Episode 17 is devoted to one of the looming crises of today: the impact of the pandemic on the mental health of American youth. Helen and Valerie will be joined by two special guests, Dr. Melissa Eshelman and Lt. Wayne Sneed. With these experts, they will delve into the causes, behaviors, symptoms, and impact of the pandemic on children, adolescents and young adults. They’ll also offer advice to families and caretakers, and discuss the treatment methods that give them hope.
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The Impact of the Pandemic on Mental Health in America Part 1 - How is it Affecting Our Youth?
Episode 18
Helen Sneed: Welcome to Mental Health Hope and Recovery. I'm Helen Sneed.
Valerie Milburn: And I'm Valerie Milburn.
Helen Sneed: We both have fought and overcome severe chronic mental illnesses. Our podcast offers a unique approach to mental health conditions. We use practical skills and inspirational stories of recovery. Our knowledge is up close and personal.
Valerie Milburn: Helen and I are your peers. We're not doctors, therapists or social workers. We're not professionals. But we are experts. We are experts in our own lived experience with multiple mental health diagnoses and symptoms. Please join us on our journey.
Helen Sneed: We live in recovery.
Valerie Milburn: So can you this podcast does not provide medical advice. The information presented is not intended to be a substitute or relied upon as medical advice, diagnosis or treatment. The podcast is for informational purposes only. Always seek the advice of your physician or other qualified health providers with any health related questions you may have. As always, if you or anyone you know is having suicidal thoughts, you can contact the National Suicide prevention lifeline at 800-273-8255. The lifeline is available 24 hours a.
Helen Sneed: Welcome to episode 17 the impact of the Pandemic on Mental Health in America, Part 1 How is it affecting our youth? Before we begin our program, we should admit that Valerie and I have had some harrowing personal responses to the pandemic. For me, the abrupt ending of all my activities, social life, work relationships were replaced by isolation and then despair and the return of uncontrollable symptoms. I literally feared for my recovery. The pandemic took me by the lapels and slammed me up against a wall.
Valerie Milburn: Wow, Helen, you just descriptively illustrated the feelings that hit me too at the beginning of the pandemic. And you have a beautiful way with words oh, thanks. You do. And my own mental health was extremely negatively affected by the pandemic. And in our next episode, when we talk about adult mental health and how it was impacted by the pandemic, you and I are going to share our own experiences. But we were drawn to this topic, the pandemic's toll on youth and young adults. Because, Helen, you know, you and I have young people in our lives whose own lives were turned upside down by the pandemic, by the pandemic's toll on their mental health.
Helen Sneed: Yeah, it's sad, but true. The past two years have been hard on all of us. Depression and anxiety have more than doubled in America. Some say quadrupled. Individuals with no prior experience of a mental health condition are now in the grip of one, are trying to be caretaker to a loved one, or both. The impact on people who are already battling mental illness has been extremely hard hitting and dangerous. The crisis is so widespread that the stigma of identifying and discussing mental health difficulties and has decreased as dramatically as the illnesses have increased. Although driven by desperation, this new openness may be one of the positive things to come out of the situation. Perhaps the most debilitating condition of our mental health crisis is that we were already in one before the pandemic began. Valerie, what can you tell us about this?
Valerie Milburn: Yes, Even before the COVID 19 pandemic, we were already in a youth mental health crisis. Mental health challenges were already the leading cause of disability and poor life outcomes in young people. And the statistics show that up to 1 in 5 children between the ages of 3 and 17 in the US were reporting a mental, emotional, developmental or behavioral disorder. And in 2016, that was before the pandemic. In 2016, that was 7.7 million children. And those statistics. Yeah, 7.7 million children. And those statistics and the following ones are from the US Surgeon General's Advisory that was titled Protecting Youth Mental Health. And those national surveys of youth have shown major increases in certain mental health symptoms, including depressive symptoms and suicidal ideation. And here are just a few statistics that illustrate those major increases. In just one decade, from 2009 to 2019, the proportion of high school students reporting persistent feelings of sadness or hopelessness increased by 40%. Youth psychiatric visits to emergency departments for depression, anxiety and behavioral challenges increased by 28%. And this one is really startling. Suicide rates among youth ages 10 to 24 increased by 57%. And all of that was true even before the pandemic dramatically altered young people's experiences at home, at school, and in their communities.
Helen Sneed: Well, Valerie, that's where we were before the pandemic. What's changed over the past two years, I'm afraid to ask.
Valerie Milburn: Well, since the pandemic began, here's what has happened. The pandemic basically caused a crisis on top of a crisis. In 2020 through 2021, rates of psychological distress among young people, including symptoms of anxiety, depression and other mental health disorders, has, as I just illustrated, increased dramatically. And recent research found that depressive and anxiety symptoms doubled during the pandemic, as you mentioned, Helen, with 25% of youth experiencing depressive symptoms and 20% experiencing anxiety symptoms. In early 2021, emergency department visits in the United States where suspected suicide attempts were 51% higher for adolescent girls compared to the same time period a year earlier. And early estimates from the national center for Health Statistics suggest there were tragically more than 6,600 deaths by suicide among 10 to 24 year old the 10 to 24 year old age group in 2020. That's an overwhelmingly sad statistic.
