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How will months of COVID lockdown impact mental health of children, teens?

CDC study: pandemic causing anxiety, depression
Posted: 5:00 AM, Nov 11, 2020
Updated: 2020-11-11 18:31:37-05
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Walnut Hills High School soccer players and seniors Jonathan Levy and Charlie Hamann.

Editor's Note: This is part of a week-long, three-part series of stories we are calling, "Cincinnati's Lost Year: Pandemic, Crisis and Recovery," which explores the less obvious impact of the coronavirus on people's lives and offer a glimpse of hope toward rebounding and recovery.

CINCINNATI -- It was a long road back to the football field for Western Hills High School senior Chris Scott.

When the pandemic hit in the spring, Scott was on crutches after surgery for a football injury to his right knee from last season. Then the quarantine cut back his physical therapy sessions to just once a week. In desperation, he said he tried to recover at home using a backpack filled with books as a weight and pushing the family car for strength.

"It's just been a long, a long process,” Scott said. “Recovery was very tough. I had to learn to walk again.”

Then, just as Scott was getting healthy enough to play, the Cincinnati Public School Board, fearing the spread of COVID, delayed games until mid-September. This happened while athletes at most other Tri-State schools got to play.

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Western Hills High School football player Chris Scott.

"I couldn't wrap my mind around the fact that we were not playing,” said Scott, who lost half of his football season.

Scott’s story isn’t unique in the pandemic: Many children and teenagers quietly suffered missed milestones and lonely isolation during quarantine shutdowns.

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In part two of the Rebound Investigation, "Cincinnati's Lost Year: Pandemic, Crisis, and Recovery," families and children are the focus. Therapists say it could be years until they understand how deeply the pandemic has affected the youngest members of society. Already some concerning trends have emerged.

A June study by the Centers for Disease Control and Prevention shows that anxiety, depression and suicidal thoughts are up sharply among young people this year.

Local divorce attorneys are overwhelmed with families in chaos; domestic violence petitions in Hamilton County are on target to hit the second-highest number in a decade, and local child protection workers are reporting more severe physical abuse this year, especially of very young children.

“It’s a perfect storm,” said Shannon Russell, a clinical supervisor at Greater Cincinnati Behavioral Health Services who oversees mental health providers at 15 school districts throughout Cincinnati and Northern Kentucky.

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Shannon Russell of Greater Cincinnati Behavioral Health Services

Young people aren’t just worrying about COVID, Russell said, but they’ve also had to cope with the anxiety of social unrest and protests this summer as well as a tumultuous election season.

“One kid, I thought for sure he was going to say, ‘I’m really worried about this pandemic,’ and he comes out and says, ‘I’m really worried we’re going to have a race war,’” Russell said.

Many at-risk children disappeared from their teachers' radar during the spring shutdown. Even now, fewer teachers are making referrals for mental health services, Russell said, in large part because they aren’t seeing students as often in-person due to remote learning.

Jennifer Palmer, a school-based therapist with Greater Cincinnati Behavioral Health, worried about what she heard from high school students during telehealth sessions.

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Greater Cincinnati Behavioral Health Services school-based therapist Jennifer Palmer

“Anxiety, depression, anger, a lot of anger and irritability, isolation,” Palmer said. “Tearfulness, family conflict -- there’s a lot of loss.”

Charlie Hamann is a senior at Walnut Hills High School who worries his dream of playing soccer in college won’t happen.

He lost his spring soccer season, where college coaches usually show up to recruit, due to the shutdown.

"So that definitely hurt the chances of me playing in college,” Hamann said. “It’s a big deal because I’ve been playing since I was three and putting in the work every week, day in and day out.”

Walnut Hills High School senior, Charlie Hamann
Walnut Hills High School soccer player Charlie Hamann

Hamann then lost half of his high school soccer season because Cincinnati Public Schools would not let athletes play games until mid-September. While players at other schools could send fresh game film to college coaches for recruiting, Hamann could not.

Hamann has not been able to return to Walnut Hills for his senior year. The school remains closed and all classes are virtual.

For Hamann, the pandemic also brought a deep personal loss. His grandfather, Lynn Foltz, died from COVID-19 on May 30.

"Just having all of that stripped away is kind of disheartening,” Hamann said.

Kole Viel is also worried about where he’ll go to college next year. He’s a linebacker for East Central High School who is still waiting for a college football offer.

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East Central High School football player Kole Viel.

“Since this quarantine has hit and COVID, I can't really visit any schools,” Viel said. “It’s just mostly trying to get my name out there … and hopefully someone catches it and sees it.”

Viel spent the spring and summer lifting weights seven days a week with teammate Nathan Griffin. Both gained at least 25 pounds, hoping it would make them more attractive prospects to college coaches.

“They’ve obviously grown into young men over the pandemic,” said East Central High School football coach Jake Meiners. “They really turned the pandemic … into something that’s a positive for them.”

Yet Viel isn't sure he'll get to play college football. The NCAA put all Division I college recruiting on hold until January 1, 2021.

East Central High School Football Coach Jake Meiners
East Central High School Football Coach Jake Meiners

As for Griffin, who has offers from football coaches at Valparaiso and Columbia universities, he may end up committing to a school without ever setting foot on campus because of quarantine restrictions.

“It is scary, because the way I look at a college, I want a college where I feel at home,” Griffin said. “It is hard to experience that when you’re not there.”

Dr. Jessica Bunce, a clinical psychologist who specializes in young athletes, said an overwhelming feeling among her clients is grief.

