-: I'm Rich Bischoff, the Associate Vice Chancellor
for faculty and academic leader success,
in the Institute of Agriculture and Natural Resources.
The social distancing and work
and study-from-home guidance associated with our response
to the COVID-19 pandemic, has created a unique challenge
related to all aspects of our health and well-being.
These challenges include heightened risks
to our mental health.
I'm talking today with Dr. Katrina Cordts.
Dr. Cordts is a faculty member
with the department of psychiatry
at the University of Nebraska Medical Center.
She specializes in behavioral healthcare of kids,
she has a particular expertise
in working with parents and young children
to promote healthy behaviors
and to prevent disruptive behavior in early childhood.
Katie, when I think of mental health,
my mind immediately thinks about adults and teenagers.
Perhaps you could start us off just by telling us
why it's so important to consider the mental health
of young children and youth?
-: Sure, absolutely.
So I think what's most important is that when kids struggle,
the parents really are their first line of defense.
The people who intervene and get them
the services that they need.
As a back-up system, we also normally have
the school system too,
so teachers and adults within the school system
can help track when kids are struggling
or maybe at risk for developing mental health problems.
Now that kids are no longer attending school,
in the formal sense,
we no longer have that extra line of defense
to help the parents out.
And so, also, naturally, we know that
when kids are struggling,
it's gonna be harder to parent them
and it's gonna create added challenges for their parents,
and so being really mindful of their mental health
and well-being is important
for the sake of the entire family.
-: That's yeah, good, thank you Katie.
Many of our faculty and staff members have children.
They may be worried about their children's mental health
during this unprecedented time.
Without that additional support that you just talked about,
schools and other organizations to help them here.
I'm wondering if you could
tell us what those unique mental health risks are
for kids and youth, related to the COVID-19 pandemic.
-: Sure, so I think the biggest problem,
is we know that all kids thrive when they have routine,
structure, consistency.
And for many families,
that's something that's lacking right now, again,
because of not having the formal education
as well as extracurricular activities and the like.
And so, for many of our kids,
this lack of a structure, routine
is creating added stressors for them.
In addition, we know that,
for our children with pre-existing mental health conditions,
the lack of structure is kind of a double whammy for them.
And, of course, you also have to consider,
many children are experiencing feelings of loss and grief.
Especially for those in those transitional age ranges
like kindergarten, fifth, eighth, and 12th graders,
that may be missing out on some milestone events
as well as just the normal end-of-year parties
and getting to say goodbye to their teacher.
There are a number of factors that we need to be considering
when thinking about children's mental health
during this time.
-: You know, I have grandchildren.
Some of whom are in preschool and elementary school.
During this time when they haven't been going to school,
it's become very evident to me how important
their interactions are with their peers.
Perhaps you could tell me about the role
of social interactions in social isolation,
to mental health in young children and youth.
And maybe even provide some suggestions
about what we might ought to do about it.
-: So we know that for our younger children,
social interactions are the way that they learn
and I think oftentimes as adults,
we really underestimate the value of social interactions.
What we know from the research and the literature
is that play for young children
is a way that they get to act out
and experience new emotions
and learn how to cope and handle
different, difficult situations.
And so, when there are no social interactions,
because they're not able to engage with their peers
in the same way that they once were,
actually, it's concerning about their overall development
and how they're going to continue to learn,
and learn these emotions and how to manage them.
-: Sure.
-: And for our teens too, I think,
we know that oftentimes their peer group
is more influential, perhaps,
at times than even their parents or their family members.
(laughing)
And so, they're not getting the same social interactions
that they once were.
Fortunately though, we live in an age of technology
where the options are endless.
And so, I'm really encouraging a lot of parents,
regardless of their kids' age,
to be thinking about how to utilize things like Zoom,
or Netflix Party or some of the different apps
where you can play games and interact with your peers,
to help keep some of those social interactions
that are so critical for our children, teens,
and even for us as adults.
-: This is an interesting comment
that you're making about the use of technology
because these are actually some of the concerns that I have
about these grandchildren that I have.
And also, I have a son who's in high school,
one of the things that I've seen is a greater reliance
on the use of technology to occupy time.
And I'm not talking about school
through distance technologies,
but about video games, online gaming, YouTube, Disney+,
you know, those kinds of things.
Could you talk to me about, you talked a little bit about,
you know, the positive things that can come from that,
in terms of creating social connections,
and using those in creative ways.
But could you talk to me about the role
of this kind of use of technology on child mental health,
and provide maybe some suggestions for parents
who may be noticing the same kinds of things
with their kids that I am.
