The Day – As pandemic wanes, kids’s psychological well being woes overwhelm system

Lucie, a mother of four, was exhausted and the stress in her home in Norwich was sky high.

Her 9-year-old son has had tantrums for some time. He found reasons to be angry and he tossed things around, sometimes aiming at her and his three siblings to harm them. Last weekend the situation had gotten worse as Lucie’s son raged every day, sometimes several times a day.

Lucie, who is not her real name and whose identity has been approved by The Day, was convinced that her son needed to be hospitalized. She called Dr. Richard Lavoie, her son’s pediatrician.

Lavoie contacted the Connecticut Children’s Medical Center in Hartford, a source he often taps on on behalf of his parents. He did so knowing that the COVID-19 pandemic had overwhelmed therapists and other pediatric psychotherapists.

He called anyway.

“I spoke to an Advanced Practice Registered Nurse (APRN) who was very helpful,” said Lavoie. “But what I had hoped for did not come true. She told me that at that point there were 30 patients aged 7 and over waiting for inpatient treatment. They stayed in hallways, sat on stretchers and in common rooms and waited to be accommodated somewhere. “

“She said if my patient showed up he would only be number 31,” Lavoie said.

While the pandemic may be on the wane, some of the shortcomings it uncovered, such as: For example, behavior-related health care, especially mental health care for children, is only now becoming apparent, according to health service providers.

“My (mental) counseling has tripled,” said Lavoie, who has practiced in Norwich for decades. “We have to deal with crises of all kinds every day. My first calls today came from therapists, teachers, carers. We are seeing a terrifying explosion of children in need of outpatient care, medication management, and inpatient care. ”

“It’s scary,” he said.

In early May, the American Psychiatric Association published a survey that found that more people than a year earlier reported having pandemic-related mental health problems and that parents were particularly concerned for the well-being of their children.

“More than half of adults (53%) with children under the age of 18 in their household say they are concerned about their children’s mental health and almost half (48%) say that the pandemic affects one of them or more of their children caused mental health problems, including minor problems for 29% and major problems for 19%, ”the AMA reported. “More than a quarter (26%) of parents say that they sought professional psychological help for their children because of the pandemic.”

Almost half (49%) of parents with children under the age of 18 said their child had received help from a psychologist since the pandemic began. Of those whose children had received help, 23% said it came from a family doctor, 18% from a psychiatrist, 15% from a psychologist, 13% from a therapist, 10% from a social worker and 10% from a school counselor or school psychologist.

A fifth of parents said they had trouble making an appointment with a pediatric psychologist.

Anxiety, depression main symptoms

Dr. Bonnie Mackenzie, medical director of emergency pediatric medicine at Lawrence + Memorial Hospital in New London, said pediatric cases in the hospital’s emergency room had decreased in 2020 but had returned to pre-pandemic levels. The average number of hours each patient spends in the emergency room has increased from eight to 14, she said, an indication that the cases are more serious.

“The general feeling in our emergency room is that the sharpness has increased,” said Mackenzie. “It feels like children undergoing mental treatment are increasing their needs. We feel it’s because of the pandemic … the stress they are feeling about (a lack of) normal social support. “

Anxiety and depression are the symptoms that most commonly lead to psychiatric visits in children. In L + M’s emergency room, children were seen for thoughts of suicide and even attempted suicide, Mackenzie said. Much less common, she said, are pediatric homicides.

“Parents seek help with difficult-to-control behavior at home, verbal or physical outbursts,” she said. Eating and sleeping disorders, as well as panic attacks, are also linked to mental health problems in children.

The provider and parents agree on the cause.

“It’s about being apart from your peers,” said Carrie Pichie, clinical psychologist and regional director of outpatient services for Hartford HealthCare’s Behavioral Health Network. “At the beginning of the pandemic, it was devastating for many children not to be in school and not able to participate in sports and other extracurricular activities. Some find it difficult to reintegrate once the schools are up and running again. “

Pichie said the number of pediatric cases she sees has increased in recent months, even as the pandemic has subsided. When schools first introduced virtual and hybrid learning plans, the children adapted. But in time, she said, the lack of social interaction caught up with her.

“Children left home to do schoolwork without adult supervision can play video games instead,” Pichie said. “When they are not in school, they miss contact with teachers, career counselors and coaches – people who can recognize changes in the way they work.”

Lavoie said the pandemic’s toll on families is a factor in children’s mental health.

“Job losses, broken relationships …” he said. “Children see it, they hear it. There is no place where they can hide and there is no place where they can vent. “

Lavoie said the amount of drugs he prescribes has also tripled, including the antipsychotics Abilify and Vraylar and the antidepressant Zoloft, all of which have side effects. His office asks patients 12 years and older to complete the PHQ-9, a questionnaire that checks for the presence and severity of depression.

The bulletin board in his office is covered with the business cards of therapists and social workers.

Lucie, the mother of Norwich, said the impulse control drugs prescribed for her 9-year-old son didn’t work. She found his remote sessions with a therapist ineffective, but said he benefited from some counseling at school and is now in partial hospitalization. She is still waiting to schedule a personal appointment for a psychiatric evaluation.

“It’s just not available,” she said of the help she needs. “I know the system is overloaded. We need more beds (in children’s psychiatric institutions), more therapists, more doctors – experienced professionals. There just isn’t enough out there. “

The resumption of full-time teaching and the associated social interactions for children in the fall, however, promises a lot.

“He rarely romps in school,” said Lucie of her 9-year-old son.

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