responsibility to handle, and it could complicate things more.

You absolutely can share those stories, but be mindful of what youre saying and how youre talking about that. If you had a sister that used to engage in self-harming behaviors, be mindful of how you describe that. Talk about what made her do that, and why she thought that was the only outlet, and then talk about, But here is what we know.

Theres a lot to keep in mind. Its hard being an adult.

Adulting is hard! But its a challenge that many of us rise to every day. And those who engage in self-care tend to do it better.

This interview has been edited for length and clarity.

lisa.gray@chron.com, twitter.com/LisaGray_HouTX

Original post:
COVID has been rough on kids. From clinginess to self-harm, here's how to help. - Houston Chronicle