We can’t forget mental health of kids during crisis

Let’s find ways to support them, Dr. Mahli Brindamour and Dr. Ayisha Kurji write.

As pediatricians, our waiting rooms are usually full of happy chaos: toys, books and piles of kids. But not today. Today is another COVID-19 day. As we sit in front of our computers in our basements and home offices (or sometimes laundry rooms, with our own kids climbing on our heads, demanding snacks and attention), the new reality of our work settles in. Our patients and their parents are good sports, brave, often grateful to be able to talk to us without having to leave their house. Their questions are different than usual, with a new undertone of anxiety. The single parent asks: “Who will be able to stay with my child if they get sick and need to be in the hospital?” The new mom wonders: “I have an appointment with public health for my baby’s vaccines next week, should I still go?” The family from a tiny community up north calls: “My teenager doesn’t sleep, she misses her friends and cries a lot more than usual, what should I do?”

As with the families we look after, the sources of our anxieties have evolved with the pandemic, and we are concerned about the longterm effect it will have on kids’ health. Data on COVID-19 is evolving, and so far children seem to have been mostly spared from the acute effects of the disease. But they are not shielded from negative consequences on their health. That’s why we must keep in mind the unique vulnerabilities of children when designing our pandemic responses.

Routine baby visits and all childhood immunizations must continue. We do not need an increase in vaccine-preventable diseases. One pandemic is enough.

We need to be mindful of worsening inequities during this pandemic. It is now clear that COVID-19, along with a long list of other infectious and chronic diseases, affects children living in poverty in higher numbers and greater

We need to be mindful of worsening inequities during this pandemic.

severity. Poverty in the pandemic does not rest. It affects which child has access to technology to attend virtual school, and which child won’t have support at home to do school work. It affects which child will have to worry about their parents working on the front lines without proper protection, and which child won’t have access to a green backyard to play in. It affects which child will be more likely to lose a parent during the pandemic.

We cannot forget children’s mental health. Children are incredibly susceptible to their environment: A stressed family, a sick relative, being separated from a caregiver needing to self isolate, or worrying about the virus can tip a usually well adapted child into coping troubles. Those with increased access to technology may also be at risk, whether due to increased anxiety over COVID-19 from what they are reading and watching, or from exposures to other sites with inappropriate content.

Children have developing brains. Early childhood interventions, schools and daycares play a crucial role in healthy development. As our usual ways of providing this education and opportunities for social interaction are decreased, we must work with teachers and childcare providers to find new ways to help kids develop.

Lastly, we must be aware that not every home is always a safe place to be, and this can be even worse during the pandemic. With added stresses on home life, and without the usual eyes and ears on our kids — teachers, soccer coaches, camp counsellors, so many others — we are missing crucial opportunities to identify and prevent child abuse and neglect.

As for our families’ questions, they are not easy, and often there are no answers, at least none that are satisfying. Like the children we look after, they demand complex, specific and dedicated answers. We can’t wait to get back to answering those questions with our patients in person. We can’t wait to have our waiting rooms noisy and messy again. But we also can’t wait until then to get children the support they need to come out of this healthy, happy and safe.

Dr. Mahli Brindamour and Dr. Ayisha Kurji are Saskatoon pediatricians and assistant professors with the University of Saskatchewan College of Medicine.