Mental Health of Children

The corona virus and the mental health of children. These were, and continue to be, the strangest days of our lives. We have never experienced the whole world united in fighting a killer disease. We have no experience of this kind of situation. Previous viruses of this nature seemed to arrive and disappear, but in other parts of the world, not in Europe. Not on our doorstep. Times change and this is a massive wake up call to deal with this one and to be better prepared for the next one. It has affected every person. We have had to radically change our daily routines.

We can no longer intereact with other people like before, including close family members and friends. At best, we can work from home where possible. Many have lost their jobs or are thrown into great uncertainty. We all salute the health workers and everyone linked to that activity who are risking their lives every day to take care of the sick.

A closer look at the mental health of children

In many ways, in The Netherlands we are lucky. The ‘soft’ lockdown we are coming out of left us many freedoms. Things are now being relaxed, but we are now in the ‘new normal’ for the coming months. However, we will also be dealing with the mental health repercussions for many, many years. This is very true for the adults under more strain at work and financial pressures at home. But what about all the children and adolescents and their ‘new normal’ ?

As the schools start to reopen, many children will be looking forward to returning. They have been at home a long time. If they have a strong family unit that is organised and disciplined to home school, this can work. But what if they do not, as if often the case? Is the strain on the parents causing too many rows and tension at home? Are the young people scared of infecting their grandparents? How are all these tensions affecting the mental health of young people at this time? And what can we do now to be aware of the causes, in order to reduce issues in the coming months and years?

Better understanding

In order to understand better what issues are most affecting the mental health of children and the youth in these difficult times, I asked some questions of Clint Steenveld. Clint is a psychologist in Amsterdam and he has been helping the expat community for years with a wide range of mental health issues. One of the areas he is very experienced in helping expat families and children, specifically in the areas of loneliness, isolation, anxiety, grief, anger and role changes at home. You can find his details at the end of the article, but for now here are some questions I asked him. The answers will be useful for many parents.

Hi Clint. I know you are a busy person. Thanks for taking the time from your schedule to answer my questions.

Q1. These have been difficult days, especially for children and adolescents. What simple steps can parents take moving forward, in order to alleviate the strain on their children ?

Develop a routine for week days and weekend days that fits your schedule and aligns with the children’s educational and developmental needs. Ensure you include some free playtime, quiet time off-screen (reading, resting, napping, but no screens) as well as movement time (this can be structured movement such as dance steps or a semi-formal game with a ball or semi-structured so that your child has some creative freedom with their body movements). It can also be helpful to have a complaints and compliments notice board or even a suggestion box for the household that gets looked at once or twice a week by everyone.

Ensure your children get enough sleep and are eating well-balanced meals. Meal times could be turned into creative interaction moments with your children if you include them in things like choosing a recipe or dish to make, meal preparation, setting the table in creative ways (by giving them basic guidelines and then letting them decorate or set the table according to their ideas for seating arrangements, etc.).

For the Parents

Ensuring you as parent have little moments of time away from your children. Parents can integrate this into your own daily routine, e.g. walking the dog, going to the store, taking a shower or even 3-5 minutes after you get out of bed or switch the light off at night to go to sleep. Another simple technique is to take 2-3 deep, long, conscious breaths before you start your day, or exit the bathroom, or enter a room. This little strategy is also something you could teach your children. Tiny moments of conscious pausing can go a long way to bringing everyone’s stress level down.

And allow yourself and your children to have mini, manageable freak-outs (not quite a tantrum, although those may happen from time to time and really should be a rarity) from time to time.

Q2. As parents, what behavioural signs should we be aware of and able to identify in our children, in order to address issues early on with the mental health of children ?

Firstly, always consult with a health professional if you are uncertain. Do not attempt to diagnose your own child. Next, aim to keep yourself in check and steer clear of hysteria, while checking facts and working with common sense.

Changes – an increase or decrease in various behaviours and functions- is generally what you need to look out for. These changes need to noticeably different to you or anyone else who spends significant time with them, or even to your child. The changes also need to be sustained for longer than just a couple of days to a week (depending on the acuteness and severity of the change) before you start thinking something is really wrong.