Helen Sneed: Yeah, this is all pretty tragic. I think it was the gravity and the universality of American mental health issues that led us to this episode on youth. Now, we can't cover everything, and we don't want to bury you in statistics, but they can serve as a kind of shorthand to the situation. So here are our objectives. Number one, to investigate the impact of the pandemic on the mental health of American youth, children, adolescents and young adults Two, to determine what institutional, educational, community, and medical support is available three, to provide advice for youth, families and caretakers and four, to define future trends and treatment options that will address and support the needs of these vulnerable populations.
Valerie Milburn: To help us achieve these objectives, we are honored to have two excellent guests joining us today, Dr. Melissa Eshelman and Lieutenant Wayne Sneed. I'll start by introducing Dr. Eshelman. Melissa Eshelman, M.D. is the associate Director for Psychiatric Services at the University of Texas at Austin Counseling and Mental Health center, where she oversees psychiatric services for both undergraduate and graduate students. Dr. Eshelman earned her medical degree from the University of Texas Southwestern Medical School in Dallas. She completed Psychiatry Residence Training and Child and Adolescent Psychiatry Fellowship training at Los Angeles County USC Medical center and her Forensic Psychiatry Fellowship training at the USC Institute for Psychiatry and the Law in Los Angeles. Dr. Eshelman is board certified in psychiatry, child and adolescent psychiatry and forensic psychiatry. She was named a Distinguished Fellow by the American Psychiatric association in 2015. Dr. Eshelman is also an
Valerie Milburn: associate professor for the UT Austin Dell Medical School Department of Psychiatry and behavioral sciences. Dr. Eshelman is a native Texan and Latina, the daughter of parents who immigrated from Peru. Her professional interests include college mental health, transitional aged youth, and improving mental health access to patients of diverse backgrounds. Welcome, Dr. Eshelman.
Helen Sneed: Thank you very much for that warm welcome. Appreciate being here.
Helen Sneed: Well, we are delighted to have you and it's my unique pleasure to tell you something about our other distinguished guest who is Police Lieutenant Wayne Sneed. Now, Wayne has served as Chief of Internal Affairs Section for the Health and Human Services Office of Inspector General from April 2004 through November 2008. He began his law enforcement career as a police officer for the San Marcos Police Department in December of 1982. During his service with San Marcos Police Department, he served and created many positions including a secondary level supervisor. He has also served as a certified instructor with both the National White Collar Crime center and National Insurance Crime Bureau. He possesses a training instructor certification, school based Law Enforcement Officer certification, and mental Health officer certification from the Texas Commission on Law Enforcement and Critical Incident Stress Management certification. He has also obtained certification in Critical Incident Stress Management from the International Critical Incident Stress Management Institute. Wayne received his Bachelor of Criminal justice and Business Management degrees from Texas State University. He is a Certified Inspector General with the national association of Inspector Generals. He has also earned the Certified Public Manager designation from the William P. Hobby center for Public Service at Texas State University, Round Rock. He has over 38 years of service with both criminal justice and law enforcement agencies. Wayne was appointed Governor Greg by Governor Greg Abbott as an advisory board member of the Texas Juvenile Justice Advisory board. So welcome Lieutenant Sneed and Dr. Esselman. We are delighted to have you and honored to have you with us today. You both understand the urgency and the magnitude of these challenges for our youth, so we're eager to be underway. And Valerie has the first question I do.
Valerie Milburn: And to start our discussion, we'd like to look at what is what is causing this new mental health epidemic in our youth. And as a little background to kick it off, scientists have proposed various hypotheses to explain this new mental health epidemic in our youth. Some believe that the increases in reported mental health challenges are partly due to young people becoming more willing to openly discuss mental health concerns. As Helen mentioned earlier. And other researchers point to such things as the growing use of digital media and limited access to mental health care, which we all know is a big issue. Dr. Eshelman and Lt. Sneed, we'd like to open this up to your expertise and we'll start with you, Dr. Eshelman, what do you think are some of the causes of this new mental health epidemic in our youth?
