For over a year, kids across Ontario have been navigating a new, difficult normal. While studies have shown that home schooling has helped spare children’s physical health during COVID-19, it has taken a toll on their mental health. This article is designed to help us keep an eye on our kids' mental health, when they return to school.

MORE NERVOUSNESS THAN NORMAL

Kids are usually anxious about returning to school each fall; after months of social isolation though, this fear is expected to be heightened. The unease students are feeling stem from different aspects of the lockdown, with emphasis on germs and separation anxiety.

• GERMS: This year, the classrooms will be filled with young germaphobes in the making (and rightly so). Unfortunately, this makes children, especially elementary school kids, more worried about the classroom experience.

To help kids struggling to live with germs it’s important to validate their feelings. They learned from you and their teachers that school was not safe; explain to them why it is now. Discuss precautions the school is taking, and explain their role in staying healthy as well.

• SEPARATION ANXIETY: Even older kids with experience in the classroom are likely to suffer from separation anxiety this September. Many are used to being home with their parents. Coupled with the above fear of germs; classmates and teachers are not seen as safe as they once thought.

To help your kids feel better about leaving the house, and you; start with practice. Rebuild their tolerance in small ways by slowly increasing the gap. Have your child play in their room alone, while you are in the living room. You may also choose to have your child stay with a different caregiver while you are out of the house for the afternoon. Each little step is one more step to making them feel safe without you.

Building new routines is another proven technique to help your child struggling with germs or separation. This could include washing their hands before every meal, or saying “hello” to a favourite stuffed animal, each time they return home. Routines take the uncertainty out of change or new behaviours. It can improve their confidence as well as distract them from what they thought would be unpleasant.

Finally, emphasizing safety measures is another crucial method to help kids struggling with alone time, or accepting that germs are a part of life. Explaining why school is different now than in 2020 will help them understand and feel safer. There is a reason why new rules and customs will be in place in September, teach them why each rule is important, this will help inspire them to grow with the change.

UNSAFE COPING MECHANISMS

Children need healthy ways to cope with such negative feelings. Like adults, the focus should be on eating well, exercising, and getting enough sleep. Unfortunately, like adults, some find unhealthy methods of coping easier, or more satisfying in the moment. While adults might turn to drugs or alcohol, kids find other ways to hurt themselves. Cutting is one of the most common unhealthy coping mechanisms a child can develop.

Self-mutilation usually begins with less harmful activities:

• Twisting their hands or skin.
• Pinching themselves.
• Not eating in hopes of feeling the discomfort of hunger.

Parents should not panic if they recognize these signs. It is not suicidal behaviour. It’s about overcoming a mental feeling they’re not comfortable with. The best thing a parent can do when they see what could be perceived as a precursor to self-mutilation is to simply talk with their child. More importantly, to listen.

Don’t approach the subject if you’ve just witnessed some of this unpleasant behaviour. Chances are they are already feeling anxious, and will see it as an attack. An ideal time for having difficult conversations (with your teens in particular), is during a car ride. Not just because they can’t leave, but it’s difficult for the parent to look at their child while driving. This can help make your teenager feel more comfortable.

During the conversation you will want to do a lot more listening than talking, but it is important you ask them about their behaviour and coping mechanisms. After discussing why it’s harmful, be sure to offer some positive strategies to replace the behaviour with.

ConnexOntario has partnered with Kids Help Phone, the Ontario Centre of Excellence for Child and Youth Mental Health, and Ontario 211, to create Good2Talk. This is a toll free, confidential helpline available to students 24/7/365. Sharing this resource with your kids could be very helpful while adapting to life at school again.

HAVE SUICIDE RISKS INCREASED?

In the years leading up to the pandemic, suicide became the second leading cause of death for children and teenagers. In fact, between 2007 and 2016 the sucide rate for youths aged 10-19 increased by 56%. The rate of increase was slowed, but did continue to rise during COVID-19. The Official Journal of the American Academy of Pediatrics released a report demonstrating direct correlation between the months that the pandemic peaked and the increased rates of suicide ideation and attempts.

Lisa Furst, Chief Program Officer at Vibrant Emotional Health which is a resource for youth that also operates the National Suicide Prevention Lifeline (an American organization). Furst released a statement addressing concerns that phone calls to the National Suicide Prevention Lifeline increased during each lockdown. “Adolescents are very peer-focused under ordinary circumstances. The nature of the public health measures such as remote school and physical distancing may impact teens and youth very significantly because they feel so isolated from their peer group”.

ELIMINATING ACCESS TO LETHAL MEANS

The most common ways teenagers attempt suicide is through suffocation, firearms and poisoning. Dr. Julie Williamson, Associate Professor of Anesthesiology and pediatrics at Emory University in Atlanta reminds us that “for adolescents, suicide is often extremely impulsive and not pre-planned, so even small barriers can keep catastrophes from happening. One of the ways to prevent pediatric suicide attempts is to keep your medications locked away”. Advising that parents invest in a lockbox is helpful guidance, not just for weapons, but prescription medication and nonprescription like Tylenol. This prevents intentional and accidental overdose.

MONITORING YOUR KIDS

It will be especially important during the first few months of normal school life to keep an eye on your kids. If a child becomes withdrawn and moody, or has changed their sleeping or eating behaviour; approach the subject gently. It is understandably difficult to note the difference between normal teenage angst and emotions that can turn harmful.

Many of the warning signs that a youth is becoming suicidal are the same for adults:

• Focusing on death whether it's during a conversation, watching TV shows on the subject, reading about death, drawing or writing, etc.
• Withdrawing from family and friends.
• Giving personal belongings away.
• Hostile or aggressive behaviour.
• Neglecting their appearance.
• Running away.
• Excessive risk taking, including reckless driving or sexual promiscuity.

Check in with your children regularly to see how they are doing. As mentioned earlier, car rides are an ideal time to start a conversation. This way you can prod a bit deeper beyond the usual “Im fine” (in a more natural and comfortable way). Let them know that it’s OK for their emotions to change, we all have good days and bad days. Keep in mind though, children usually take their emotional cues from parents, so it’s important to manage your own emotions.

Managing your emotions includes talking about them with your kids. They can see when you’re upset, so explain why. Be honest about the emotion, and then tell them what you’re going to do about it. If you had a bad day at work, tell them you are frustrated, so you’re going to go for a walk, or take a bath, etc. Setting a good example like this is a great way to instill positive coping mechanisms in your kids.

A DELAYED REACTION TO THE PANDEMIC

As adults, we were feeling the effects of the pandemic, including the toll on our mental health; almost immediately. Children process a crisis differently. It usually takes six months to a year for mental health problems to manifest in children after a trauma. This means a child who is currently coping well, and hasn’t seemed too affected by COVID-19 can still have a negative reaction.

Returning to school will help many kids. Being around their peers and having a regular routine makes a big, positive difference. Some kids though will feel the opposite about going back to school. Remember to set a positive example by talking about your emotions, and dealing with them in a healthy way. Taking the time to listen is equally important.