The impact of the novel coronavirus (COVID-19) pandemic on the U.S. health care system goes well beyond the hospitals currently struggling to keep up with care for the multitudes of sick patients. The CDC has urged health care facilities and clinicians to delay non-urgent patient care, resulting in a reduction of services across many specialties.
Among them, pediatric behavioral health—a discipline already facing a shortage of providers prior to the pandemic. To address the needs of its patients and families during this time, Fatima Watt, director of behavioral health services at Franciscan Children's in Brighton, Massachusetts, launched a series of webinars to share information with and answer questions from the community.
Children's Hospitals Today caught up with Watt to discuss how the pandemic affects mental well-being and what behavioral health providers can do now to meet the needs of their patients.
With everyone's focus on protecting their physical well-being during the pandemic, are you concerned that people may neglect their mental health?
That is definitely a big concern. What we're seeing right now as people are adjusting to new schedules and kids are out of school is that there's a lot of stress and anxiety. When people are more stressed, it can suppress the immune system and make them more susceptible to illness, so it's really important that we don't put our mental health on a backburner—the mind and body are very much connected.
If you have a pre-existing condition, it can certainly make your current symptoms much worse. Now is not the time to neglect our mental health—we should actually be paying much more attention to it.
As a behavioral health provider, what can you draw from your training and experience to inform how you care for your patients in the face of such an unprecedented crisis?
We have psychological and behavioral research that we can rely on to say, "This is what we can do during a natural disaster to help everyone cope."
We do know that too much media of any kind is not good for people in trying to manage stress and anxiety. And research shows that social media can produce more anxiety than traditional media, so people need to be mindful of how much media they're taking in.
We are social beings by nature, and this pandemic has the unique aspect of isolating us, so it's important to maintain human connections as much as possible—whether it's the people you're living with or virtually. As humans, we need to have those outlets for social communication, so we should use whatever technology we have at our disposal to keep those connections.
I would also say it's important—especially for parents—that we are giving our children opportunities to make choices. Whether it's allowing them to choose what they're going to wear that day or to pick from two or three choices of what they're going to have for lunch or dinner, we know from research that a lack of control can make stress and anxiety much worse.
Social distancing guidelines and restrictions on non-urgent medical care make it more difficult for behavioral health providers to care for their patients. What can they be doing during the pandemic to ensure their patients' needs are met?
First, try to find a mechanism for staying in touch with those families or children with whom you've already been working. Even if we're not able to have full hour sessions, just being able to check in for 10 or 15 minutes to say, "How are you doing? How are you holding up? What are you doing to manage your stress? How is the family getting along and interacting with each other?" Anything we can do to maintain those connections will help the parents and children we serve know they're not alone.
We know that our kids with developmental delays or mental health difficulties are at even more risk now than usual. As providers, it's very important that we're proactive and have a concrete safety plan in place for our high-risk kids—and make sure parents know what to do if they feel their child is a danger to themselves or others. Typically, we may say to go to the emergency room, but that may not be the best approach right now.
What kinds of long-term challenges does this crisis present for behavioral health caregivers and their patients and families?
Right now, we're all dealing with the primary issue of the coronavirus and trying to cope with the quarantine and isolation. But even after the pandemic is over, there are secondary stresses that might contribute to mental health difficulties, so it's going to be important for parents to keep an eye on how their children are functioning:
- Are they reintegrating into school as we'd expect?
- Are they having trouble with separating from their parents or leaving the house?
- Are they generally more irritable, careful or worried?
- Are they not participating in activities they previously enjoyed?
- Are there disruptions in the amounts they're sleeping or eating?
These are all signs that something could be off with your child. We shouldn't take for granted that when the pandemic is over, everyone's functioning will go back to where it was before—there may be kids who need a little more support as they adjust back to our previous baseline.
The first episode of Watt's webinar series, Coronavirus and Our Kids, covered general pediatric mental well-being around COVID-19. The second installment in the series airs April 16 and will focus on grief amid the pandemic.