Helen Sneed: Well, as you both eloquently pointed out, the rates of childhood mental health concerns and suicidal ideation actually had already been steadily increasing. And in part, I do think that a lot of prior to the. I think a lot of that had to do. As with what you pointed out, some youth are now able to speak more about it, but there is more stress with social media. Youth are posting typically about positive stuff that's going on in their life. So if there's an individual who is experiencing more depression or anxiety, all they're seeing is what looks like everybody else is doing well and doing wonderfully. And in comparison, they're struggling. I think that causes a lot of pressure. In addition, I also think with technology, although fantastic over the years, a lot of our youth have difficulties with delayed gratification. So they're so used to getting an answer right away. They're so used to posting and it's up immediately. So it's really hard on them when something doesn't occur right away. And so that also adds to a lot of distress and a lot of disappointment. And then I think with when you add the pandemic. Oh my gosh,
Helen Sneed: the pandemic, as both of you talked about how much it increased loneliness, it really disrupted for our youth their ability to attend school, which is a huge social aspect for them to have contact with their friends or have contact with their peers and their teachers. And instead they were all home quarantined. And so that added to social isolation. Many parents had to work, so they weren't there with their kids or if they worked from home, they had to do their job too. So they're trying to struggle. These parents are trying to guardians trying to struggle with helping their young child or older child with how do you navigate setting up zoom meetings and how do you navigate all these difficulties, which just added to the stress and social opportunities dropped so there wasn't an opportunity to meet up with their peers. Which really helps your emotional health is when you're having opportunity to spend time outside of your family life. And the pandemic also disrupted access to healthcare. Right. For there was a period of time we couldn't go in to see our doctors. And then even though it's fantastic that telehealth came up, there's a lot of people who may not have access to a computer. And so that. And I think the thing that it really had a negative effect on those who already had vulnerabilities to begin with. Our youth who have disabilities or have racial or ethnic minorities or those from low incomes were definitely negatively impacted. So I had wanted to add that piece in terms of how much the pandemic really affected our youth.
Valerie Milburn: Thank you. Wow, that's a lot to think about and definitely is backed up by the research we did. And, Lieutenant Snade, what do you think has helped cause this new epidemic in mental health with our youth?
Valerie Milburn: Well, I think Dr. Usherman pretty much hit on all of the high points. The one aspect that I would say that some parents weren't able to go to work, especially at the height of the pandemic. So then you had economical impacts to those families and to those households. Access to food, access to medications. And then, as she said, the social, emotional piece of interaction with their peers, with their friends. We noticed that when school came back in that a lot of our kids had missed a year and a half of school, and therefore, they didn't have a lot of the social emotional skills and interpersonal skills that was needed at the level that they were at. For example, our fourth graders came back as sixth graders. Right. Our eighth graders came back as sophomores in high school. And so they missed out almost on two years of interactions and just learning those social rules, for lack of a better word. So we had a lot of disruptive behavior in schools, inability to regulate a lot of their emotions, and it just led to a multitude of different types of things. But I think Dr. Usman summarized the big impact, I would call it, on how it impacted young adults. I will say that when I testified before the legislature in 2019 on mental health and suicide in schools, we had gone two years, 2018, 2019, and 2000, with zero completed suicides, which had always been our goal here. We. Our belief was one child's life is way too many. And, you know, we have seen a stark increase similar to the numbers that we saw at the highest level, you know, through this. Through this school year. So it is obvious that the impact is monumental on our youth in their ability to deal with the things that are going on in their lives.
Helen Sneed: Okay, well, this is something that, for me, as an adult, I keep thinking these conditions would be so impossible for me to navigate, and I just think of trying to do it as a young person and also to imagine what is it like for a little child. So next we would like to look at the specific challenges by sector children, adolescents, and young adults. Dr. Sharon Hoover of the national center for School Mental Health said nearly every child in the country is suffering to some degree from the psychological effects of the pandemic. There was a mother on Sunday today with a very troubled
Helen Sneed: 11 year old daughter who put it very well. She said the pandemic took away the spirit of being young, which is a sad thing to lose. She used that term. The pandemic took it away. There are so many young people, I'm sure you've heard them, who say that they feel robbed by the pandemic, that it's taken so much from them. First we're going to look at children ages 5 12. The situation is alarming in the very young. The Huffington Post reports that in children there is a 24% rise in emergency department visits. 8% of children 9 to 10 have thoughts of suicide. And the condition of at risk children is worsening. Children of color are 2 1/2 times more likely to have lost a parent or caretaker to Covid. The suicide rate for black children 5 to 12 is nearly twice as high as that of white kids. And we're going to have more information on this in the adolescent sector. I wanted to start. Lieutenant Seed, you have worked so closely with the schools. What impact is this having on the very young children who are really incapable of understanding what's happening?
Valerie Milburn: Well, as you pointed out through your statistics, we've seen a substantial increase and calls for service for our young. I call them elementary age kids. We take it obviously very seriously. As I've mentioned before and testified before, you know, the youngest student we've lost is a nine year old. There was a point in time when I would have believed that an elementary school age kid was not capable of completing suicide. But that theory obviously was taken away during that time. But we have heard some of the same things from some of our students that they feel like the pandemic did take away a large portion of their lives. Even from a child's perspective that was stolen from them.
Helen Sneed: I was wondering, have you run into this with children where, you know, a lot of times, you know, kids blame the bad things on themselves. And I read of one girl whose dad had died of COVID and she, she thought it was her fault and got, you know, in a very bad way because she, she said, well, if I had been with him, he would have been all right, you know. And I just was wondering if this seems like this would be something that would be really hard on on children as well.
