Student Suicide Cluster in Las Vegas
Disease containment procedures for COVID-19 included moving education to a virtual platform. In order to mitigate the risk to teachers, students and minimize community spread, schools across the country closed their doors. In the wake of these changes, there was a spike in suicides among students within the Clark County school district. It was a tragic microcosm of a disturbing national trend. An article in The New York Times vividly captured the painful details of the 18 student suicides that occurred over the nine-month period of school closures in Clark County, Las Vegas.The fifth largest school district in the country, feeling the urgency of the situation, began making plans to re-open their doors to in-person learning.
Emergency Response System
In response to the rise in student suicides, Clark County launched an emergency response system on its school-issued iPads. The system was designed to identify worrisome searches or concerning language. This was an effort to be preemptively find students who may be in crisis or at risk of suicide. For example, a 12-year-old searched “how to make a noose” on his iPad. This led to prompt notification of his father, who then went to the boy’s room and found a noose made of shoelaces around the child’s neck.
The Mental Health Fallout From COVID-19
The year 2020 ushered in abrupt and unforeseen changes to daily life as a once-in a-century financial and health catastrophe was unleashed on the planet. The coronavirus pandemic set in motion stay-at-home mandates in over 200 countries across the globe. This meant lockdown and social distancing for billions world-wide, including nearly all of the 55 million American children from kindergarten through 12th grade.
Impact on Children
The pandemic is not over, and the full scope and scale of the consequences of it have yet to be fully understood. However, within the first year, studies regarding the mental health fallout of COVID-19 have revealed an ominous picture of the psychological effects on children. Because children are still developing, their worldview and perception of themselves are still unformed. Part of how children come to an understanding of themselves is through their environment. A child will perceive themselves as good when an adult smiles at them when they walk into the room or rewards them. For children, the world is a mirror and their identity is shaped, in part, by what is reflected back at them. Now imagine that the mirror has been shattered. What happens then? Children who quarantined during the pandemic are significantly more likely to suffer from:
Acute stress disorderAdjustment disorderGrief
Furthermore, up to 30% of children in areas with social distancing mandates experienced symptoms consistent with post-traumatic stress disorder (PTSD). These children were also more likely to experience depression, anxiety, and sleep and appetite disturbances.
Why Children Have Been Affected
Extensive research shows that fear is contagious, and children are particularly sensitive to the emotional state of others and the adults around them. Adults are typically the source of emotional stability for children. However, the pandemic upended the security of many parents due to employment uncertainty and illness that impacted so many American households.
Abrupt Changes to Living Situations and Daily Routines
For some, the changes to life as we knew it led to separation from one or more parents or parental figures due to disruptions in co-parenting arrangements, death, or concern for exposure to the virus. Separation from parents is shown to correlate with likelihood of mood disorders, psychosis, death by suicide, and poor mental health outcomes overall in adulthood.
Financial Strain and Domestic Abuse
In some households, quarantine resulted in more close contact with family. This, in addition to a surge in stress and financial strain, increased violence and abuse in the home setting for many families. One study reported a tripling of domestic violence incidents during lockdown. There was also a precipitous increase in child abuse, mistreatment, neglect and gender-based violence. Fifty percent of parents admitted that concerns about money during the pandemic have affected their parental skills, including a rise in aggressive behaviors towards their children like yelling and slapping. A notable increase in substance use during the pandemic, particularly alcohol, is possibly a contributing factor to negative changes in parenting.
