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The pandemic has taken a big toll on the mental health of children


Remote learning, isolation, the loss of loved ones and just a general disruption to their lives - all of that is exacerbating the mental health challenges facing young people. It prompted U.S. Surgeon General Vivek Murthy to issue an advisory last month, highlighting what he calls an urgent public health crisis. Speaking to NPR, he told us why.

VIVEK MURTHY: Before the pandemic, 1 in 3 high school students reported persistent feelings of sadness or hopelessness. That's a 40% increase from 2009 to 2019. In a similar time frame, suicide rates went up 57% among youth 10 to 24. And we've also seen that during the pandemic, the rates of anxiety and depression have gone up. So I believe that this is a critical issue that we have to do something about now.

MARTÍNEZ: Dr. Nadine Burke Harris agrees. She's a pediatrician who has long advocated for children's mental health. She's also California's first surgeon general, appointed back in 2019. Doctor, welcome.

NADINE BURKE HARRIS: Thank you for having me.

MARTÍNEZ: Now, medical groups such as the Academy of Pediatrics - they've issued a state of national emergency in children's mental health, noting a dramatic rise in emergency room visits. What kinds of emergencies are we talking about?

BURKE HARRIS: Yeah, what we're seeing is increased rates in depression, anxiety. We're also concerned about suicidality, self-harm, things like that. We are definitely seeing increased rates of substance use and misuse among teens. So all of these things are certainly a significant worry.

MARTÍNEZ: When it comes to suicides, too - I mean, that - for any parent, any grandparent, anyone that has a kid somewhere in their orbit, I mean, that has got to be absolutely terrifying to know that's happening.

BURKE HARRIS: Yeah. I mean, it's certainly a concern, right? But the thing I think that's really important is that when we understand what is driving these increases, then we can use that understanding for prevention. And that's what we're very focused on doing here in California.

MARTÍNEZ: What are some of those reasons?

BURKE HARRIS: Well, a lot of what we know about how our experiences and environments can impact our mental and physical health comes from a big research study from the CDC called the Adverse Childhood Experiences study. And what that shows is that activation of our stress response, which a lot of us are experiencing now during the pandemic, can actually affect the way children's brains develop and put them at greater risk for developing both mental and physical health conditions. But it also tells us that safe, stable and nurturing relationships and environments are healing and that they can help the body biologically be able to weather these stressors in a way that is much more healthy for kids in the long term.

MARTÍNEZ: And, Doctor, how is that different - that trigger - that brain trigger that you mentioned? How is that different in children as opposed to adults? Can adults handle it better or kids maybe not know what they're dealing with?

BURKE HARRIS: Well, children's brains and bodies are just developing. So when children experience high doses of stress and adversity, it can actually change the way their brains develop. That's why putting these resources in place to support safe and stable, nurturing relationships and environments are so important. And that's also why early detection and early intervention leads to much better outcomes because kids have the benefit of what we call neuroplasticity, the ability for one neuron to make a new connection to the next neuron. So we can use that for healing.

MARTÍNEZ: All those things that have been limited or, in some cases eliminated, because of the pandemic, things that have left children by themselves to try and figure things out, and a lot of the times no one can get to them - a mental health professional, a teacher. Anyone that has experience with this can't get their hands on them or their eyes on them to see, OK, they might be dealing with an adverse childhood experience that we need to help right away.

BURKE HARRIS: And that's why everyone in a child and young person's environment needs to be aware and understand how adverse childhood experiences may be impacting kids. And that goes from educators to law enforcement officers and the person doing the checkout at the grocery store. Because what the data shows is that just as the experiences of adversity can accumulate to increase risk, the experiences of nurturing, buffering care add up to protect our kids.

MARTÍNEZ: So there is hope then. Or is this damage at all somewhat permanent in some cases?

BURKE HARRIS: No, there is plenty of hope. The science is very clear on this. Early detection and early intervention, nurturing relationships and other buffering care interventions can lead to healing. And that starts by just recognizing what's going on, checking in with our kids, seeing how they're doing - so tuning in. But that safe and stable relationships and access to high-quality mental health care are also critical.

MARTÍNEZ: Now, states such as a Maryland, Wyoming, Utah - they're all trying to raise awareness of adverse childhood experiences or do something about them, as well. As the surgeon general of California, Doctor, you're building an infrastructure that you hope others will replicate. What has California done that's different?

BURKE HARRIS: Well, California began even before the pandemic. Our efforts were very timely. In January of 2020, we launched a first-in-the-nation effort to train over 20,000 health care providers in California to screen for adverse childhood experiences. And in fact, in California, the Legislature passed a law, which was signed by the governor last year, that required private health insurers to cover screenings.

MARTÍNEZ: Now, Doctor, you're a parent. I'm a parent. I'm a grandparent, too. What advice can you give all of us on how to help children through these times - how to spot things, how to just make sure that kids are getting what they need right now when they really need it?

BURKE HARRIS: So, you know, what I'm going to say is a little counterintuitive. But as a mom of four boys and a pediatrician and a researcher, one of the things that the data tells us is that in order to be available for our kids, we need to put our own oxygen mask on first. Self-care is not selfish. So we do need to care for ourselves, and that's what makes us available to tune in to our kids so that we can be available. Because the science is very clear on this. These nurturing relationships really are healing.

MARTÍNEZ: That's Dr. Nadine Burke Harris, California's surgeon general. Doctor, thank you.

BURKE HARRIS: It's my pleasure.


MARTÍNEZ: And if you know someone who is having thoughts of suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255.

(SOUNDBITE OF FELBM'S "HERAUSWEH") Transcript provided by NPR, Copyright NPR.