Valerie Milburn: Oh, absolutely. I believe that parents always have the best intentions for their kids. However, I believe that some of the conversations and some of the experiences that they experience as adults and they share with young kids. Those young kids take that to heart and they take responsibility many times for those things, whether it be a loss of a job, loss of income, and they carry that. And we've had students that have made outcries because but they did not want to bother quote or burden their parents with this because financially they couldn't afford to take on any expenses for mental health services. So that kid does not want to say anything in fear that they're going to create more of a burden for their, for their family, for their household.
Helen Sneed: Gosh, that's sad.
Valerie Milburn: Thank you for all of the insight you just shared with the young children. And let's move on to adolescents. Let's look at the challenges facing adolescents. We know that most mental health disorders begin during youth between the ages of 12 and 24, although they are most often first detected later in life. We also know that poor mental health is strongly related to other health and developmental concerns in young people.
Helen Sneed: Yeah, and I had said I would bring up this some more about the at risk youth because it's the statistics are underreported and under researched. So what we're learning is distressing and great cause for alarm. American Indian adolescent girls are three times more likely to die of suicide. LGBTQ teenagers, 73% have anxiety and depression and 48% serious thoughts of suicide. This is a number that has risen dramatically among black female high school girls. The center for Disease control reports that 15% have attempted suicide.
Valerie Milburn: These statistics
Valerie Milburn: definitely illustrate what we've been talking about and we've given a lot of statistics, but we really think they do illustrate what we're talking about. And Lieutenant Snead, what do you think are some of the key challenges facing adolescents both before and because of exacerbated by the pandemic?
Valerie Milburn: Well, I'd have to agree with some of the information that's been shared here amongst this group. We have seen a stark increase in our students with gender or sexual orientation identification. It seems to be more prevalent than it was before pandemic. We did see it quite a bit before the pandemic, but it has increased, it appears post pandemic or I wouldn't say post. I guess we're still in the pandemic. It's just not as severe as it once was. We've definitely seen an increase.
Valerie Milburn: One of the things I read about challenges addressing mental health needs was really interesting. Dr. Vikram Patel, who does a lot of research in the area of adolescent mental health, said that one of the challenges is that there's a fairly low capacity and motivation of non specialist healthcare workers to provide quality mental health services to young people. And I was just wondering if either one of you wanted to comment on that because I thought that was a really startling thought coming from someone who does a lot of research in the area of adolescent mental health.
Helen Sneed: I can go ahead and just speak to the access to child psychiatrists. Here in the state of Texas we don't have enough child psychiatrists. So many if a child or adolescent needs mental health treatment, especially in the form of medication, they're generally seeing their family medicine doctor or nurse practitioner or physician assistant. And so they're not getting that specialized care that child psychiatrists provide. That is a major issue. If there are child psychiatrists available, their first appointment may not be for three to four months out which when a child is having a mental health crisis or issue they really need help now or very soon, not in three to four months. So I think that at least the availability of child psychiatrists illustrates that point.
Valerie Milburn: Right. There are 254 counties in Texas and over 200 of them don't have a psychiatrist of any type. Child psychiatrist, psychiatrist, adult psychiatrist. More than 200 counties without a single psychiatrist. It's really alarming.
Helen Sneed: It is alarming. And there's many general psychiatrists who might see adolescents but then they choose to not see under 12 or under 14. So that leaves those children with limited resources.
Valerie Milburn: I really vulnerable.
Valerie Milburn: Well, I've gained a lot more knowledge already about adolescents and there's another sector we wanted to look at and that's the area of young adults. The challenges to young adults and the mental health statistics we've given so far are unfortunately mirrored in the young adult population. The same increase in symptoms and reporting and and the suicidal ideation statistics and it's the same in this sector. But there is one statistic that is specific to young adults that comes from the Journal of American Medical association that is startling and bears mentioning and that is that alcohol related deaths in young adults rose 40% in one year from 2019 to 2020. And I think this really brings home the impact the pandemic has had on the mental health of young adults. And Dr. Eshelman, what challenges do you think the pandemic has exacerbated for young adults?
Helen Sneed: The isolation has really contributed to increased rates of depression as well as increased rates of anxiety in our youth. And those, what I just mentioned are the top reasons that college students at the university I work at will access or look for treatment is because of those. And even within our last year, social isolation and loneliness was named as top issues for college students. Now remember, this is an age where a lot of the mental illnesses will emerge. And so a first time that someone might have a manic episode if they have bipolar disorder, even though they may have had symptoms of depression anxiety for a while or it could be the first time that they're having eating disorders. But as a result of the pandemic, everyone was under quarantine. So many of the these young adults were not saying anything to their family, worried about the burden that they could create. And then these symptoms continued. Many of them turned to alcohol or drugs in a way of self medicating. And so that's why you're seeing the increase in the alcohol related deaths because they're either drinking too much or driving while under the influence of alcohol. And then many of them have also developed addiction to different substances. So this has just been very difficult. I think a lot of our college age students are talking about low motivation, how hard it is for them to get going and to be excited about things. There's some grief, so many. And I thinking about the high school students who graduated didn't have graduation, right? And here they started at, many of them started at college but didn't have that peer group support. So now they're starting this year finally getting to meet their peers, especially if they come from a town far away from the city where their university is located. So that's a huge transition and much more difficult than it had been had we not had the pandemic. And then academics, I think all of this really affected their ability to learn, especially with the online, online learning. I think many individuals do better when they're in, in person learning because you just have better attention. And there are some youth who do great in front of a computer, but a lot of people, they can't just do that all day. I can also attest to that. It's hard, it's hard to be sitting in front of a laptop all day long. And so I think that's negatively impacted our young adults and those that are college aged.
