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Despite the fast-evolving omicron virus killing over 40,000 people just this summer, President Biden says the “pandemic is over.” But what isn’t over is the long-term psychosocial turmoil that young people and their parents are still experiencing from the Covid crisis.
The progression of the COVID-19 pandemic increased youth anxiety, depression, and self-injurious behaviors, resulting in an overwhelming number of suicide cases in emergency room visits. During the 2021 summer, there was a 50.6 percent increase in emergency room visits for adolescent girls aged 12-17 when compared with the corresponding periods in 2019. And some youth have repeated hospitalizations because of family conflicts around mental illnesses in the household.
Prestigious health academies and associations have declared this child mental health pandemic a national emergency, including the American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association. Additionally, health systems are struggling to retain front-line mental health providers, further compromising the care of devastated youth.
As young people navigate difficult emotions, parents should also be supported for the mental exhaustion they suffer. Struggling with their own mental health conditions and other overwhelming life demands can lead to a lack of reflective functioning and healthy parenting techniques, especially under pandemic-related stressors. These problems reduce child-parent connectedness and lower positive family expressiveness, leading to more frequent and severe family problems and perpetuating the cycle of mental illness.
In my work as a child and adolescent psychiatrist, I notice high levels of “othering feeling” within the teen-parent dynamic. Neither side feels adequate in their relationship and communication, creating an intangible hurdle for youth who want to seek help. This is especially true if children feel they cannot talk about suicide without being criticized, bringing shame, or provoking panic in the family.
Vacations might strengthen the bond between parents and children, but this is a surface-level solution for underlying mental health illnesses. Family conflicts can happen unexpectedly on a vacation, triggering a mental health crisis for young people transitioning out of hospital care.
Family-based therapy or mental health services could also help children and parents by serving as preventative care solutions before the onset of emergencies. However, therapists need time to build rapport with families before mitigating issues, like work and family conflicts, that can be easily overlooked in treatment.
From my clinical experience, I’ve witnessed creative ways parents can boost family mental health. From my clinical experience and the Yale Compassionate Home, Action Together (CHATogether) outreach works, I’ve witnessed creative ways parents can boost family mental health.
A group of colleagues and I started a group to promote family mental health while socially distanced. First, we started storytelling support groups on Zoom as a safe space to share internal conflicts (fear, worries, and survivor guilt) with family members overseas.
Gradually, interactive theater was incorporated to simulate good and bad versions of difficult child-parent conversations and shared them on social media. The participants who wrote, acted, or viewed the simulations experienced a powerful catharsis; they emotionally connected to characters’ sadness or frustration, imagined themselves going through the conversations, and learned virtually how to converse with empathy in a non-defensive way.
The cathartic experience of these groups on challenging child-parent topics helped participants relate to their own life challenges and share more openly in discussion groups. We also broke down communication barriers by experimenting with different media, such as graphic novels, puppet shows, and self-directed filmmaking by teenagers.
Mentalization, curiously imagining each other’s perspectives without imposing judgment on one another, is critical to start a healing conversation. If parents can regulate their own emotional reactivity, they can listen to their children with more composure and emotional validation before resorting to a quick-fix mentality. Instead of defaulting to a quick fix, parents can ask children if they want advice or solutions as a response. Children may not always want to talk, but non-verbal cues and space or time to process can be effective.
Parents can also cultivate a “permission to feel” atmosphere by sharing their own struggles and feelings with their children. For example, a movie night followed by a family discussion on the movie characters could open a gateway to understanding children’s feelings. In younger children, role-playing using puppets or discussing characters from a book is a similar exercise to practice permission to feel at home. This atmosphere humanizes parents and models healthy sharing without burdening children with immediate problem-solving.
Improving teen-parent relational health can start with parents’ understanding and communication that validates a teenager’s feelings and emotional needs because parents are naturally bonded with their children. Yet, there are still youth mental health programs that miss the mark without a focus on child-parent treatment. As a child psychiatrist, I know that both the parent and child play an important role in removing family communication barriers. By working with family units, mental health professionals can help create environments that build healthy connections that last far beyond the years of the pandemic.
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