(Trigger Warning: Suicide) New York Times: There's a Mental-Health Crisis Among American Children. Why?

"Last June, researchers from Texas Children’s Hospital and Baylor College of Medicine documented six unusual cases in the journal Movement Disorders. The subjects were teenage girls between 13 and 16 who had started having “abrupt-onset tic-like movements.” The tics were puzzling because Tourette’s syndrome and other tic disorders — characterized by involuntary and repeated movements or sounds — are far more common among boys and tend to first appear in early childhood with small movements; the girls’ movements, though, were large, accompanied by vocalizations and had other unique traits. Among them: The girls all described having watched TikTok videos of tics before their symptoms began, suggesting the potential spread of a social contagion.

Indeed, the C.D.C. last month reported a pronounced increase in similar tics based on evidence from a source never before used to assess specific mental-health conditions among the nation’s children: emergency-room data. For girls ages 12 to 17, the proportion of visits to the E.R. for tics nearly tripled during the pandemic as of January 2022. Visits also doubled for eating disorders, and there were increases related to anxiety, trauma and stress and obsessive-compulsive disorders.

These findings, particularly the rise in what have been called TikTok tics, have received considerable media coverage. But “equally striking,” says the lead author, Lakshmi Radhakrishnan, a health scientist at the C.D.C., is the marked but less widely discussed decrease in mental-​health visits by adolescent boys.

Why do girls appear to be struggling? Are boys faring better? Or are their problems more likely to be overlooked? The numbers can’t answer questions like these. “No single, comprehensive surveillance system for children’s mental health in the United States exists,” the C.D.C. noted in a supplementary report. The current surveys that keep tabs on various aspects of mental health in children are too slow to capture swift changes amid a national crisis. And though rapid surveys have evaluated the pandemic’s impact on the mental health of adults, fewer have considered how children are doing. “A lot of times kids aren’t the first in line,” says Daniel Dickstein, the associate chief and director of research at McLean Hospital’s child and adolescent psychiatry division. And, he points out, if more children were getting adequate mental-health care earlier, fewer would end up in the E.R., a venue that is not set up for ongoing treatment of psychiatric conditions.

“With the social isolation and lack of social connection, I think that hit girls harder than boys,” Piacentini says. “Girls tend to socialize in different ways.” If, as experts believe, the tics that many of them have experienced during the pandemic mirror behavior they saw online, it may be an unintentional way of trying to make connections during what for many has been a period of loneliness. “I think it’s a little beyond their control,” he says of the tics. “I don’t think most kids are doing this for attention.”

It would be easy to blame the pandemic for changes in mental health that have been observed since March 2020. But in December, when the surgeon general noted a “mental-health crisis” among young people, he made clear that rising numbers of children and young adults were struggling with anxiety and depression before Covid-19. Between 2013 and 2019, A.D.H.D. and anxiety were the most common mental disorders among those 3 to 17 years old, with each condition affecting roughly one in 11 children, according to the C.D.C. More than one in five 12- to 17-year-olds experienced a major depressive episode. Yet in 2019, fewer than 15 percent of children between the ages of 5 and 17 received some kind of mental-​health treatment. “Pre-Covid we had a mental-health crisis,” says John T. Walkup, chairman of the psychiatry and behavioral-health department at Lurie Children’s Hospital of Chicago. “The biggest misconception is that Covid makes people mentally ill. From my point of view, Covid unmasked people who have underlying vulnerabilities.”

Unfortunately, that means letting go of the popular notion that a return to “normal” for children — in-​person schooling, no more masks — will reverse those trends. In fact, such measures may compound the stress many students already feel, says Lisa Fortuna, the U.C.S.F. chief of psychiatry at Zuckerberg San Francisco General Hospital. And an estimated 200,000 children in the U.S. who lost a parent or guardian to Covid-19 may need additional support. Screening for depression and anxiety at schools and pediatricians’ offices will be crucial, because the symptoms associated with those conditions are easier to manage and do less damage when addressed early. For adolescents, substance abuse, eating disorders and thoughts of suicide can be complications of both anxiety and depression.

Opening a dialogue with children about how they are feeling and listening without judgment are critical. “I would encourage parents to talk to kids and ask them, ‘Are you feeling sad?’” says Anita Everett, director of the Center for Mental Health Services at the Substance Abuse and Mental Health Services Administration. “We encourage people to also ask about suicide,” she adds. Doing so won’t plant the idea. If there’s a problem, don’t ignore it and hope it will go away. “Some sort of path forward is important,” Everett says.

*There are a few aspects of this article that I loved! First, I really liked how the acknowledged the fact that Covid didn't cause mental illness in people, but that is just unmasked it. I view this as almost a good thing because more people were able to receive the help that they needed! Secondly, I like how they discussed being open and talking with your children about how they are feeling. More so, talking about suicide. I know it can be a taboo subject, but I think talking more about it can decrease the stigma and allow more people to openly talk about it without fear of judgement. As stated above, "Doing so [talking about suicide with children] won't plant the idea." I also thought it was interesting how some children were starting to experience tics after watching people who have tics on TikTok. It seemed as though it was a subconscious attempt at some girls trying to connect with others during times of loneliness due to the pandemic. The pandemic was hard on children and I'm sure it definitely unveiled a lot of children who already struggled, but were not seeking treatment. It saddens me to see such a mental health crisis among children.*

What do you think the root cause is of the mental health crisis among our children? Do you believe social media could have an influence?

#MentalHealthCrisis #Children #Covid19

Read the full article here.