Valerie Milburn: You mentioned the loneliness and lack of social support. Helen and I, you know, I mentioned earlier that we have young people in our lives whose mental health was affected. And we both know people, young adults who went off to college their first year and were basically in their dorms alone with their computer and told, stay in your dorm with your computer and do your classes. And they several. I think Helen and I counted seven people that we know going off to school who either didn't make it through the first semester or if they did, didn't go back for their second year and laid out for a while, just really had their lives disrupted. And it was hard to watch these youngsters struggling like that.
Helen Sneed: Right. The loneliness really impacted their ability to perform academically to their best potential. And so that. That leads to them not necessarily staying in school or as you said, taking a pause from school.
Valerie Milburn: Right.
Helen Sneed: Both of you have really helped sort of, I think, define the damage and the impact that this has had on our youth. But I think it'd be great to try to investigate so what can be done about it. And both of you have already sort of mentioned some of the things that are shortcomings. But I'm curious what support is available in our society? I mean, you know, the schools and medical and psychiatric fields, law enforcement community. I wanted to give one example of what the pandemic is bringing to bear on institutions. And this is the national alliance on Mental Illness, nami, which we've talked about a lot. Now, it is an organization that is national in scope, but it's a not for profit. And so they have limited funds. Right. And NAMI has had a 200% increase in calls asking for help since the pandemic began. And this to me is just an example of the increased work and support the pandemics demanded from our institutions. Dr. Thomas Insel, who's
Helen Sneed: the former head of the National Institute of Mental Health, put it this way. The problem is not scientific. The problem is not in the science. It's in the lack of a social safety net. So, Lieutenant Sneed, do you represent law enforcement? And you have worked very closely with the schools. In our current conditions, which institutions and communities are offering support for these kids? What's out there?
Valerie Milburn: Sorry, yes. Some of the things I would applaud Austin ISD School District for is implementation of on campus therapeutic clinics. Right. It serves many purposes. The main purpose being it has the ability that A child does not have to leave school to receive services. A parent doesn't have to leave work to research services. So in addition to these on campus therapy clinics, one of the other resources that we've utilized is our mental health authority. And in Travis county, that's integral care. We work very closely with them. They have been a very the lifeline for Austin ISD in providing on campus assessments, follow ups with our family and our students in their homes and just been a mountain of support. They've got a section on first episode psychosis that have been very beneficial to us in the campus. As Dr. Moon pointed out, a lot of times this happens their freshman year in college. But we've seen some early onsets, you know, amongst our students. And so having that resource there is good. We've also built a very strong relationship with our mental health private hospitals in the area. And we had a situation just recently where one of our students, high performance students, right before graduation, experienced a very sudden mental health and psychosis episode that resulted in arrest. And so what we've done or had done before is we worked with Judge Temple over at Gardner Betts in the juvenile justice system and trying to help get our students help rather than jail time. We've worked with the Misdemeanor Division of Mental Health in the Travis County DA's office and the felony courts in the Travis County DA's office to help kind of support the students rather than make it a punitive deal where they're doing it, it's to get them and to funnel them and to help. As we know, our jails, our county jails and our prisons are full of individuals who had diagnosed or undiagnosed mental illness but did not receive the treatment that they needed. My nephew is one of them and ended up with 40 years in prison. And if he would have had the support that he needed beforehand, I think this could have been avoided. So with that, I'll turn it over to Dr. Esch.
Helen Sneed: I can speak to university. At our university, we have worked on increasing access to college students. So some of the things that we started even before the pandemic was telehealth visits, which of course, once the pandemic started and quarantine occurred, that that was our only way that we had actual visits with students. We also have expanded and have counselors that are embedded within the different colleges because we realize many students aren't going to walk over to a building on the other side of campus, but they will go downstairs within their same college building and meet with a counselor. So they're called care counselors and they're in different the different colleges. We also have diversity counseling outreach specialists who are available to students who have different identities. So these are counselors who identify as black or Latinx or they represent international students and other identities. So a student who might want to work with a black identified counselor has access to one.
Helen Sneed: That's remarkable. That's just wonderful.
