Children and teenagers have gone months without their school routines, and without regularly seeing friends, extended family and educators during the COVID-19 pandemic.
For some, this isolation has produced depression and anxiety, made worse by seeing their own parents or guardians go through their own frustrations.
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Dr. Howard Pratt, a child and adolescent psychiatrist at Community Health of South Florida, has advice on how to step in and support young people who are struggling with difficult emotions and stress.
Pratt spoke with WLRN’s Veronica Zaragovia, as National Suicide Prevention Month concludes this week.
Warning: This post contains discussion about suicide and suicidal ideation.
WLRN: If someone close to us is suffering from severe depression, who has thoughts about suicide, what’s the most effective thing we can do?
PRATT: If you're suspecting that your loved one is depressed or not doing as well as they should be, more than just the pressures of the pandemic, then you have to address it. You can't ignore it.
People tend to be forthcoming if they are thinking that way, and probably the most difficult thing to do is listen to them and they will tell you things that will probably make you very uncomfortable. They will tell you reasons that they want to die. They will tell you reasons why they haven't committed suicide, but the thing about it is you have to let them know that that does bother you, that you care about them, that you love them.
But, the thing is, you can't do that on your own. Most of us are not equipped to deal with a suicidal family member or a loved one, so I cannot stress enough getting the help.
What are signs to look out for in friends, family, students — people in our lives?
One of the ways I always tell parents is they need to look for changes in their child. That could be changes in their friends, if they're isolating themselves, if they're just not taking pleasure in the things that they used to really enjoy. Those are the things that you want to look at and talk to your kids. You can't be passive in this because when it comes to their mental health, it's so much easier to help people when they're younger and then they get coping skills and learn how to tackle things when they're an adult, than just letting things go and hoping for the best.
So it starts with a conversation. Because a lot of times, you know, as adults, we kind of try to shield kids from everything or we do the extreme, where we share too much. There has to be a balance.
Therapy and other mental health services can be very expensive. What kind of affordable mental health services are available?
I work in what is known as a community health center. I have a good portion of my patients that do not have insurance or their means are very limited. If you seek out your community health centers, you have a lot of dedicated people willing to help.
There's inpatient and outpatient treatment. I don't ever want to see a child in the hospital that does not need to be. The best way to deal with things is starting early. If we start when we first see symptoms, we start with therapy, and I hope that they never get to that point that they are needing to be hospitalized.
So typically, here, where I work, if a physician sees a child or an adult that they don't seem like they're doing well, they get referred to me outpatient and to other psychiatrists that we have here.
At Community Health of South Florida, we are building our children’s crisis center (Note: It's expected to be completed by 2021). The children that are in this community get sent far away, some as far as Broward and families may not be able to come and see their children while they’re getting treatment. There are very few places that have the space for children. Now, add to that the fact that the community that we serve ... they may not have transportation to go see their child. So now you have someone who's in crisis that's been separated from their family.
We're finally going to be able to treat kids that are here. I don't have to look at a parent and say, I don't know where your kid is going to be. They're going to be here, and you can see them.
When we’re so much more separated from each other, physically, than before the pandemic, how can we still be thinking about our collective responsibility for each other — making sure people are still watching out for each other, especially during such a difficult time?
In South Florida, as a community, we come from so many different places, but one of the things that I've noticed is that we're a very touchy-feely community and it's difficult when you see your loved ones to not want to hug them and tell them you miss them. But right now, that's kind of an issue with COVID. You have to connect with people.
If you haven’t talked to someone, give them a call, send them a text. You don't know how they're doing, and you may be the only person who's doing that. So it’s keeping those human connections that are really important.
My goal is to be able to fire myself, and I know that sounds funny, but I don't ever want to have a child come to me and think that they are going to be in treatment for life. You're kind of in a rough spot right now, but this isn't forever, and that really is something that affects them because it says, "OK, you think I can do better, my parents think I can do better, my school thinks I can do better" and they have this enormous support around them. They end up doing better.
If you or someone you know is struggling, or needs help, here's a list of numbers and organizations that provide services and assistance:
- National Suicide Prevention Lifeline is at 1-800-273-TALK (8255)
- For anyone experiencing a crisis, call 211
- Lifeline Chat is a service of the National Suicide Prevention Lifeline that uses web chat
- The Trevor Project for LGBTQ youth is at 1-866-488-7386
- The national hotline of the Substance Abuse and Mental Health Services Administration is at 1-800-662-HELP (4357)
- The free THRIVE app aims to help parents start speaking with their teen or young adult on health topics
- The Jed Foundation is a non profit organization that aims to prevent suicide among teens and young adults
- The Society for the Prevention of Teen Suicide's mission is to reduce youth suicides through educational training programs
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