While I’ve lived, breathed, and worked in the health policy space for years, I didn’t start out my career there. My path to policy began when I was a special education teacher. Like many who pursue teaching as a profession, it was far more about passion than profit, and about making a difference in the lives of the children who were my students. In reality, I was always shocked I was allowed to teach as I had no formal training to do so. The principal of the school I worked at asked me to join as a teacher after he saw me keep showing up as a case manager at the school. His students were on my caseload, and he and I got to know each other, leading to me changing jobs. As a teacher, I almost immediately was faced with the harsh realities of a system that kept my students and their families thriving the way they should. It was that realization that spurred me to devote my time and energies to the systemic policy reforms that I so frequently write about.
School offers more than opportunities for education, although that’s the primary and most obvious reason we send our kids there every day. But schools are also a space for kids to hone their social skills, to nurture their relationships with friends and fellow students. For some less fortunate students, school is a place where they find a support system that is sadly absent at home. In too many cases, it’s the only place where a child can feel confident that they will be fed or receive mental health services.
Our collectively indecisive, half-hearted and, frankly, lazy approach to dealing with mental health during the COVID-19 pandemic has put all of us, but especially our children, even more at risk than they should have been. And with Omicron and the latest back and forth of schools being open or closed, it feels like a game of mental tug-of-war. Children who were ushered back into classrooms after a year of remote learning have displayed an increase in both anxiety and antisocial behavior. Emergency room visits at children’s hospitals for mental health soared throughout 2020 and 2021, prompting the U.S. Surgeon General to issue an official advisory in December on youth mental health and challenges that the pandemic has presented.
This might – nay, this should – prompt parents to wonder, “How do I know if my child is okay or not?” While every child is different, and children’s mental health is incredibly nuanced, there are a few signs to watch out for that can give an indication that your child may be struggling mentally. I give you these less so to be “clinical” and more so because I too am a parent and worry about my kids.
● Are there changes in the good stuff? How’s their sleep? Their appetite? It may seem a little basic, but noticeable changes in your child’s sleep schedule or eating habits can be signs of underlying stress. Teenagers should be getting 8-10 hours of sleep every 24 hours, so if your child is banking a lot more or a lot less than that, pay attention. Similarly, if they regularly devour a whole pizza singlehandedly but now barely touch their meals (or vice versa), chances are good that something big is bothering them.
● Are they showing up? Have they stopped talking to you? This one is tricky, as it seems like almost a rite of passage for an adolescent to give their parents the silent treatment at one point or another (yes, I’m speaking from experience). But if you find that your child suddenly stops confiding in you about their feelings, good or bad, it’s prudent for you as a parent to do a little digging and ask some probing – but not invasive – questions in order to restart that dialogue.
● Follow the emotions: How are they expressing themselves? When you do talk with your child, take note of how they respond. Are they more irritable than usual? Do they experience angry outbursts? If they do get angry, does it take them a long time to cool down? Whatever their reactions, it is important for you to remain calm and remember that it is your job to keep the line of communication open. It’s also vital that we, as parents and responsible adults, actively demonstrate how to navigate our own emotions in a healthy way.
So many kids may not know how to articulate that they are hurting inside. If your child tells you that they’re struggling, listen to them. Believe them. Don’t tell them to “toughen up,” “lighten up,” or dismiss their pain as “just a phase.” Make use of the children’s mental health resources available to you and get them help.
From a very young age, children are often noted for their resilience. There will undoubtedly be a number of kids who come out of the other side of this pandemic having made the best of it, perhaps taking up a new hobby or learning a new skill, though that should by no means be an expectation. As I have said before, however, this country is teeming with disparities when it comes to, among many things, physical and mental health care. I fear that many communities – and therefore, many children – will not have access to the necessary resources and support systems to effectively address children’s mental health crises if and when they arise.
The absolute worst reaction we collectively can have, as parents and policymakers, is inaction. It’s unacceptable for us to not move in meaningful ways now on mental health. We must acknowledge the very real link between mental health and physical health and get the legislation and funding necessary to properly care for both. Integrated delivery. Integrated financing. There is an opportunity before us to prioritize our children – all children – in a way that we haven’t yet. If we want to own our titles of caregivers, protectors, providers, and guardians, then it’s essential that we rise to this moment and give our children the support they deserve.
And finally this week, a most sincere and heartfelt thank you to all of the educators out there. As bleak as things have sometimes seemed lately, they would be exponentially worse if not for your continued commitment and sacrifice in the service of educating our children. Please remember how valued you are, and to take the necessary time to care for yourselves. You, as the kids say, are the real MVPs.
If I may Dr. Miller respond to this brilliant and important post. First my disclaimers (i.e. grain of salt), I'm not a parent like ever, I'm not a mental health professional, and I've only recently become active in mental health with teens not many years here.
I am a crisis counselor and I am a counselor on an app for jr. high and high school kids. Volunteer again.
Without a doubt from my small lens and limited experience you are absolutely correct about children and mental health. I see so many children in crisis coming on to share, talk, looking for help, and to find someone who will listen.
"Follow the emotions How are they expressing themselves? "
Again, from my small lens and limited experience I have been and continue to be so very impressed with how articulate and insightful kids can be will be when we listen, allow them to share in a safe place, at their pace, and validate their feelings emotions pain. I've come to see in their texting words something I can only describe as I listen and share 'They take their shoulder blades out of their ears and relax'. Suddenly words flow like an artesian aquifer. I get to smile. And I'm no parent so I can only imagine how a parent must feel to make that connection. All jelly here.
Of course: small lens, small sample, and really the ones I chat with come into to say, as you note, they are struggling. Predisposed to wanting to share.
In the end I have a sense that I helped just in listening. I helped in my compassion. I helped in my offering resources. Once they log off, better for a moment I pray, I pray they know sharing is a path to finding a way forward not alone. A path to being who they are worthy to be.
I've received many responses to my conversations with those struggling. I've gotten a few you saved my life. The most recent one that meant the most to me and is the perfect cap to my rambling here is this
"I felt seen"
Indeed the children need to feel seen though listening and sharing. You got this mom and dad. Like totally just observe and act.