Helen Sneed: It is wonderful because many
Helen Sneed: students have difficulty difficulties and it's helpful when you can connect to someone who has your similar background and kind of knows what you've gone through. First generation students, for example, it's really different for them versus if your family, you've got a bunch of people who went to college. We also have connected them with, we have a service called My SSP that offers free counseling via an app because we know so many of our youth really use their phones and so that this way they can connect either with someone, either by their laptop or using an app on their phone. And it's a 247 option that students have available. And then the last thing I want to mention has to do with law enforcement. We have individuals who sometimes are in crisis. It could be a student who's having a psychotic break or someone who's suicidal or someone under the influence of drugs. And in the past all we had is our university police to respond. And as can imagine, that can be really distressing. Police show up at your dorm room and that is distressing. And then obviously some individuals have had negative experiences with police, perhaps feeling targeted because of their identity. And one thing that our university has done is we actually have what we call mental health mhart Mental health access and referral counselors who can co respond with officers when there is a mental health crisis. So the person that is talking to the student is the counselor and not necessarily the police officer is co responding and they're in the background just in case they're needed, but then they're having an opportunity to discuss things with a counselor. And so in this way we're helping to provide that support when someone's in a mental health crisis on campus. So those are some of the things that universities can do to respond to the mental health needs of our students.
Helen Sneed: Well, both of you have described very forward looking innovative ways of dealing with these situations and it sounds terrific. I wanted to discuss for a moment or stop and look at, I guess I would call it support at the private level. And that's what to tell those who are caring for a troubled youth. The Children's Hospital of Chicago has this great report about the concerns of parents and caretakers, and it's very severe. 70% or more reported that the pandemic is the worst thing to happen to their child. The pandemic has taken a toll on their child's mental health. They're fearful that the pandemic has impacted their kids social, academic, and emotional development. They're concerned about their child's cognition and physical development. And 65% felt their children could have benefited from seeing a counselor or other mental health professional throughout the pandemic. So kind of breaking this question into two parts. The first is, what advice do you have for those supporting a troubled youth today? These adults are lost and fearful, many of them. And first off, what symptoms and behaviors should they look for in their children that are warning signs for a mental health issue? Dr. Eshelman, what do you tell people?
Helen Sneed: I think in terms of looking for warning signs, Some things for. And if we're talking about parents and family members, changes in behavior, isolation, suddenly not wanting to interact, spending a lot of time in your room, maybe increase reckless behaviors, maybe hanging out with a crowd, and you're like, I don't even know these other kids. So behaviors that are different and changing, looking depressed or perhaps not eating, losing weight, not sleeping, they seem to be up gaining all the time. So being alert to all those behaviors, I think is really important. The other thing I think is, in terms of advice for parents and guardians, is to start creating an environment where you not only talk about what going well in your child's life, but making sure that they know they can always talk to you about what's not going well. I think so many times kids don't want to disappoint their parents, so they want to only report the positives and don't report any of the negatives. And I think it's also helpful if parents can talk about times when they struggle or talk about times if they mental health issues. I think sometimes that is really helpful because kids, if you keep it from them, they don't know. And then they figure, okay, well, this is just something wrong with me. So you can create an environment where
Helen Sneed: where you can talk about it and invite your child to let you know if things are not going well, or even invite and give them permission and say, sometimes it is really hard to talk to your own parent because it is.
Helen Sneed: Hard to talk to your own parents.
Helen Sneed: And it may be easier to talk to an adult sibling or to an aunt or uncle or to your grandparents. But for parents to let the child know if you're ever in trouble or feel you're distressed, and it feels too hard to talk to myself or your other parent, it's okay to go talk to another adult, too, just to let them know it's okay to get that support from someone else. I think it's also helpful to look for signs of bullying, which certainly can occur at any point. And I think it's very silent people. Most of the youth don't talk about that. And then maybe even parents asking, have you witnessed bullying? Because lots of times they have, and then that may be an opportunity for them to share if that's actually occurring to them as well. And I think the very last thing I want to say is emphasizing how problems are solvable. I think so many times for youth, a problem feels awful and they feel like there's no escape and there's nothing they can do to fix it. And so everything's awful and they can't think of a solution. And helping individuals, youth know that sometimes problems are awful, sometimes they're bad. It feels like there's no way out, but they are solvable, and I can be there to help you with it. It's kind of like thinking about a plan for a mental health emergency. I think we're really good at teaching our kids about911.1, what to do if there's a medical emergency, but not necessarily a mental health emergency. So helping them realize that, yeah, they may not want to tell you they're having suicidal thoughts, but they can tell you that they're in distress or not doing well, and then you can assist them with how you can take their symptoms seriously. Don't go. It's just a phase they're going through. That's a lot of parents. Do they're distressed because they're in college? No. I think if your child is telling you they're in distress, you. You need to listen and pay attention and go, honey, what do you think you need?
Helen Sneed: Yeah. I came across a quote where someone said, if your child tells you what he's feeling, believe him, you know, and validate it. You know?
Helen Sneed: Yeah, validate it and say, I'm here to help you. If they say, I think I want to see a counselor, don't immediately dismiss it and say, oh, well, you just need to go work out more or eat healthier. Those are things that can be helpful. Sure. But they might need services from a mental health.
