I spoke with Walkup to discuss the findings of his research and to discuss what parents and caregivers can do to help their children right now.
CNN: Are you saying that we haven’t seen a lot of new mental illnesses in children over the past two years? What we’re seeing is the hardships exacerbated by the pandemic, right?
Dr. John Wocab: yes. As you know, on average 20% of kids have mental health problems before they graduate from high school across the United States. Only half of these children receive some type of evaluation or treatment, and only about 40% get clinically beneficial benefits. That is, about 15% of children with mental health problems get help. Then take school, family, peer support, sports and force them to stay at home. You know these kids won’t do well over time.
There will probably be a small group of children who have had Covid for a long time where you could say there is some direct effect of Covid on the brain, but this is a very small group of children. But in general, when we think about what Covid has done, it has already destroyed the infrastructure for children with mental health issues. If you think about it a little deeper, we’ve been championing children’s mental health for a long time. Families and schools are becoming more aware of mental health issues, so you now have this kind of perfect storm of increased awareness and increased advocacy, which has led to an increased need for care. The structure of this care has fallen apart over the past two years.
CNN: Looking at these numbers, do you feel the pandemic is going to shed some light on children’s mental health needs that we wouldn’t have seen without this crisis?
walk towards: I think we would have seen an increased awakening in both cases because the advocacy efforts are there. We now have effective treatments for every major child psychiatric disorder, and treatments are good. Once you get the treatment, you can defend effectively, right? So before the pandemic more and more children were coming in for quality care and care. But then, when you strip away all the supporting infrastructure (school, activities, etc.), these kids will develop symptoms much more quickly. Without that infrastructure, we’ve seen a huge and unexpected rise in pathology.
CNN: She has highlighted the distinction between mental illness and distress. What is the difference?
walk towards: Anxiety and sadness are normal human feelings. Anxiety helps us prepare for difficult outcomes, and sadness helps us get closer to people. What we work on in terms of mental illness are pathological forms of anxiety or sadness. This is clinical depression and anxiety disorders, and those things are qualitatively different from normal human sadness or normal expected and proportional anxiety.
During Covid-19, when children did not know what to expect, their normal anxiety and distress would have risen because they are not with their friends and not at school. They have questions about their future. But this is not satisfactory. This is expected, proportionate and understandable, and will go away when things get normal.
CNN: You also suggest that the pandemic has had a greater impact on girls and the gay community. Any idea why that might be?
walk towards: When the pandemic hit, more children who did not receive treatment or abuse began to be cared for. The prevalence of anxiety and depression in young women is greater than that of males, which may explain the disproportionate treatment request. More girls needed help that wasn’t there in the past two years.
In the gay community, these young people struggle. It’s hard to be different when you’re young. This group also experiences higher rates of bullying. Many feel that they do not necessarily fit in with their family. So you would expect these kids to really struggle during this period of time, and they did.
CNN: What risk factors should parents and caregivers look for now?
walk towards: This is really important. Parents should take a look at their family history. If there is a psychiatric disorder somewhere in that family history, be aware that these things are genetic. They pass from generation to generation. It is also important for parents to understand that these psychological disorders arise at predictable times in developmental stages. Children with ADHD are present between the ages of 4 and 7 years. Children with anxiety disorders are 6 to 12 years old, and children with depressive disorders for the first time are in their mid-teen years.
Therefore, if you have a family history of ADHD, you should look for ADHD symptoms in your 3, 4, and 5 year olds. If you have an anxiety disorder in your family history, you should look for anxiety between the ages of 6 and 12 as well as depression. Share this information with your pediatrician. Your pediatrician knows what these presentations of symptoms look like so you can get them really early.
CNN: You’re saying don’t wait for your child’s symptom profile to appear? Be proactive.
walk towards: the correct. If you have a family history of ADHD and you have a two- or three-year-old, be really good at parenting because these kids are hard to deal with with the parents. If you have a family history of an anxiety disorder, mom and dad should make sure they are in a good emotional state. You will need to become brave because we know that the cure for anxiety is dealing with those things that are scary or difficult. We also know for families with a strong history of depression that being physically active and participating in the world is the best behavioral therapy.
If you know your family history, you know the age of onset of risk, and you know the things you can do to mitigate that risk once the condition appears. Your child will be much better off and easier to treat if all this work is done before symptoms actually appear.
CNN: What can parents or caregivers do now to help their children ease any emotional difficulties caused by the Covid-19 pandemic?
walk towards: Take a deep look at your family history and not all symptoms are attributed to Covid. If you have a strong family history and you notice symptoms in your child, don’t rule it out. Take it seriously. Learn, read and talk to your pediatrician because they know about these conditions. They will begin to lay the groundwork for the intervention. If you don’t need to intervene now, laying the groundwork and preparing is much better than being caught off guard later.
Families often hire a financial advisor or legal advisor. Why not have a mental health counselor if you have a family history of a mental disorder? Get a mental health counselor to work with you early on about prevention and early intervention. If you start paying attention to these conditions early, you can reduce the impact. If you do not, you risk maximum impact on long-term results.
CNN: Do you feel hopeful moving forward on the mental and emotional health of our children?
walk towards: I think we have great therapies, and if we can get the kids to get the treatment, we’ll be fine. We have a lot of “anti-treatment” sentiment in this country and a lot of letting go of the mental health pandemic. We don’t take it seriously enough, so my feelings are mixed. If we put children in care, we treat them very well. They respond well and get better. On the other hand, there are many hurdles that families have to jump over to get care nowadays. This can make it difficult for children to get the care they need.
In general, we will see a significant reduction in the mental health burden on children simply because parents and guardians will figure out how to move past emotional difficulties. Paternalistic leadership within the family can ease a lot of heartbreak.