Look for certain signs

Things to be on the lookout for are: sleeping and eating patterns; bodily functions, e.g. toilet habits; level of activity and stillness; degree of interest, pleasure and engagement or disengagement from tasks, activities and people; amount of time spent on-screen as well as off-screen; emotional expression and range of expression (much more than usual, much less than usual); degree of curiosity. Schoolwork, sport and extramural activities are also areas to look for changes.

Aches and pains are another sign of potential problems: headaches and tummy aches are the most common in children. Of course, you need to have these kinds of things checked out medically if they’re persistent, severe and start interfering with the child’s functioning. Other common physical signs of stress in children: rashes, frequent colds, falling more often than usual.

Lastly, if you or your children have gone off-piste a bit from the usual, try to gently coach yourself and them back again. When in doubt, course-correct. If you cannot do so or the problem behaviour, sign or symptom becomes worse or is persistent, then you would need to consider professional support.

Q3. Can you recommend activities that parents and their children can do together to lighten tense atmospheres at home ?

Play games together.

Cook.

Exercise.

Create fun playlists and have a dance party.

Hug pillows and stuffed toys if you’re feeling overwhelmed. This activity is about soothing and self soothing: bringing yours and your children’s stress level down a few notches.

Meditating together. There are some great options for children that are easy to find online.

Gardening together.

For older children/adolescents, time spent with peers is important, so ensure your child or teen has sufficient socialising activity planned into their weekly routine.

Learning a few words of a new language together in an informal and fun way.

Finding things that you and your children enjoy, based on everyone’s personalities.

Resting together.

Q4. As grown ups, what can we do to improve the general situation at home? In these strained times, how can we be more patient and understanding regarding the mental health of children?

Observe as much as you are striving to manage and function. This gives you the information about yourself and your children to determine what to do: nothing, something or a combination of both.

This time is good to teach yourself and your children about change and about surrendering control. I think of the “serenity prayer/motto” here: To accept the things I cannot change; Courage to change the things I can; And wisdom to know the difference.

The 4 A’s of stress management could also be a helpful guide:

– Avoid:

planned, time limited avoidance of difficult things is healthy for the mind. At some you do need to return to address serious problems. Don’t sweat the small stuff. Distraction and escapism are valid, but not for too long. Never avoid addressing an acute, serious problem or any problem that impedes the running of your life.

– Alter:

Change and control or manage what you can, where you can. Make adjustments. Doing the same thing repeatedly will only get you the same results and keep you stuck. Get help if necessary – from books, talks, webinars, youtube videos, friends, family, professionals, etc.

– Accept:

What you cannot change and that some things are beyond your control.

– Adapt:

Develop a new mindset, acquire new skills, broaden your perspective, change your routine, find a new daily rhythm. All of this means you are allowing yourself to evolve with the situation.

Q5. Which long terms effects have you identified that parents should be aware of in their children ?

Persistent, disruptive changes in sleep, eating/appetite, play, interests, moods, choices and general behaviour towards self and others.

The emergence of nail biting, bed wetting, new fears or phobias, soiling, disrupted routines like brushing teeth, bathing and such

The new occurrence of nightmares or night terrors that could also manifest as a child wanting to be cuddled much more or much less (bearing in mind that as a child gets older, they may not want to be cuddled any longer), especially at night time, wanting to sleep in the parents’ room or bed, or a sibling’s room or bed, fear of going to bed (sometimes expressed as fighting going to sleep or defiance at bedtime).

Persistent refusal to get out of bed in the morning (outside of the usual resistance a child may display).

Increased desire to play video games, watch youtube videos, etc. (increased screen time, generally). There may naturally be a tendenc.y towards more screen time during this time. Some of it is expected, but if it starts to interfere with the child’s routines and functioning, that usually means something is going on that the child may be trying to ‘self-medicate’ or escape from.

Thank you Clint for these extremely useful insights into the mental health of children and your time. These are indeed strange days and we all have a role to play. Identifying the causes of stresses and strains at home can be useful in order to reduce their negative effects. Thank you again for your insights, which will be very useful for all families during these difficult times.