Helen Sneed: Okay, now, Lieutenant Sneed, I know that you were earlier talking about. I'm wondering if this is different with how it's different with younger kids. Because you were talking about how a lot of times they want to protect their parents from that. The parents can't afford to get them treatment, so they don't want to tell them about their problems or whatever. Are you seeing a lot of this?
Valerie Milburn: Yes, yes, we are. Obviously the pandemic has created an increase across the spectrum of ages of our students and young adults. But one of the things that Dr. Usherman hit on a lot of big points to be aware of or warning signs may want to call them. I think that one of the things that parents can do to really enhance the opportunity for their child to come forth, as she said, is, you know, to embrace that, that outcry and just let them know the support it does several things. Number one, I think it breaks the stigma about talking about mental health. Right. Which is, I think something our nation as a whole could benefit from. Number two is we've seen situations where we're looking at, from a school perspective, we may be looking at increased absences, changes in grades, drastic changes in grades, skipping school, you know, things like that. They're hanging out with a different group of kids than they were hanging out with before. Some of the same things that she's talked about, but just in a school setting and how it would be impactful from a school perspective. So that's some of the areas that we truly focus on. But yes, we have seen a definite increase across the board, across all ages, with, with outcries. But. And one of the key parts is, as she pointed out, you know, if you can't talk to your parents, which many kids don't, right. They talk to other kids, you know, and that's how we learn about kids in distress. Is they. That their peers will come forth and say, I'm concerned about so and so. And to really bring, bring that to the forefront, attention our counselors in our school, which is a resource that I failed to mention earlier. Our counselors in our school and our licensed mental health professionals within Austin ISD do
Valerie Milburn: a fabulous job of doing a what we call triaging pre level assessment and then determining what resources would be best and then helping not just give the parent the information but having them access it. Because we have found that, that parents, if we give information to parents, many times they become so frustrated with the system that they don't seek the medical assistance that their child needs psychiatric wise. And we end up back at point A with that student again. So we now encourage, one of our protocols is to actually help set up an appointment, help set up access not just. Just give it out there and let them kind of flounder through it. Because we found, obviously when we're dealing with a child in crisis, we're dealing with a house in crisis. Right. We're dealing with a campus in crisis. It is not. It's not linear in that it only impacts that child. It impacts the whole household. When we're laying out that this child had a complete plan and they had the means and they had all these things. And you're giving this to a parent that is overwhelming to anyone to try and digest in a setting. And, you know, for a parent, it can be. Depending on that parent, it can be really overwhelming for them. And then now we just send them off and say, hey, you need to call, you know, these individuals or this group of individuals. Pick someone to call. It can very easily get placed on a back burner, and then bad things can happen. When that happens.
Helen Sneed: Well, it sounds. Both of you are. This is really. I think that you have given good advice as to sort of what to look for in a troubled child. And then also sort of, you've been very good about describing how parents and caretakers, what behaviors they can exhibit to help the situation when they've got someone in trouble that they're taking care of. On that subject, do you have anything that either one of you want to add on that? Because you've been very eloquent about it. Well, about everything, darling. What can I say?
Helen Sneed: I want to add because we did focus on parents and caretakers, but friends, I think friends, most of the time, youth will go to their friends and talk to them about things. So listen to them. Them. Take seriously. If you're hearing a friend who's talking about feeling depressed, especially if they mentioned suicide, take seriously. If they've done that, suddenly they're not answering text messages from you, they quit talking to you. There's that again. That's that isolation, right? And that's not as a friend. Don't hold that all by yourself. You can always go talk to an adult because that can take a toll on you, too. You're constantly worried and trying to support your friend. But please make sure that you take care of you and get help from another adult because they can help guide you, whether it's a school counselor or maybe your mom to help you with that situation. So you're not trying to navigate it all by yourself.
Valerie Milburn: Right. That's all really great advice for both warning signs and what to do when in a crisis. And I want to wrap up today's Rich Discussion with a hopeful focus service We've already talked about some future trends and treatment methods that are promising and make professionals hopeful. But is there anything we want to add about what is promising for the future? What corrections and remedies look promising? What makes you hopeful? Lieutenant Snead?
Valerie Milburn: The things that made me hopefully are the friends and family members who have reached out to notify support systems when they have noticed a change in their family member or their friends. I think at some point that was deemed to be that you were in some way betraying that relationship. But we've actually found that it saves lives in many cases, especially if someone is in a deep, in a deep state, an inability, and somehow their mental capacity has been incapacitated or diminished to some degree. That you can truly save a person's life by just reaching out, whether it's the National Suicide Hotline, any local authorities, you can call 911. They also here in Travis county, they have military health professionals that will actually triage services over the phone when
Valerie Milburn: you call. They'll ask now if you need fire, police, EMS or mental health services, which is good, you know that that service is there. It may not necessarily be exactly what that person needs, but they may be able to help that person access those services. So I would say that's been a big helpful and encouraging part for me and changes in our community.
