[Skip to Content]

Support your child’s behavioral health through the pandemic and beyond

Adjusting to the “new normal” during this past year’s pandemic may leave us wondering what exactly is considered unhealthy. Regarding child and adolescent mental health, the line between typical developmental behaviors and those that require professional help can be difficult to discern even in the best of times—which means monitoring for unhealthy behaviors is that much more important during the ongoing public health crisis.

It is understandable if a child or teen is experiencing increased anxiety or difficulties with sleep; struggles with staying focused in online classrooms; or frustration over limited extracurricular activities. However, unlike adults, children and adolescents are experiencing these common stressors during key developmental periods. Further, with fewer coping and adaptive skills, they are more vulnerable to these stressors, increasing the likelihood of post-traumatic stress symptoms developing during and after the pandemic. Additionally, considering that 50 percent of all lifetime mental illness develops by age 14, the current challenges may very well exacerbate existing mental health issues or trigger symptoms in at-risk individuals.

The pandemic has intensified concerning behavioral health trends

Prior to the pandemic, data related to the mental health of U.S. children and adolescents had already been trending in a worrisome direction. For example, 18.8% of high school students had seriously considered attempting suicide during the year leading up to the survey, and 8.9% had survived a suicide attempt.

The pandemic has ushered in several complicating factors, including:

  • The reduction in services and treatments (i.e., school counseling; speech or occupational therapy etc.) due to lockdowns has placed children with special needs at greater risk of plateaus in progress—or even regression
  • The significant restrictions on in-person contact through school and extracurricular activities have limited an avenue by which emotional and behavioral changes can be recognized. Whereas in pre-pandemic times a teacher or coach may have noticed a concerning behavior shift, this monitoring responsibility is now falling more fully to caregivers.
  • An increase in screen-time leads to potential risks ranging from disturbed sleep patterns to cyber bullying to reduced exercise.
  • The frustration that parents and other caregivers are experiencing may be displaced onto the children, leading to increased risk of domestic violence and abuse. Historically, periods of economic downturn, including the Great Recession of 2007-2009, have been associated with increases in abuse toward children.

Early identification and intervention are key to reducing risk

Concerning signs and symptoms may vary depending on age. One preliminary study has shown that 3- to 6-year-old children demonstrate clinginess and fears of family members becoming infected, while those 6 to 18 years old show inattention and ask many questions about COVID.

Any worrisome signs or symptoms warrant a professional evaluation, which may start with the child’s pediatrician and advance to an assessment by a child and adolescent psychologist or psychiatrist, in person or via telehealth. Additional recommendations for caregivers include:

  • Talk to children directly about their concerns and fears as they relate to COVID
  • Intervene early if school performance declines
  • Secure any medications, recognizing that even over-the-counter medications can be dangerous if taken in inappropriate amounts
  • Any weapons should be secured and made inaccessible to children. Monitor other potential weapons, such as kitchen knives.
  • Teach/coach skills to help children stay healthy and develop a sense of control—thereby fostering resilience. This includes practices such as personal hygiene and social distancing as well as self-care skills (i.e., yoga, meditation, journaling, exercise).
  • Maintain a schedule and routine as much as possible, including consistent bedtimes and morning wake-up times
  • Facilitate social interactions as much as is possible and safe
  • Encourage physical exercise and creative pursuits
  • Monitor screen-time, including social media and news exposure
  • Attend to one’s own stress-management skills and mental health, acknowledging the importance of modeling behavior
  • Make yourself aware of local resources for urgent or emergent mental health help. Texting “HOME” to 741741 will connect with a crisis counselor. The National Suicide Prevention hotline can be reached 24/7 by calling 800-273-8255.

Managing the long-term mental health conditions due to the pandemic, especially among children and adolescents, may well pose a significant future challenge. Early identification and intervention remain the best approach to trying to get a handle on a behavioral health crisis poised to emerge from a physical health crisis.

11 Comments. Leave new

Sharon Headrick
April 1, 2021 2:56 pm

I hope telehealth and phone behavioral health services will result in another permanent option for access at FQHCs and CMHCs especially in the rural areas. Have you any idea if this will continue to be a paid service for our patients?

Dale Seamans
April 7, 2021 9:11 pm

Thank you for your question. The permanence of telehealth flexibility/allowances are still being decided by Congress/CMS. The American Telemedicine Association has urged Congress and the new administration to ensure Federally Qualified Health Centers and Rural Health Clinics can furnish telehealth and receive equitable reimbursement.

Helene ZimmermanLCSW
April 1, 2021 3:07 pm

The analysis and description are on target. However parents are going through a major life change. The home environment is the focus, and needs flexibility, addressing changes .


Yes these times are trying our young. I have seen three girls with suicidal thoughts. One seven year boy whose parents think he is acting out when he gets upset but still talking it seriously enough to get him therapy. One of the girls is back in school and excited to go back. Will see how she does to see if it makes enough of a difference.

Kathleen Ann Sirois, LMHC
April 1, 2021 4:19 pm

Thank you for this wonderful article. I actually have saved it for some of my parents that have children showing some of these symptoms. The more we have have in open communication, the better we can share.
Thank You

Nancy Kunsak, PhD
April 1, 2021 4:48 pm

Assessment for family based may be in order; especially when parents are experiencing marital discord, jobs have been lost, drug and alcohol use has increased.


It’s frustrating trying to keep teens from thinking about suicide when I can’t recommend what I would usually recommend, exercise outdoors, hiking, biking, getting together with friends. So I have to ask them to tell me how they feel and then when they tell me how upset they are at being locked in I can empathize with them and normalize the situation in that everyone is going through it and they aren’t alone. I also recommend online groups that have teen chats.


Don’t know where you live MJ. We here in Chicago area of course have just come though our usual winter. I did ” walk n talk” sessions with kids and adults through most of the winter. In many cases we were masked if the client felt the necessity of that. We were always distanced. I don’t understand why this is a unique approach. We need to get folks outside.


I am working with five children from 14 through 18. Two have what I suspect is ADHD and have prevailed upon parents to have them tested. One lost a father at only 9 years of age, and slowly helping him to deal with his sorrow and anxiety as well as anger. Another has a malignant narcissistic father, though luckily a very good mother, divorced. All are also having difficulty dealing with Covid and the abnormal restrictions Re Zoom schooling, inability to see friends, lack of sports and outdoor life. Luckily none have suicidal ideation but suffer nonetheless. And, of course, issues with working virtually. Because of a very full schedule, I have had to turn down youngsters, which is painful to have to do. But I do make a difference!


Thank you. Have added the emergency text and support phone number to my email signature!

Nebechi Chukwu
April 12, 2021 6:21 pm

Thanks a lot it’s a very nice help working with kids of all ages ADHD plus others. Thanks for helping
us .


Leave a Reply

Your email address will not be published. Required fields are marked *
Comments that are inappropriate and/or not pertaining to the immediate topic at hand will not be published.

Top Link