“I have some who are contemplating gap years,” Bunce said. “I have some who are unsure if they will have any exposure to college coaches and scholarship opportunities.”

Dr. Jessica Bunce, psychologist specializing in young athletes
Dr. Jessica Bunce, psychologist specializing in young athletes

That same deep loss was also felt by the 2020 graduating high school class who missed their last months of in-person school, spring sports, prom and graduation.

“I had students who still had stuff in their lockers thinking they would be back in a few weeks, and they had to get it in the summer,” Bunce said. “They never got those final closing moments of high school.”

But Bunce also worried about teens who are living in unstable families or have tense relationships with parents.

"For those that are in less safe home environments, that's where some of the concern has been around tension and conflicts at home,” Bunce said. “People in close quarters … that can stir up or amplify the feelings that were already there.”

Attorney Shawn Evans has also seen that turmoil in divorce cases.

“I kind of compare it to being in a pressure cooker,” said Evans, who chairs the Cincinnati Bar Association’s domestic relations committee. “Not only do you have the added stresses of financial uncertainty, you have the additional elements of homeschooling children, working from home, everyone living together.”

She and her law partner, Trista Goldberg, blamed the pandemic for the increase in substance abuse, domestic violence and confrontational divorces seen at their practice this year.

“More combative, more litigious, more difficulty in resolving disputes,” Evans said. “I think it’s driven a lot by fear. Fear and uncertainty. We don’t know what’s going to happen in the next two to six to 12 months.”

Cincinnati Children's Hospital Medical Center psychiatrist Dr. Courtney Cinko.
Cincinnati Children's Hospital Medical Center psychiatrist Dr. Courtney Cinko.

Children sense their parents' stress and often take it on, said Dr. Courtney Cinko, a child and adolescent psychiatrist at Cincinnati Children’s Hospital Medical Center.

“They know the world is in chaos, they know their house is in chaos, and that just adds to their stress levels,” Cinko said.

When schools shut down in March, Western Hills High School Varsity Football Coach Armand Tatum immediately worried about the players who rely on school, football and off-season weightlifting to keep them out of trouble and well-fed.

“One of the biggest things that I know that us as coaches were concerned about was, number one, how are they doing mentally and, are they eating?” Tatum said. “Unfortunately, a lot of our kids struggle with having proper nutrition … at least when they’re here with us we know that they’ll get a breakfast and lunch here, they’ll get a before-practice or before-game meal, and then something afterwards.”

Western Hills High School Varsity Football coach Armand Tatum
Western Hills High School Varsity Football coach Armand Tatum

Throughout the quarantine, Tatum said he and other coaches dropped off boxes of protein bars and other food to boys who needed it.

“It’s another trauma in their lives,” Tatum said. “The staying at home, some of them by themselves. Some of them were the caregivers for younger siblings and still trying to do their schoolwork.”

Mental health providers worry that a new round of school closures this fall and winter could make things worse for students who are already teetering towards depression.

“I feel like there is more suicidality or more thoughts of wanting to die or being dead,” Cinko said, who noted that suicide is the second-leading cause of death for adolescents in a normal year. “Unfortunately, some kids feel like they’d rather be dead than having to deal with all of the stressors of what’s going on with their life right now.”

Warning signs for children who may be at risk of suicide include: changes in sleeping or eating patterns, isolation, or loss of interest in hobbies and activities they once enjoyed, Cinko said.

Cincinnati Children's Hospital psychologist, Dr. Lynne Merck
Cincinnati Children's Hospital Medical Center psychologist, Dr. Lynne Merck

Dr. Lynne Merk, a clinical psychologist at Cincinnati Children’s Hospital Medical Center, said she’s had more conversations with families recently about suicide because she’s hearing from more children who are having thoughts of wanting to die.

“If you have concerns about your kid, if you’re worried – talk to them,” Cinko said. “Keep connecting to them, keep making sure they’re okay, keep checking in. That can go a really long way for kids’ mental health.”

Mental health experts are also monitoring the long-term impact of the pandemic on youth development. Education skills such as math and reading may come slower with remote learning, but social skills such as learning how to sit still in a classroom might be the most delayed, Cinko said.

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East Central High School football players

“It’s important for us to recognize that there’s a gap in their development that we are going to have to figure out a way to make up for,” Merck said.

Russell, of Greater Cincinnati Behavioral Health, said the pandemic could cause children to overreact to threats of danger for years after the pandemic is gone.

“So, long term, what could happen for kiddos is that part of their brain that evaluates threats could be skewed off and that could last into adulthood,” Russell said. “We have to kind of calm the brain to allow ourselves to think, 'Oh, somebody’s coughing. That’s a normal thing; people cough. It doesn’t necessarily mean they have coronavirus.'"

But many mental health experts believe the resiliency of youth will triumph, allowing them to readjust to life after the pandemic and even take away some valuable lessons.

East Central High School football player Nathan Griffin
East Central High School football player Nathan Griffin

"One of the long-lasting effects of this pandemic, I think, could be that parents and children are actually more connected," Cinko said. "That maybe our families become stronger."

For Griffin, the pandemic brought him closer to his East Central football teammates.

“We came into every game, every practice, like this could be our last,” Griffin said. “We have to love every experience that we get from this because every experience could be our last.”

The pandemic also changed Scott's perspective, teaching him patience, resiliency and a deeper appreciation for his family and Western Hills teammates.

“Things happen in life, things are going to happen in life,” Scott said. “What you have to do is really get your feet on the ground, and just stand.”