Amara Bhatia is now free from the pandemic depression she suffered, but the teenager feels worn down and in a state called "neutralness." Virginia Shipp is also adjusting, but admits that returning to normal is "kind of unnormal" for her.
Many children are now feeling the effects of the pandemic or confronting new challenges in reentry after months of social isolation, online schooling, and other restrictions.
Children's Hospital Colorado declared a state-of-emergency in May due to a rise in suicide attempts among teens and other mental health issues. Inpatient beds and emergency departments were overwhelmed with children with suicidal thoughts and others with other mental disorders. Jason Williams, a pediatric psychologist from the hospital in Aurora, stated that in May, the average waiting time for psychiatric treatment in an emergency department doubled to around 20 hours.
Similar challenges are faced by other children's hospitals.
Even the most resilient children can find it stressful to attend finals, proms and summer job-seeking as they come to an end of the school year. Williams stated that many children are exhausted after dealing with the pandemic restrictions for more than a decade and don't have enough resilience to deal with stresses that were previously manageable.
"When the pandemic hit, we saw an increase in severe cases of crisis evaluation," as children struggled with "their entire world shutting down," said Christine Certain, a mental counselor at Orlando Health's Arnold Palmer Hospital for Children. "Now, as the world is opening up, it's asking these children to make a big shift again.
Some children's hospitals have had a steady increase in psychiatric patients throughout the pandemic, while others have experienced a recent spike.
According to Terrie Andrews, a hospital psychologist, the number of behavioral unit admissions for children in crisis aged 13 or younger at Wolfson Children's Hospital in Jacksonville, Florida has been rising since 2020. They are expected to rise to 230 this year. This is more than four times more than in 2019. Admissions for older teens were five times more than usual last year, and they remained elevated last month.
Admissions to the Dayton Children's Hospital's mental health unit increased 30% between July 2020 and May 2019, totaling nearly 1,300. According to Dr. John Duby (a hospital vice president), the hospital increased the number of beds available to 24 and decreased the minimum age to receive treatment to 9 from 12.
Amy Knight, President of the Children's Hospital Association, stated that "the overwhelming demand for pediatric psychological health services is putting a strain on pediatric facilities and primary care schools as well as community-based organizations that support children's well-being."
Dr. Alison Tothy is the medical director of the University of Chicago's Comer Children's Hospital's pediatric emergency department. She said that her ER has seen children in crisis every day since last year. They are suffering from suicidal thoughts and self-harm behaviors like cutting, depression, and aggressive outbursts. Children are stabilized and referred to other treatment.
"Families come to us because, in some cases we are the last resort." She said that outpatient resources are limited and that parents can't get appointments for up to two months.
Andrews stated that Florida has longer wait times for outpatient care and that many therapists won't accept children who are covered by Medicaid.
Children's Hospital Colorado saw an increase of 90% in behavioral health issues emergency department visits in April 2021, compared to April 2019. The number was also up in May. Although the pace was slower in June, hospital officials are worried about another spike once school resumes.
Williams stated that the hospital treats all types of mental health problems, from children who have had previous mental health problems that have gotten worse to people who have never suffered from the pandemic.
Williams stated that Colorado, like many other states, doesn't have enough therapists for children and teens. This is a problem even before the pandemic.
Outpatient treatment is often required by children who are in need of it. It can take six to nine months to schedule an appointment. Many therapists aren't willing to accept insurance so families in financial trouble have few options. Children may end up in the ER because of delays in getting treatment.
Williams stated that those who have improved after receiving inpatient psychiatric treatment but aren’t well enough for home are being sent out to Colorado because there isn’t enough Colorado facilities.
Sampson claims that he was overwhelmed by too many things last August, which led to his first crisis. The teen from Jacksonville, Florida struggled with online education. He spent hours alone in his bedroom scrolling the internet and playing video games.
A friend saw his thoughts and called the police. He was admitted to the hospital for psychiatric treatment and stayed there for a week.
His parents worked in mental health, but he didn't know how he was feeling.
We realized that he was spending more time alone, and not showering or doing other things. But we were still in the middle of a pandemic. Jennifer Sampson, his mother, said that no one was doing these things.
Although the teen tried virtual psychotherapy, his self-destructive thoughts returned in March. His mother recalls that he was denied treatment at the hospital psychiatric beds. He waited for a week in a waiting area before he could receive treatment.
He's now on mood stabilizers and continues therapist visits. He also finished his sophomore year. He is excited to return to in-person school this autumn. He admits that it is difficult to get out of bed to exercise or meet up with friends.
Sampson stated, "I find my social skills are definitely rusty."
His mother stated, "I feel like this is something that we're going to have to deal with for quite some time."
This is true even if you haven't reached crisis level.
Bhatia (17-year-old) is a self-described "stereotypical introvert" with severe anxiety. She also worries about her senior year in school.
According to the Oakland, California teen, the pandemic started as a welcome surprise. It takes work to be social, so she was able to recharge in isolation. Despite her struggles with depression, she was able to reconnect with her friends and get frustrated by virtual school.
She was once a hugger, but she has now become "a bit less of a germaphobe" and claims that the few times she has been hugged since social distancing restrictions were lifted, she froze.
She says the pandemic has worn her down. "It's like running a marathon and I'm finally at the end. I'm just getting tired at this point."
She said, "I don't think I have the energy to be happy."
Shipp (18 years old) was also from Oakland when the pandemic struck in her senior year. She was planning a trip in Europe and anticipating going to college in the fall. She described 2020 as a year filled with negative thoughts, and said neither happened.
She said, "I felt anxious and depressed. I was very afraid for the future."
She wanted to march with protesters against George Floyd's murder as a Black woman but she decided that close contact with strangers was too dangerous.
Shipp doesn't know of anyone who was very sick or died but she worries about COVID-19 every day. Shipp also used meditation to relieve stress.
She was recently vaccinated, and she learned that Cal Poly Pomona will host college in person this fall. She's still not 100% ready.
It's still strange, but now you don't have to wear the mask. Shipp described it as "jumping into the water too quickly". "The normalcy for me is kind of unusual."