Op-ed: More Than Ever, We Must Prioritize the Mental Health and Well-being of Children

Stanford psychiatrist and an attorney from the National Center for Youth Law call attention to the potential mental health impacts on youth from the COVID-19 pandemic and trauma surrounding racial injustice in America

A new op-ed published today by Rachel Velcoff Hults, equity and access attorney on the National Center for Youth Law’s Health team, and Steven Adelsheim, MD, director of the Stanford Psychiatry Center for Youth Mental Health and Wellbeing and associate chair for community partnerships in the Department of Psychiatry and Behavioral Sciences at Stanford, calls on us to keep the well-being of children and youth at the forefront of our response to COVID-19, and to recognize that racism, discrimination, and race-related violence create additional stress and trauma for youth, which in turn threatens to further widen existing mental health inequities impacting communities of color. In the op-ed, Hurts and Adelsheim state:

“As youth struggle to cope with these ongoing challenges brought on by COVID-19, they are now also processing news of the violent murders of George Floyd and other Black Americans, the country’s reaction, and the impact on themselves, their families, and their communities. Many are experiencing a range of intense emotions, from grief to anger to hopelessness, to hopefulness about the possibility for real change, to name just a few, with limited access to the support they need to process these complex feelings.”

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“Both the experiences our young people face now and the supports they receive from us in coping with and navigating these challenges will have profound impacts on their abilities to be successful adults, parents, and citizens for years to come.”

For many, they state, this period of time is marked by feelings of isolation, fear and confusion, and may trigger new mental health issues, or cause a worsening of existing ones. These stressors are heightened for youth in communities of color, which have suffered a disproportionate number of COVID-19 infections and deaths. Stressors affecting these populations can accumulate, and the impact can become immense, Hults and Adelsheim explain:

“With increasing stress comes increasing risk for mental health symptoms, or re-occurrence of symptoms, with fewer options for getting simple supports that can help lower stress levels. When our homes have increased stress, the chances of depression or substance use rise, as does the possibility of abuse or violence at home. These are all factors identified as potential Adverse Childhood Experiences (ACEs), and we know from many studies of ACEs that when young people have these early experiences, they face increased risk of lifelong morbidity or mortality.”

Hults and Adelsheim’s call-to-action is clear: “It is imperative that we recognize these potential impacts on the next generation and take proactive steps to mitigate them.”

Within the op-ed, they charge the community with accomplishing this in several ways:

• Continue to promote stress management techniques, and increase awareness of online tools for support and community connection for mental health and wellbeing.
• Expand social-emotional learning programs to help build wellness and resilience, and evidence-based trauma-focused treatment and suicide prevention programs, like CBITS and Sources of Strength.
• When schools begin to re-open, we will need to:
  • Implement more formal structures for mental health screening in schools and community settings.
  • Expand mental health awareness and stigma-busting programs, such as Bring Change to Mind and NAMI high school.
  • Support school districts and behavioral healthcare agencies in working together locally, to ensure that when schools re-open, students will have the mental health services they need on campuses and in their communities, such as the developing allcove program in California.

Hults and Adelsheim also call on our nation’s policymakers to increase investments in and use their voices to promote early mental health screenings and interventions, resiliency and wellness efforts, suicide prevention programs, and strategies that create positive connections for young people. An excerpt:

“Our young people are the future of our country. They need our focus and support through this unprecedented time. We must not lose sight of the fact that the period from 12-25 remains a critical time of brain development and maturation. By making the investment of support, commitment and care for our youth right now, we will be building the foundation for a hopeful and viable future.”

Across all of these strategies, Hults and Adelsheim call on policymakers and leaders to recognize and acknowledge the deep inequities that already exist in access to mental health care for youth of color, and the many ways that communities of color, especially Black youth in this moment, may experience disproportionate negative impacts from these crises. They state:

“Efforts to increase mental health supports and services must specifically focus on expanding access and reducing structural barriers to care for Black youth. These efforts should also leverage research from the National Child Traumatic Stress Network and other organizations regarding best strategies for addressing the traumatic impact of racism and exposure to violence on youth We must also invest in creating and expanding mental health career pipelines for people of color, to ensure that the community of pediatric mental health providers reflects the diversity of the children and youth they serve.”

Read the full op-ed online here.