The ‘trauma’ of the pandemic and how reopening is driving adolescent anxiety, suicide

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• Judy Woodruff:

  It's been a difficult year for everyone, not least of all children who saw their lives turned upside down by the pandemic.

  According to one large hospital system in Colorado, the economic toll on kids has become a state of emergency, with adolescents experiencing high rates of anxiety, depression, and self-harm.

  William Brangham talks with one of the heads of that hospital.

• William Brangham:

  Judy, the number of kids arriving at Children's Hospital Colorado in mental health distress has reached levels officials say they have never seen before.

  Behavioral health visits were up 90 percent in April compared to last year. It is the top reason for emergency room visits, and suicide is now the leading cause of death for children over the age of 10 in the state.

  Dr. David Brumbaugh is the chief medical officer for Children's Hospital Colorado, and he joins me now.

  Dr. Brumbaugh, this has obviously got to be terrible news for all of you in the hospital system. Can you give me a sense of when you started to see this uptick? And what were you specifically seeing?

• David Brumbaugh:

  Thank you, William.

  Really, towards the end of the winter, in February, we started to see increased number of kids presenting to our emergency rooms with acute presentations of behavioral health problems, suicidal ideation being the most concerning.

  And then, in March and April, we saw spikes, as you mentioned, that were much higher than we have seen in years previous, so much so that our about the provide the in-patient behavioral health resources that they needed were quickly overwhelmed. And we had kids, dozens, waiting in our emergency department for admission to an acute behavioral health unit.

• William Brangham:

  I mean, obviously, each child and their circumstances are unique, but do you have a sense generally of what is driving this?

• David Brumbaugh:

  Well, I think this has been a long haul for our kids.

  And they have been, in many ways, the most dutiful citizens during this pandemic, wearing masks, following rules. But they have been disrupted from normal activity, school, their peer networks, sports and other activities.

  And I think that's taken a toll over time. And I think it's been a low-level trauma over these last 15 months. I think that the surprising piece of this is that this spike in acute presentations is occurring at a time point when we're starting to see some hope and rays of sunshine on the horizon with this pandemic.

  But it could be that we're exiting survival mode, and so we're seeing kids experience really deterioration of their mental health at a time they're exiting the trauma and back reentering into normal life.

• William Brangham:

  So, it's your sense kids have been in some way almost clenched for this entire pandemic, and now that normal life, whatever that may be, is starting to emerge, that that is a big driver of anxiety for them?

• David Brumbaugh:

  That is our best explanation thus far.

  And what we are seeing, William, are kids who are experiencing normal childhood adversity, disappointments, not making a sports team, maybe some difficulties in school, who, instead of really tapping into their resilience resources, are instead contemplating ending their lives.

• William Brangham:

  I mean, you touched on this, that your own hospital system is struggling to provide beds or appropriate care for them.

  What about broader psychiatric care? I mean, we have heard anecdotal report around the country that people have a very hard time finding good psychiatric care that they can afford and that they can get into. Is that the same issue in Colorado?

• David Brumbaugh:

  Very much so.

  Here in the state of Colorado, we're actually in the bottom 10 states in terms of funding for behavioral health services for children. And so we were an already stretched system before this pandemic and before this spike of cases. And it's certainly reflected in our inability to care for these very, very sick, acute presentations.

  But, as you mentioned, even for kids that need more primary care behavioral health for treatment of depression, anxiety and other problems, very difficult to access those resources. For our kids on public insurance, such as Medicaid, they can wait weeks to month for an initial appointment.

  And even for folks that have commercial insurance, it can be a real struggle to get an appointment with a behavioral health provider. And many don't take insurance and just require cash payments. So this is an overstretched system, and we're seeing it break in the face of this pandemic.

• William Brangham:

  In just the last few seconds we have, for kids who are in distress and for parents of those kids, what would you counsel them to do?

• David Brumbaugh:

  So, the most important thing, William, is to have a conversation with your kids, especially your teenagers, I think, who have been the most disrupted in terms of their ability to have school and peer networks.

  Have a conversation with your son or daughter about how they're doing, ask them how they're doing. And then, over the next few weeks and months, really encourage them to get back into their peer network, spend some time with a friend, find ways to make that happen as a parent.

  Our kids have been disrupted for that. It may take some encouragement for them to get back into it, but I really think that interpersonal connection is what's been missing over the last year and what is fundamentally going to be the way we get out of this current crisis.

• William Brangham:

  All right, Dr. David Brumbaugh of Children's Hospital Colorado, thank you very much for being here.

• David Brumbaugh:

  William, I appreciate our time together and your attention to this topic.

• William Brangham:

  For more on this important topic, our own Student Reporting Labs has just put a podcast specially about the mental health challenges facing teens today. It's called "On Our Minds With Noah & Zion"

  And you can find it wherever you find podcasts.