The Absence of School
As students entered their second year of disrupted schooling, many experienced academic uncertainty, boredom, and either decreased or no contact with their peers. The academic consequences are likely to be greater for those from a lower socioeconomic status. Decline in Children’s Nutrition Due to Food Insecurity It’s important to consider the importance of what school provides outside of just an education. For certain families, meals provided at schools make the difference between being food insecure or not. Therefore, many kids went without meals or saw the nutrition and quality of their meals decrease during remote learning. Pediatricians noted a sharp increase in the weight of children during quarantine. This is believed to be due to the limited access to whole foods and an increase in cheaper foods or carbohydrate-heavy sweets. Emotional eating as a self-soothing mechanism and decreased physical activity also likely played a role. Lack of Health Services Many schools are the main source of health services for their students, including mental health services. For some, school is the primary or sole source of psychological interventions and mental health information. In fact, up to 57% of such communities access mental health services only from the school setting. During quarantine, children went without those benefits, with racial and ethnic minorities being disproportionately affected by this problem. Psychosocial Benefits of School The psychosocial aspect of the school setting can also not be overstated and, for most, the home cannot replicate these benefits. Play with same-aged peers is crucial to psychological development. Impact on Younger Children While a child might have been engaging with siblings and parents during lockdown, the significant difference is that those are hierarchical relationships. Parents are either in service of their children or telling their children what to do. Likewise, within sibling relationships, there is an age-based power differential, with the older sibling usually taking a leadership role, or the younger sibling being indulged. Within the average household, there are no true peer relationships. Think about how it would be for you, as an adult, if everyone around you was either subservient to you or in a supervisory role. There would be emotional and mental aspects of yourself that would be unchallenged and underdeveloped. Parents have been known to discourage a child’s craving for acceptance of their peers. However, wanting acceptance to a social group in school is developmentally appropriate and actually has benefits. In the home environment, your acceptance into the fold is a given awarded to you as an accident of birth. You don’t have to compete for it. Competing for acceptance among others who are your equal is what instills in us all those behaviors and tendencies associated with being a well-behaved citizen. In peer relationships, the child is incentivized toward emotional regulation. They learn to control their behavior as they are challenged by activities that include sharing, helping and waiting their turn. As young people develop the skill set needed for those things, they are rewarded with belongingness. It is within peer relationships that children learn patience, kindness and civility. They also learn the ability to self-soothe as emotional dysregulation will probably lead to social exclusion. As a result of social distancing, children had to go without all of those foundation-forming fundamentals which were previously taken for granted. Impact on Teens Teenagers were also separated from their peers. The ages between 12 and 18 are identified by the developmental psychologist Erik Erikson as the identity versus role confusion stage. Many of us recall these ages as awkward and excruciating, but navigating the social challenges of middle school and high school builds resilience and strengthens one’s identity.
Children Are Spending More Time on Their Phones
During the enforced social distancing mandates, many young people had a dramatic increase in their screen time. This meant watching a crisis develop in real time on the news, including reports of illness and death, and fear and worry caused by the unemployment crisis. It also meant access to social media containing conflicting stories and aggressive rhetoric. Social media is also a platform for cyber-bullying and place where kids compare themselves to the seemingly “perfect” lives of others, both of which can contribute to anxiety and stress.
Challenges Specific to Children
As young people have limited coping strategies, they were naturally unprepared and unarmed to deal with the dramatic and sudden changes brought on by a pandemic. They also, depending on their age, have limited language with which to express their pain and confusion. An inability to fully express the psychological turmoil one is experiencing is an added frustration.
Feelings of Hopelessness
Children tend to be more “in the moment” and focused on the present. This is sometimes what adults envy most about children, but during a global catastrophe, this is a huge disadvantage. An inability to picture life beyond the pandemic left many children feeling hopeless. This also meant being unable to imagine healing from the depression and negative feelings that COVID-19 brought on for so many. Unfortunately for some, the inability to imagine a better future made suicide feel like a viable option. One of the Clark County students who ended their life left a note in which he wrote, “I have nothing to look forward to.”
How to Take Action
So, what do we do now that widely-available vaccinations have slowed the spread of the virus and things are opening up? Certain actions are being taken to repair or undo some of the damage wrought by the coronavirus, Improving access in the community to the mental healthcare services previously provided for by schools is now a priority. Clark County, for example, has made virtual counseling readily available to its students.
Early Intervention
Early intervention procedures and social services for children known to have pre-existing psychiatric diagnoses are needed. This is particularly true for households in marginalized communities, as statistics show this population is especially vulnerable. As we learn about some of the psychological devastation the COVID-19 pandemic has caused children, becoming proactive makes clear sense moving forward.
Resources for Parents and Loved Ones
Parents and parental figures can find resources to learn how to reassure their children and provide age-appropriate education about news events. An adult voice to help guide a child’s understanding of recent turbulent times is important so they are not left to interpret the news on their own. Adults should also make every effort to maintain their child’s daily routine as we slowly return to normal. Continue co-parenting arrangements, if at all feasible, while considering the latest COVID-19 safety guidelines, being that we understand contact with both parents to be essential for optimal emotional development. Researchers also recommend setting aside 15 minutes daily for your child to focus on fun activities. This time can also be used to listen to any concerns or questions your child might have.
