Q&A: University Health pediatric hospitalist explains child mental health crisis, options available

In 2018, suicide was the second leading cause of death for youths ages 10-24 years, health experts said

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Our children and teens are facing a national mental health crisis. Depression and attempted suicide were already on the increase and the pandemic ratcheted up the pressures, anxieties and isolation on kids and their families.

According to the AAP, the American Academy of Child and Adolescent Psychiatry (AACAP) and Children’s Hospital Association have declared a national emergency in children’s mental health, citing the serious toll of the COVID-19 pandemic on top of existing challenges.

Before COVID-19, rates of childhood mental health concerns and suicide had been rising steadily for at least a decade. By 2018, suicide was the second-leading cause of death for youths ages 10-24 years.

Dr. Dina Tom, a pediatric hospitalist with University Health, discussed the crisis, the signs of trouble and the options available.


1. Why are pediatricians and mental health professionals saying we are experiencing a national child mental health crisis?

Answer from Dr. Tom:

Prior to COVID, about 1 in 5 children had a mental disorder, and only 20% of those kids were getting professional help. The COVID pandemic brought with it isolation, uncertainty, fear and grief, experienced by children as well as parents.

Almost 200,000 children have lost a parent or grandparent to COVID; that is 1 in 4 COVID deaths that left a child without a parent or grandparent. The rates of severe anxiety, depression, trauma, abuse, and suicidality in children and teens have skyrocketed.

Additionally, many parents and caregivers have been under extreme pressure through COVID (i.e. losing jobs, financial stability, isolation, illness, etc.) understandably making it harder to tend to the needs of their children.

To learn more on how to talk to children about grief and COVID-19, click or tap here.

2. What are the signs that a child or adolescent may be experiencing a mental health crisis?

Answer from Dr. Tom:

If you are noticing your child struggle with persistent sadness for more than two weeks, then they may have a mental health issue that needs to be addressed professionally. If you notice them withdrawing from family or friends and isolating themselves, or very poor personal hygiene, this is concerning.

Strong emotional or behavioral outbursts that make you afraid for their safety or your own is a sign that they are struggling with a mental health issue and you should seek help. And if they have harmed themselves or others, or are talking about wanting to die or not be alive, you should seek help immediately.

3. What can you do if your child or adolescent is (or appears to be) in crisis?

Answer from Dr. Tom

It’s important to normalize feelings of stress, fear, uncertainty, and sadness through these tough times. As their parent or caregiver, they do look to you for reassurance that what they feel is “normal.” Attempt to engage your child/teenager regularly in a supportive way (good old-fashioned communication -- family dinners, cellphone downtime, one-on-one time with each child).

Make sure they know they can come to you and that you love them no matter what. If you notice a trend of sadness or irritability or isolation in your child that is concerning, go ahead and make an appointment with a pediatrician or family physician.

Clarity Child Guidance Center has resources on their website, claritycgc.org, with a number to call if your child is experiencing a mental health emergency -- and a walk-in option 24/7 for those in crisis.

Community resources are stretched thin due to the COVID pandemic and widespread mental health challenges, however, there are hotlines and resources available within San Antonio.

If you are having a mental health emergency – especially if you are having thoughts of suicide or self-harm – please call 911 immediately, or dial the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

For additional crisis resources from University Health, click or tap here.