-: Yeah, this has been one of my biggest concerns
with the pandemic.
Is the use and reliance on technology to,
not only engage in school and classwork,
but also to make those social interactions
as well as just the normal adolescent use of gaming,
even our young children are doing that now too.
So I think this pandemic has created
somewhat of a blurry line for parents to regulate
and monitor what their kids are doing online.
And, not to mention, technology for many kids
is very distracting.
And so for those of us that are parenting
and working from home,
parents need to be able to get things done.
And s technology can, out of necessity,
become a babysitter for some
because we've gotta be on Zoom meetings
and engaging with our colleagues as well.
-: Right.
-: So, I think one of the best recommendations,
especially since so many of us
are no longer able to follow
the American Academy of Pediatrics' recommendation
of 60 minutes or less of screen-time per day,
is creating routines and predictability for our kids,
about when they can use technology.
So, for instance, still setting limits on,
you can play this video game for an hour,
but then you need to take a break and go do something else.
As well as the normal limits around,
if you don't normally allow screens or electronics
at the dinner table,
keeping those rules and limitations in place.
It's just continuing to enforce
some of those pre-COVID limits around technology,
as much as possible.
And maybe thinking about when kids are able
to access technology and reserving that for a time
when you, as a parent, really need to be engaged
in something for work,
like on a Zoom call or leading a meeting.
-: Yeah, no, that's good, that's very helpful.
Katie, my area of expertise is in relationships,
family relationships,
and so I understand how important
relationships are to our mental health
and also to that of our children.
You know, for me, how one of my kids or grandkids
is feeling and functioning,
effects how I feel and function and vise-versa.
It's no surprise to me that parents
carry their own worries about the COVID-19 pandemic,
their jobs, the economy, their relationships,
their own physical and mental health, those kinds of things.
How would these worries, or how could these worries
that parents have, effect children?
And then, what suggestions do you have
for our faculty and staff members
who find themselves, maybe,
carrying these kinds of anxieties
in their interactions with their kids?
-: Yeah, so children are sponges.
They pick up on everything,
and not just children, I think our teens too.
And so, it's really incredible to me when parents
come in to session and tell me,
well we've tried really hard not to fight
in front of the kiddo,
or we try and limit these conversations
to happen after they've gone to bed and things.
But kids still have this ability
to pick up on what adults are feeling.
It's really, truly remarkable.
So I think one of the ways that we can combat that,
and actually, as we're dealing with our own stress
and anxiety related to COVID,
is having open and honest conversations
and communications with our kids.
Creating a space for them to ask questions
and also for you, as a parent, to share your concerns
about how this is effecting home life and work life.
But keeping in mind that using
developmentally appropriate language, is really important.
So thinking about what your five or your six year old
can cope with or understand,
is different from maybe your 15 or 16 year old.
So really watching your language
and thinking about what cognitively and developmentally,
what a child can handle at that age.
The other part I think that's so important with this,
is that this is stressful and this is hard.
And we're all dealing with a range of emotions
and sometimes we have multiple emotions at the same time.
It's okay for kids to see that.
This is part of their learning and their development,
is learning, what do I do when I'm sad
or when I'm worried or when I'm angry even.
So, as a parent, so often want to limit
their children's exposure to your more negative emotions
but it's also critical for their development
that they see you, as a parent,
at times experiencing stress and worry and sadness,
but it's how you handle it,
that's gonna be so critical for their development,
so that they learn healthy ways
to cope with their emotions too.
-: Katie, what should parents be looking for
that would suggest that maybe a mental health problem
in their child, is developing?
-: The first one that I always think about,
is sleep problems.
So if your child is having a hard time falling asleep
or staying asleep or is reporting nightmares,
feeling tired during the day,
even though maybe they did get a good
amount of sleep the night before,
those are really important things.
That's usually a first sign for many children.
Another thing that might be coming up,
are things like stomach aches or headaches
or oh, I just don't feel good.
And that's without any known cause.
Of course, you wanna make sure
that getting them medically evaluated as needed.
But really, when you've had them evaluated
and there's no reason for them to have a stomachache
or a headache, sometimes that can signal
there's some underlying anxiety or worry there.
Also if you're noticing an increase in tantrums
or just low mood and mood swings,
similar to what we might see in adults,
those might be ques, or signs
that maybe your child is struggling
and might need some extra help.
But the big thing to point out here is that,
we're looking for a deviation from normal.
