MINNEAPOLIS — This is a staggering statistic: More than 200,000 Americans under 18 have lost a parent or adult caregiver to COVID-19 according to the CDC. It is up from October and today, it is layered with consequences of the pandemic and images of war overseas.
It means children are struggling.
Dr. Kyle Cedermark, the chief psychotherapy officer for Prairie Care and a child adolescent psychiatrist said it has been a tricky storm of mental health challenges. Dr. Cedermark said they are seeing much higher activity and demand for services.
"What we do see is a lot of diminished hope. We see a lot of, you know kind of challenges with the family system with parents also simultaneously struggling then also on top of their own need to self-regulate, then needing to worry about their kids who might really be struggling with unsafe behaviors," he said.
Dr. Cedermark said times like these are when a coping toolbox is important for both the adults and kids.
"Sort of a mix of different skills and strategies that kids can use and that families can use to support their children, and they're trying to make sense of and deal with these difficult emotions feelings anxieties that come up," Dr. Cedermark said.
Dr. Cedermark said kids express symptoms in different ways. He said they may be a child who internalizes more, meaning they might be withdrawn, apathetic, or they stop eating. Others might have a more external style, where they act out, scream, or slam doors.
In any case, Dr. Cedermark says it’s important to start here:
"Taking a break, setting aside a specific time to discuss these issues and I think also coming up with some safe language that's mutually agreed upon can really be a good starting point," he said.
Then when something is brewing, open up that toolbox!
It should include things like deep breathing skills, mindfulness or relaxation apps, or a healthy way kids can distract themselves until they can come back to deal with the emotions when they’re less intense.
Dr. Cedermark said those distractions could be a part of a physical toolbox.
"That physical tool box can include any sort of fidget or tactile thing that can help a child kind of distract and kind of engage their sensory nervous system," he said.
All the while, Dr. Cedermark said the parent is present to acknowledge and support them when they dig into that toolbox.
"I think the task there is to be rooted in reality and to offer hope," he said. "As long as we can all kind of keep our heads on straight and try to coach our kids through it, I think we'll be able to get through it."
Here are some common questions parents or caregivers might have. The answers are provided by Prairie Care:
How do I know when my child should see a therapist?
The main factor in determining if it is time to ask a doctor or mental health professional about possible mental illness depends on the duration and intensity of the concerning behaviors.
If any of the following symptoms/behaviors occur for two weeks or more, it is advisable to seek a professional opinion:
- Irritable mood or behavior changes
- Trouble staying focused on tasks
- Sadness/teary
- Apathy, just not engaged or caring
- Isolating/withdrawing from family and friends
- Use of alcohol or other drugs
- Unfounded fear or nervousness in daily activities
- Changes in eating and/or sleeping patterns
- Frequent headaches or stomach aches
- Self-injury such as cutting or burning (seek help immediately if this symptom is present)
- Thoughts of suicide (seek help immediately if this symptom is present)
Does my child have to see their primary care doctor in order to get connected with a therapist?
To find a therapist for your child, you can start by asking for a list of in-network providers from your insurance company. Asking your child’s primary care doctor for a recommendation or referral is another great starting point. If you contact a major healthcare network in your area and let them know you’re looking to see a therapist, they can also point you in the right direction. However, this method usually means longer wait times.
Websites like psychologytoday.com and therapyden.com are also good tools for finding a therapist who will be a good fit for you or your child, and helpful for sorting out if you’re more comfortable with a therapist of a certain gender or background.
What’s the difference between a therapist, a psychologist and a psychiatrist?
Therapists, psychologists, and psychiatrists often work together to improve a patient’s mental health, but they are different professions.
A therapist is a more general term. A therapist is usually a licensed counselor or psychologist who can use talk therapy to help you treat mental health symptoms and improve how you manage stress and relationships.
Some psychologists have a master’s degree (M.A. or M.S.) in psychology while others have a doctoral degree (Ph.D., Psy.D., or Ed.D.) in clinical, educational, counseling, or research psychology. They can provide psychological testing, evaluations, treat emotional and behavioral problems and mental disorders, and provide psychotherapy.
A psychiatrist is a physician with a doctor of medicine (M.D.) degree or osteopathic (D.O.) degree, with at least four more years of specialized study and training in psychiatry. Psychiatrists are licensed as physicians to practice medicine by individual states and can prescribe medications for psychiatric conditions.
What if I don’t want my child to take medication?
It's important to talk to your psychiatrist about this. This is a very common situation that we run into. Medication is not always necessary, and for certain diagnoses, it's about as effective as psychotherapy. This is the case with anxiety. On the other hand, non-medication treatments are minimally effective for ADHD. Informed consent is important. Everything, even psychotherapy has potential side effects, and informed consent is critical before starting any type of treatment. Child and adolescent psychiatrists are the top experts and will work with you and your child on a treatment plan that works.
How much is this going to cost?
We are a long way away from full mental health parity, but generally speaking, all insurance plans are required to cover mental health services. You’ll want to be aware of your insurance coverage, and things like co-pays, co-insurances and deductibles, as you may see out-of-pocket charges accumulate with weekly visits (as opposed to every three months visits with a psychiatrist for meds). Your health plan will also have an out out-of-pocket maximum and if you have a high-deductible plan, your HSA will cover these fees as well. Some people prefer privacy and broader choice available by privately negotiating a fee with a therapist and then seeking insurance reimbursement afterward.
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