TAMPA, Fla. — As we near the two-year mark of the pandemic, doctors say a national emergency declaration in children's mental health made just six months into the pandemic is now a crisis in full effect.
“I can tell you, without a doubt, that the majority of our hospitalizations during the omicron surge in adolescents were not for complications of actual COVID infection, they were for behavioral health concerns,” said Dr. Christina Canody, Medical Director for the BayCare Health Systems Pediatric Service Line.
Many of the adolescent intakes at BayCare were for suicidal ideation as well as severe anxiety attacks, Canody said.
“January was the busiest month we've had on record for COVID hospitalizations and pediatrics within BayCare. It was more than double any previous month to date, and the entire month of January was busier than the entire surge of delta put together,” Canody explained.
"During each month with a surge of COVID, BayCare experienced an average of 25-50% increase in emergency department visits for adolescents with behavioral health emergencies,” she added.
The crisis is the result of a number of factors.
Schools went virtual for months, some districts carried out distance learning for the rest of the year, and even began the 2021 school year virtual as well. Many children and teens became isolated from friends during online learning.
While Florida’s pandemic shutdown for establishments and businesses was much shorter than most other parts of the country, many normal activities for kids and teens changed drastically.
ABC Action News found grades suffered for many students, especially in mathematics.
In addition, adolescents are greatly impacted by their environments. During the pandemic, parents lost jobs and housing; they stressed over paying the bills and family health. Children feel those mental weights in the home as well.
“Many of the things that our children are now dealing with — school, jobs, losing parents, losing family members, losing classmates, the news, ever-changing world, we didn't have those things when we were growing up,” said Natasha Pierre, Dean of Mental Health at the Institute for Leadership and Lifelong Learning International.
“So the fatigue that adults are experiencing, is also felt by our children, yet they lack the life experience and the vocabulary to articulate exactly what they're feeling,” she went on. “So how is it coming out? It's coming out in insomnia. It's coming out with them wetting the bed, it’s coming out with aggression and with apathy to many of the things that they enjoy.”
At BayCare, Canody said they do a mental evaluation on any child that comes in for any reason.
“I've seen an increase in the amount of kids with chronic headaches and chronic abdominal pain and drop in their grades at school and behavioral problems, and all of it can be traced back in some way shape or form,” she said.
“For those that don't have great coping mechanisms, or don't have what we call a really good emotional IQ — which is being able to be in touch with who you are emotionally and your aptitude for understanding your thoughts and feelings… they don't have the tools they need to address that increased anxiety and truly deal with the higher stress level,” Canody added.
One local family therapist attributes a large part of the current crisis to what she calls “social interests.”
“It’s a separation from society,” explained Emalee Gabriel with Gabriel Counseling. “The antidote for depression is thinking about others.”
Gabriel said children aren’t thinking about others because they haven’t had to while isolating at home or in their small communities.
“They aren’t being taught how they contribute to the world,” she went on. “Getting outside of your head. ‘How can I contribute?’”
Instead, she said, she’s seeing a lot of 13 and 14-year-olds with the mindset, “‘How am I gonna be a superstar? A TikTok star? The most popular?’ “Oh, I’m not like that? Then I don’t like me.”’
Even younger children are significantly behind on how to interact in society.
“For a lot of them, they haven't spent a lot of time out in the world. Many of them came in from daycare, their parents were working from home, they just don't have the social skills that we saw in previous youngsters simply because they haven't had those exposures,” Canody explained. “And now, when they're going out into the world, people are masked. They don't have as much facial expression and they can't really make that relationship.”
When any person is admitted into the emergency department on a behavioral health issue, Canody said they are treated and then staff determines their next step of care, whether they need to be transferred to an institution or connected with other resources.
However, in just the last two months, Pierre said she’s had to help four families get their teenagers into mental health treatment. When it comes to mental breaks as serious as suicidal thoughts, Pierre said the state of Florida doesn’t have enough programs to help teens in the long run.
“Sadly, the state of Florida just doesn't have the capacity for the need and so there are some that were able to get into some programs, but those programs are really just a bandaid,” Pierre said. “They're a temporary, stabilization, and that’s it. Stabilization means ‘We deem you no longer to be a danger to yourself or others and so we're going to send you back home,’ but you're going home without the skills, without the understanding, without being able to participate in your own recovery.”
Pierre said many of the therapists and mental health professionals she is in contact with are working 12 to 14 hour days to fit in as many clients as they can, and they have waitlists.
“But people need services now,” she said. That’s why she joined First Unity in St Petersburg. “At First Unity, we have various support groups that could be a way for people to cope, and to get some hope until they can see a doctor until they can get to their therapist.”
An article in the American Psychological Association calls attention to a significant shortage of children’s mental health resources, stating, "Only 4,000 out of more than 100,000 U.S. clinical psychologists are child and adolescent clinicians, according to APA data."
According to research by the Claude Pepper Center at Florida State University, “Florida has long maintained one of the lowest per capita mental health expenditures in the nation.”
The report states, “According to the most recent available data, (2002-2013) Florida has a SMHA per capita mental health services expenditure of $37.28, giving it a rank of 49th for mental health funding in the U.S.”
Governor Ron De Santis and First Lady Casey DeSantis allocated more funding to mental health in the state’s budget last summer — $137.6 million to community-based services and $3 million into the 211 crisis help-line and crisis network.
Schools received more than ever before. The Florida Department Of Education shows the increases from $75 million in 2019-2020 to $100 million in 20-21 and $120 million this year.
Hillsborough County Public Schools (HCPS) said they received about $8 million more.
“We've tried to use that to support our schools the most we can,” said Michael Kelleher, Supervisor of Clinical Care with HCPS. “Whether it's adding additional social workers or counselors, we've actually in over 100 schools have added a mental health therapist to help those students on campus there.”
One thing everyone agrees on from pediatricians to therapists is the role a parent can play in helping their child.
Canody urges parents to pay attention to any changes in their child's behavior such as withdrawing from friends and activities or only spending time on social media and not talking in person. Ask questions. Call your pediatrician, many of whom are now incorporating mental health questions into their checkups.
“This is not the time for us to stick our head in the sand and hope that you know, they'll come around. They'll love sports once again, they’ll want to hang out with their friends once again,” Pierre said. “This is a time for the courageous conversations. ‘Tell me what's going on. How do you feel?’” Pierre advised. "There might be in some indicators of where parents can provide greater support.”
Parents anywhere can also call 211 Tampa Bay Cares to be connected with a crisis hotline and get help or advice.
Another free resource in Tampa Bay is nonprofits like Champions for Children.
“We offer developmental screening for children under the age of five. So not only are we looking at their cognitive ability, and do they know their letters, and are they speaking at the level that they should be talking at, but we're looking at their social-emotional competence,” said Champions for Children Executive Director Amy Haile. “We are here to wrap that family around with additional activities and support and education to make sure that those strong connections between children and the adults in their life is as strong as possible.”
If you have a college student who may need mental health help as well, LEAP Tampa Bay College Access Network launched a website, YourCollegeCares.org, to connect college students to mental health resources.
In addition to their on-campus resources, the site also connects young adults with resources available through providers in Hillsborough, Pinellas and Pasco counties.
You can read more about this and suggestions for how you can help from the American Academy of Pediatrics here.
