Loss of connection fuels more teen mental health problems

Marc Zarefsky , Contributing News Writer

More than one-third of high schoolers have reported experiencing poor mental health during the COVID-19 pandemic, according to a nationally representative Centers for Disease Control and Prevention (CDC) survey whose results were published this spring. The same survey indicated that, last year, 44% of high school students persistently felt sad or hopeless during the past year.

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Teen mental health was a problem prior to the pandemic and has been exacerbated by the realities of the past two-plus years, according to Sandra DeJong, MD, MSc, a child-and-adolescent psychiatrist in Cambridge, Massachusetts.

"Things like vaccinations and antiviral medications can help take care of the physical symptoms of COVID," said Dr. DeJong, who is also secretary of the American Psychiatric Association Board of Trustees. "The mental health and the social-emotional impacts have been much harder to break free from."

Dr. DeJong talked about the rise of teen mental health issues amid the pandemic as well as what physicians can do to help support adolescent patients and their families during a recent episode of “AMA Moving Medicine.”



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Dr. DeJong started her outpatient practice in 2001, and at that time, she said there was already an increased rate of anxiety, depression, suicide and substance-use disorders.

So Dr. DeJong was not surprised that the percentage of children suffering from poor mental health continued to rise during the pandemic, particularly when considering the impact of the psychosocial effects of COVID-19, including confronting illness and death, family stress due to unemployment and financial pressures, and increased rates of domestic violence. Combine that with the large stretch of times that schools were closed during the pandemic, further isolating students, and it's no wonder their mental health worsened, she said.

"They've been cut off from their peers, which is critical for youth to develop that sense of identity, which this stage is really all about," Dr. DeJong said. "Academic skill loss has been a factor, disengagement from school, and really just lots of loss of structure and routine."

Dr. DeJong believes conditions for teenagers and adolescents have improved since schools reopened and students have been able to find a new sense of normalcy, but unfortunately, the long-term impact of the pandemic on children's mental health is still unknown.

"We really don't know what the effect of this is going to be over time," she said. "We think that vulnerable youth are going to be more at risk, but really, I think we have to think about this as a whole generation at potentially increased risk."

Starting in July, a new, three-digit phone number—988—was launched to help dispatch mobile crisis teams immediately to anyone going through a mental health crisis if needed. The goal of 988 is also to have 24/7 crisis call centers to move mental health crises away from policy involvement and to behavioral health specialist involvement.

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Long term, Dr. DeJong believes the system for improving child mental health needs to be evaluated and improved. But in the short term, there are simple suggestions she said physicians can make to help their teenage patients.

"I really encourage people to connect with others," she said. "It's such a huge part of our mental health to feel connected and part of a greater whole. I often refer people to community efforts or encourage them to have family events or get together with their friends. Those kinds of things [are] a way to pull together after this really challenging time."

AMA Moving Medicine” highlights innovation and the emerging issues that impact physicians and public health today. You can catch every episode by subscribing to the AMA’s YouTube channel or the audio-only podcast version, which also features educational presentations and in-depth discussions.