Speaker 1: (00:00)
It would be a tragedy. If we beat back one public health crisis only to allow another to grow in its place. Those are the words of us surgeon general Vivic Murphy from his public health advisory issued yesterday on children's mental health. The advisory is meant to focus attention on an increased rate of depression and being diagnosed in children. Much of it apparently arising from the stress of the COVID 19 pandemic. The advisory calls for government, social media companies, schools, and parents, to respond to the problem with increased mental health resources. But it's not clear if schools social media communities or the government are up to the child. And just as a warning to listeners, some of this discussion will concern suicide and suicidal ideation, which some people might find disturbing joining me as Dr. Willow Jenkins medical director of inpatient psychiatry at Brady children's hospital and Dr. Jenkins. Welcome.
Speaker 2: (00:58)
Thank you for having me on now, this
Speaker 1: (01:00)
Public health advisory says that symptoms of depression and anxiety among youth have doubled during the pandemic. Is this something that you've seen treating patients?
Speaker 2: (01:10)
Absolutely. We have seen a huge increase in the number of children that have been coming to the inpatient side of the hospital at radi children's during the pandemic we have had just as an example from September, 2020 to August, 2021. So about six month period, we had 3000, almost 3000 children endorse suicidal ideation. When they came through our emergency room, this is a staggering number. And so absolutely we see more and more depression and anxiety presenting since the start of the pandemic
Speaker 1: (01:41)
And how young are the children affected.
Speaker 2: (01:43)
They can be quite young. And that's something that we've noticed over the last 10 years that children are presenting younger and younger. So for depression and anxiety, we can see this down to toddlerhood for the suicidal ideation. Typically we're seeing children down to eight, not usually less than that, but for us, that's far too young.
Speaker 1: (02:03)
And how do younger children exhibit depression or anxiety? So
Speaker 2: (02:07)
For young children, typically what you'll see is more disruptions in their behavior. Maybe they're acting out more, getting into more trouble at school, being a little bit more irritable or short tempered. And of course, disruptions in sleep, not sleeping as well, changes in appetite. These are other signs that your young child might be struggling because they don't always have the capacity to be able to tell you I'm depressed. I'm anxious. Now, one
Speaker 1: (02:32)
Of the most disturbing statistics is that suspected suicide attempts by adolescent girls were up 51% in early 20, 21 over last year is social isolation thought to be the main cause of suicidal depression among young girls.
Speaker 2: (02:49)
It would be difficult to say it's the main cause. But I think it certainly is a factor that the pandemic is amplified. We know that the amount of social media use screen time use has increased exponentially with the pandemic and that the quality of these relationships is not the same as in-person relationships. And it leads to feelings, loneliness, and isolation. And so it's been a very large contributor in the last two years, but it's certainly not been the only one issues of racial injustice. The political year has been very divisive. These are all other issues that have been affecting our adolescents. And
Speaker 1: (03:23)
What other problems are you hearing about that kids are experiencing?
Speaker 2: (03:27)
Well, I think one of the things that is the most striking is that it's children that are marginalized and underserved are youth of color that are being disproportionately affected by the mental health crisis. And so it issues like I just mentioned of racial injustice, the political divisiveness, even things as the climate emergency, these issues are weighing heavily on our adolescence and are huge factors. In addition to all of the impact that the pandemic has brought both on youth directly and indirectly through the impact on their families. Now, when in
Speaker 1: (03:59)
And schools opened up again, we heard that most kids were very happy about it, but apparently the transition back has been hard for some students. There are anecdotal reports of more absenteeism and acting out at school what's causing this. You know,
Speaker 2: (04:15)
It is difficult to say, cause it's gonna be individual to the environment and also to the student. But for some students, especially those with disabilities, the transition back to the classroom has been quite difficult. Resources have changed the way things have been set up to support students looks different than it did pre pandemic and retaining staff in different school settings. I know this is the case in San Diego has been challenging. So it makes the comedy and resources to support students that may need extra support less than what they were. So this can create more problems. In addition, youth have been accustomed to being at home, doing things over the computer. And so for some, it was actually preferable. If you'd been bullied or had difficulties with social interactions, perhaps being online was easier than returning to in person. So a lot of different factors for sure,
Speaker 1: (05:06)
You alluded to this earlier and many child psychologists say the problems of anxiety and depression were already growing among children even before the pandemic. So do you see this as an ongoing problem,
Speaker 2: (05:18)
The pandemic exacerbated and already existing problem? I used the example that at radi children's hospital, we'd seen an huge increase, exponential increase in the need for mental health. That before the pandemic started, we were planning to open a specialized psychiatric emergency room. And as luck would have it, you know, in a sad way, the pandemic started in the need even went further up. So we were able to open our specialized psychiatric emergency room in the pandemic, and it's been full since. So absolutely the need was there before. And the pandemic has just worsened. This crisis that was already present.
Speaker 1: (05:51)
What signs should a family look for? If they suspect their child is going through some sort of difficult mental health disturbance,
Speaker 2: (05:59)
A change in their behavior is key. If they're withdrawing from the family, not doing things that they normally enjoy, not hanging out with their friends or changing friend groups, these are all signs that something has gone astray, difficulty sleeping is key changing in appetite, not feeling as energized. These are also signs that something's not going well. And of course the obvious is if your child is talking about it saying, I feel sad. I just don't feel the same. I'm feeling really worried. I'm feeling really anxious. And that's why it's so important to be really direct with children. And just ask, how are you feeling? Are you you feeling sad and of course asking directly about suicide as well. It's a unfortunately common enough phenomenon in youth that as parents, as teachers, as people working with children, we need to be directly asking them, have you had suicidal thoughts asking about suicide does not cause suicide. If anything, it saves lives. The,
Speaker 1: (06:57)
In general says, communities need to respond quickly with a wide ranging approach to confront children's mental health problems. What would you like to see in that response?
Speaker 2: (07:08)
I would like to see some more funding to be able to allow for expansion of existing programs. And I think that that needs to come from the federal level and it needs to allow access to all families. I also think that we need to very much improve school-based mental health care treatment provide more support to the schools. They are at the front lines. It's the school teachers, the counselors that are identifying children, you know, at risk. And also we need to improve integration into our primary care and pediatric offices because for the, in this line of work, we believe that prevention is key. These mental health issues are preventable. They are treatable, and we need to catch children early.
Speaker 1: (07:47)
I've been speaking with Dr. Willow Jenkins, medical director of inpatient psychiatry at radi children's hospital. Dr. Jenkins. Thank you so much. Thank you. If you were someone, you know, or having thoughts of suicide call the national suicide prevention hotline at 802 7 3 8 2 5 5.
Speaker 3: (08:19)
I.
