What to know about the pandemic’s mental health toll on young people

Mental health experts say watch out for changes in behavior and listen

On Dec. 7, U.S. Surgeon General Vivek Murthy issued a public advisory on the emerging crisis of youth depression. “The pandemic era’s unfathomable number of deaths, pervasive sense of fear, economic instability, and forced physical distancing from loved ones, friends, and communities have exacerbated the unprecedented stresses young people already faced,” he wrote in a 53-page report, citing data from the CDC showing that, in early 2021, hospital emergency room visits for suspected suicide attempts nationwide were 51% higher for adolescent girls and 4% higher for adolescent boys compared to the same time period in early 2019.

Leading into the pandemic, there was already a rising sense of worry about teen depression and suicide rates. Data from kidsdata.org shows that in San Francisco, between 2017 and 2019, over 27% of students in grades 9 and 11 reported having suicidal thoughts.

Nationwide, there was a 31% increase in mental health-related ER visits among adolescents — 12 to 17 years of age — in 2020 compared to the previous year.

At a recent briefing, Michelle Doty Cabrera, executive director of the California County Behavioral Health Directors Association, said that several counties in California reported a twofold and threefold rise in the number of people in acute mental health crisis during the pandemic.

Shockingly, Cabrera also revealed, “We have children as young as 8 years old who have been hospitalized due to suicidal ideation.”

Who is at risk?

Mental illness has a complicated landscape. Suicide is the second leading cause of death for youth and young adults between 15 and 24 years. The risk of suicide spikes during adolescence and more boys than girls commit suicide, but more girls than boys have suicidal thoughts.

Children and youth from minority and marginalized populations are often more at risk than others. According to KidsData, 30% of Black SFUSD students expressed depression-related feelings, the highest among all racial and ethnic categories. The study also showed that more than half the students from the LGBTQ+ community felt anxious and depressed.

Exposure to trauma

“This move to distance learning and social isolation and shelter in place stripped away the very tools that Black families and youth historically leaned upon to survive,” said LaTonya Wood, director of clinical training at Pepperdine University. In addition to grappling with grief and loss of life, educational gaps widened and barriers to accessing care grew. Nationwide shutdowns caused loss of income and food insecurity and the racial unrest during the summer of 2020 added to the experience of trauma among Black youth, she added.

Cabrera noted that while not all children who experience trauma have a mental illness, children who have experienced significant levels of trauma, “including the emotional toll of racism, are vulnerable to experiencing anxiety, depression and PTSD, which can result from these experiences.”

The Asian American chasm

Commenting on the Asian experience, San Francisco–based family therapist Ulash Thakore-Dunlap said that “being blamed for the spread of COVID” and either witnessing their parents or members of their community being verbally or physically abused, or dealing with racially motivated attacks themselves, have left many Asian youth feeling anxious and troubled.

Among Asians, culture and language problems are deterrents to seeking help. “There is shame and stigma in accessing services,” said Thakore-Dunlap, citing a national Latino and Asian American study, which found that 18% of the general population sought mental health services while only 8.6% of Asians sought counseling services in 2021.

The problem lies on both sides of the mental health chasm. Asian parents and children hesitate to seek help, and there are not enough Asian American psychologists and psychiatrists who understand the cultural, linguistic and social norms of Asian experiences.

Among the private providers listed on the Behavioral Health Services site in San Francisco, a city with 35% Asians, only one out of the nine providers speaks an Asian language (Cantonese).

What should parents look out for?

Watch out for changes in behavior, said Gabii LeGate, director of operations at Blossoming Minds in the Bay Area. “If your kid usually enjoys watching TV with you or talking with you in the evenings after dinner and they don’t anymore, or if they are not eating dinner with you guys; if they say they’re not hungry or already ate, that could be a sign,” she said, adding that she did not want to ring alarm bells unnecessarily.

Sudden changes in personal appearance or attire are reasons to be more observant, said Wood. “Peers are usually the first ones to know what is going on,” so check in with your children’s friends occasionally, advised Wood.

Unexplained bruises and Band-Aids should be a red flag for parents, remarked Thakore-Dunlap. Self-harm is a coping mechanism, so watch out for your children cutting themselves, she cautioned, adding that this is a moment in an ongoing crisis when parents need to be given resources to cope with a changing world, both for themselves and their children.

And, if an adolescent says they are struggling, take it seriously, emphasized LeGate.

How do we move forward?

Most critically, we need to normalize conversations around mental health among parents and children.

In 2017, I sat in on a group counseling program organized by Huckleberry Youth in San Francisco. A student related a story about a fellow student going through depression.

“We never noticed until like last month and she was acting really weird and all that stuff, so the school decided to call an ambulance and they took her. She’s been in the hospital for more than a month and … we just don’t know what happened and she doesn’t share anything.”

Notably, no one reacted to the term “acting weird” to describe a student in the throes of a crisis, and how easy it is for us to accept that a person in crisis “doesn’t share anything” with others. Both speak to the heart of how mental illness is so profoundly ostracizing and alienating and how ostracized and alienated people develop mental health issues.

Jaya Padmanabhan is a journalist, author and director of programs at Ethnic Media Services. Twitter: @jayapadmanabhan.

Why a Real Emotional Support Animal Letter Matters.

The popularity of an Emotional Support Animal has grown rapidly in recent years, with pet owners claiming their furry friends…

By SF Examiner
Robbed shopkeeper says San Francisco is so broken it needs Batman

The Deli Board’s Adam Mesnick is sick and tired of SOMA crime

Redwood forest in California is returned to native tribes

523 acres will be transferred to 10 tribes whose ancestors were forcibly removed from the land