Valerie Milburn: Right. And that's a new change that adding the. Or do you need mental health? That's just been added, I think, in the last year, year and a half. And that's a really great addition to the 911 service. I'm glad you pointed that out. Dr. Eshelman, what about you? What makes you hopeful? What's promising for you in the future?
Helen Sneed: I think the fact that it's being highlighted that there's more emphasis and people are looking at it. So I think of the medical professional societies like the American Academy of Psychiatry, the American Academy, excuse me, American Academy of Pediatrics, the American Academy of Child Adolescent Psychiatry, and the Children's Hospital association are all putting an emphasis on child mental health issues and how much it's taking a toll, which of course then highlights that we need to expand access, that we need to look at ways to decrease barriers to, to mental health services and recognize how there are some groups who are disadvantaged disproportionately and making sure that they get services. And then podcasts like this, where we reach out to others and talk about this, to make them aware and give them information, I think is so invaluable for Those who want more information about the youth mental health crisis, I think is what brings me great hope.
Valerie Milburn: Well, thank you, and thank you both for being here today. I just, I can't thank you enough for spending time with us today. I know how hard it is to carve time out from your schedules, and Helen and I are really grateful that you did so to be with us today. You've enriched our discussion immensely. Thank you.
Helen Sneed: Yeah, I want to second that sentiment and triple it or something, because this. This has been a remarkable discussion, and I'm sure you know, is that you. We don't know how many people you've helped today, but it's many, many people, and we are forever in your debt. Now, as an important reminder, one more time, the National Suicide prevention lifeline is 800-273-8255. That's 800-273-8255. And it's available 24 hours a day. If you know someone who, you can also dial 911 or you can go to the closest emergency room. We feel like we want to bring this up because we did talk about suicide and suicidal people. It's great length today. We wanted to give you another sort of aspect, another, another angle to this whole incident. Problems with our youth and their mental health. This is also from the Surgeon General's report. Mental health challenges in children, adolescents, and young adults are real, and they are widespread. But most importantly, they are treatable and often preventable. If we step up for our children and their families in their moment of need and lead with inclusion, kindness and respect, we can lay the foundation for a healthier, more resilient and more fulfilled nation.
Valerie Milburn: Thank you.
Helen Sneed: So, on that note, yes, thank you.
Valerie Milburn: Thanks for sharing that upbeat, wonderful message.
Helen Sneed: Well, and again, hearing our two guests today, you give me hope.
Valerie Milburn: Yes.
Helen Sneed: As you will anyone who listened to this today. So, on that more optimistic note, which you've contributed to vastly, we're going to move on. And now Valerie will guide us through a much needed mindfulness exercise, as she does every. Every time we have an episode.
Valerie Milburn: That's right. We are at the close of this episode. And the way we will close is how we always close, with a mindfulness exercise. What is mindfulness? I always give a definition. Mindfulness is a mental state achieved by focusing one's awareness on the present moment while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations without judgment. Mindfulness empowers us to choose our mindset and to shift how we relate to our experience so that we have less stress and more joy in our lives. Today's mindfulness practice is called Set Intentions for the Day. Let's begin with our deep breathing diaphragmatic breaths. Let's settle in and breathe. Close your eyes if you can. Whether your eyes are open or closed. Let's steady our breathing with two diaphragmatic breaths. When you do this on your own, take as many breaths
Valerie Milburn: as you need to become calm and centered. Let's breathe. Inhale through your nose, expanding your stomach as you inhale. Inhale to the count of five. Four, three, two, one. Exhale through your mouth, pulling your stomach in as you do for the count of 7, 6, 5, 4, 3, 2, 1. Inhale through your nose, expanding your stomach as you inhale. Exhale through your mouth, pulling your stomach in loud. It's a forceful breath out. Keep this slow, steady breath going. Let's set our intentions. Ask yourself, what matters most today? What matters most this week? What does my heart long for? Let's set intentions for seeing, being and doing. Keep your intention short and simple. What do you want to see more? More beauty. More wonder. Acts of kindness. Good news. Humorous moments. What do you want to be more today? Calm. More focused. More open Minded. Patient. Generous. Accepting. Gentle. More forgiving. What do you want to do more today? Stop and breathe. Listen deeply to others. Do one thing at a time. Once you have set your intentions, you may choose to write them down or share them with others. Thank you for doing this mindfulness exercise with me.
Helen Sneed: Well, thank you, Valerie. I always have to kind of shake myself and get back into the mode here. We want again to thank Dr. Eshelman and Lt. Sneed for their invaluable insights and this great generosity that you both have displayed, not just with your time for being here, but with your knowledge and your experience and obviously your great commitment to your work, which is inspiring to see. To our listeners, we send our gratitude for giving us your time and attention. Our examination of the impact of the pandemic will continue in our next episode. The Impact of the Pandemic on Mental Health in America Part 2 what is happening to the grownups? We promise a deep exploration of the plight of adults who are suffering from mental health conditions brought on by the pandemic. So please join us. And now I leave you with our favorite word, Onward.