Six-year-old Elijah Wastell, of Omaha, started feeling anxious last fall.
It came hard for the kindergartener at bedtime. His parents tried breathing exercises. They attempted to build up his confidence. They tried everything they could think of, but the anxiety only got worse.
It got to the point where “he wanted to be in bed with a blanket over his head before the sun went down, which can be tricky in September,” said his mother, Anna Wastell.
Elijah himself didn’t tie his newfound anxiety to the pandemic that has altered the lives of everyone — including children — over the past two years.
But experts say cases like Elijah’s have become increasingly common in the wake of COVID-19, which has stolen normal school years and upended social and emotional development of Nebraska children.
“For kids, routines and structure are so important to their mental health and their wellbeing, and the pandemic just turned it upside down,” said Kristine Bosiljvec, the Boys Town National Hotline manager.
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Elijah is but one snowball in an avalanche of Nebraska children now facing issues that pediatric mental health providers are attempting to address. Providers report seeing a spike in all types of mental health issues, including:
Screenings that detect depression have hit a new high at Children’s Hospital and Medical Center. Normally roughly 15% of kids age 11 and up receive a positive depression screen at their pediatrician appointments, Children’s officials say. During the pandemic, that’s risen to more than 20% — some months hitting nearly 30%.
Between February 2020 and 2022, the Boys Town National Hotline received more than 50% more calls from Nebraska children reporting anxiety than they received in the two years prior.
The Children’s intensive eating disorder program, which has a capacity between 6 and 8, saw its waiting list grow to up to 25 children during COVID-19.
And these mental health struggles, including the scariest ones, go much wider than Nebraska.
Nationally, rates of reported suicidal ideation and thoughts of self harm have skyrocketed, up 45% in early 2021 when compared to early 2019.
“Our entire family systems were stressed, and we were all being asked to deal with issues that we’d never developed coping strategies for,” said Michael Vance, director of behavioral health at Children’s Hospital & Medical Center. “While we were trying to deal with this ourselves, we were at the same time trying to figure it out for our kids.”
The Wastells continued to try to figure it out. They took Elijah to Play Therapy Omaha. After his first few sessions, his anxiety lessened. He continues to attend therapy, though less frequently now. He and his parents agreed to share his story.
“We work hard to normalize mental health care and mental health treatment,” Anna Wastell said. “I don’t ever want my children to find any shame or any guilt in mental health care.”
The Wastells are far from the only Nebraskans trying to guide their kids through new mental health needs. On top of normal life stressors and brain chemistry, the pandemic upended many parts of normalcy. Current second graders have never had a “normal” school year.
Several experts identified one key issue: The pandemic caused disruptions to routines, and that can create issues even for adults.
“Human beings in general, and kids in particular, really benefit from structure and routine and predictability,” Vance said. “And the pandemic threw a wrench in all that.”
The Boys Town National Hotline addresses crises of all types, from a fight with a friend to a suicide attempt.
Over the course of the pandemic, it saw a jump in calls from both youth and adults, Bosiljvec said.
Call volume remains high, but she said Boys Town is now starting to see a decline in the more serious types of calls, such as thoughts of suicide.
“We’re certainly starting to see that people are feeling better about the situation,” she said. “But there’s still stress and anxiety. I think there’s enough going on in our country that people are still feeling a little bit anxious about what’s going on.”
The pandemic undeniably brought a lot of unpredictability to kids’ lives. Was the track meet going to happen? Was school going to be on tomorrow?
This had the added problem of removing unofficial support networks — coaches, teachers and more — that some kids rely heavily on for mental well-being.
All that was coupled with family stress as many parents lost jobs and grandparents got sick. And on top of that all, kids missed out on the peer interaction that is important for social development.
“We were dealing with something that none of our generations had dealt with that had such a collective impact on our lives, and it was not something that was under any of our control,” Vance said.
One factor that no experts identified as a problem: mask mandates.
“Not at all,” said Tom Reimers, Boys Town Behavioral Health Director. “Nobody likes to wear a mask, but the kids have adapted much better than the parents. The younger they are, the better they are.”
Tim Royers, president of the Millard Education Association, said teachers are seeing some of the biggest struggles in kids who entered a new school during the height of the pandemic. In the 2020-21 school year, kindergarteners, sixth graders, freshmen in high school all struggled to adjust under new restrictions.
While Millard resumed full time school for anyone that wanted it in fall 2020, many school social events remained canceled until vaccines became widely available last summer.
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“I don’t regret the decisions that we made,” Royers said. “It’s just that there are always consequences.”
Now, teachers and others are trying to reach struggling kids. But the teachers themselves are overwhelmed.
“As a teacher hands down, that’s one of the worst feelings in the world, when you know there’s kids that need more, and you can’t get to them, and you’ve given them everything you can,” he said.
Another challenge for school officials: Children, particularly young ones, are not always able to articulate their feelings.
Some kids act badly instead. Others internalize their negative feelings.
“They communicate through behavior,” said Stephanie Hoesing, Omaha Public Schools’ social work supervisor. “They don’t even necessarily understand what they’re experiencing physically or emotionally to be able to name it.”
For parents who are worried about their kids, Jennifer McWilliams, a medical doctor and psychiatrist at Children’s, has two pieces of advice. One, look for changes that could indicate your child is struggling more than normal. Two, listen to your kids without trying to share your experiences.
The key is “listening to what your kids say and not minimizing it,” she said. “It’s easy to say ‘Well, we didn’t have anybody that we knew died.’ Sometimes a lost softball season is pretty darn traumatic to that particular kid.”
There is some good news. After two years of coping with the pandemic, pediatric health experts, school districts and others have identified some solutions.
Some Nebraska school districts have implemented partnerships with mental health providers, decreasing the barriers for kids to get access to care.
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OPS has had such a partnership with the Methodist Community Health Program for more than two decades, Hoesing said.
A longtime partnership with Project Harmony has also strengthened OPS students’ access to services.
Royers pointed to an initiative in Millard to hire staff who are not assigned to a classroom, but support kids in various ways.
Others have found additional silver linings.
Vance lauded families who’ve found ways to spend extra, positive time together. Some families implemented new traditions or routines such as family game night or theme night.
Hoesing pointed to a new, increased focus on mental health care for kids.
“One of the unintended consequences is more recognition around mental health,” he said.
Even as a host of groups work to help Nebraska children recover, it will take time for kids to rebound from the mental health effects of COVID-19.
“There are going to be some days where we measure progress in inches not miles,” Royers said. “There’s no way to force a kid to move out of trauma at a certain speed. You have to meet them where they are and support them where they are.”
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