Because if your child was having a lot of tantrums
before COVID hit and they're still having a lot of tantrums,
one, that may be a sign to also reach out and get some help,
but we're really looking for
if this is something new to your child.
So if they didn't have headaches before,
they were a pretty upbeat and happy kid,
and now they're feeling really sad
and appear to not be interested
in the things that once interested them,
those are the signs, kind of, that shift,
or that deviation from how they normally behave.
So just keeping an eye out for some of those new behaviors
that pop up, knowing that some of it
might just be in response to COVID,
but might also be a signal
for some emerging mental health concerns.
And I think the biggest part about that,
is that our interventions are incredibly effective
in the behavioral health and psychology world,
and they're usually best when they're applied proactively,
so, early intervention piece is critical.
-: Okay well, that's really helpful.
Katie, what observations do you have
about the kinds of challenges to family well-being,
that could be expected
in the face of a mental health problem?
Either with a child or with an adult?
-: Yeah, so I think one of the things
that naturally comes up that, as adults,
but especially so as parents and caregivers,
we tend to be fixers,
we want to make things better.
And this is something that, quite simply,
does not have an easy fix.
Of course, we have an amazing team of scientists
and institutions that are working on this problem,
but there's not a quick fix to this.
And so, thinking about the challenges to family well-being,
it's important to acknowledge that having conversations
and just acknowledging that this is hard
and that there are some big emotions
tied to this experience and that's okay.
This isn't something that we can readily
jump in and fix, but just allowing space and conversation
for acknowledging how difficult this has been
and what it may mean in terms of loss and grief,
not only of people and individuals that we care about,
but just the loss of experiences
and the things that we're no longer able to participate in,
at least currently.
-: Sure, so throughout this interview so far,
I guess I've just been hearing you say that, you know,
any of these kinds of experiences that either our children
or that we might be having,
that they're normal and probably to be expected.
(laughing)
That to experience loss and grief
and maybe even to act out a little bit,
or something like that,
that, that's not necessarily outside of the realm of normal.
-: Yes, absolutely.
I think a natural response,
and actually a somewhat helpful and logical reaction
to a pandemic, is increased anxiety and stress.
But what's really critical here,
is that we manage that stress appropriately
in a healthy way.
So added stress about making sure
we're sanitizing things and washing our hands,
it's helping to keep us safe,
but we also have to acknowledge
that we need to manage it in a way that's healthy
and that's gonna promote well-being in the long run.
-: Okay, great, so we've been talking
about child mental health and the role of parents in that.
Would you be willing to talk with us a little
about the kinds of things that adults
should be considering about their own mental health
during this time?
-: So, certainly if an individual
has a pre-existing mental health condition,
like anxiety or depression, they're likely at greater risk
for an exacerbation or worsening of those symptoms
because of, you know, not being able to access
the social interactions,
which are so key to our environment,
and the changes and the uncertainty
and everything that's going on.
But also for those individuals
that don't have a pre-existing mental health condition,
it's important to know that
there are a number of stressors right now
that may or may not signal a mental health diagnosis,
but are just important to be aware of.
So adults can experience grief and loss too.
Some of us are missing out on weddings
and maybe family members are having babies
that we can't go see, birthday parties and things,
and so it is natural to have a pretty strong reaction
in response to some of the events that we're missing out on,
regardless of whether
you have an existing mental health condition.
-: That's great, I appreciate those comments about that.
You had mentioned earlier that early intervention is better.
So the sooner we can intervene is the better.
Now I'm thinking that if we can intervene
before we need to intervene,
that we'll probably be in the best shape.
So could you comment a little on preventative strategies?
Some things that we might do before we start noticing
problems with mental or emotional health,
either with, you know, children
or with you know, ourselves, as adults?
-: One of the things that I've been frustrated by,
with the pandemic, is the poster encouragement
to take up a new hobby or to be overly achieving
on a number of different tasks.
One of the things that I'm commonly hearing
within an academic medical center is, well,
now that you're working from home,
you've got all that time to write that paper
or write that grant or to achieve that project.
And I think we need to step back
and give ourselves some grace and acknowledge that,
well yes, I am working from home,
but I may be trying to parent and teach now
or manage a house full,
and also deal with my own natural, emotional response.
So, I'm really encouraging everybody
to just give themselves some grace and be realistic
about what can be accomplished during this time.
And it's okay if it's not a period
of increased productivity for you,
despite what you may be seeing on Twitter
or social media outlets,
or just in conversations with colleagues.
The other thing that I think is important
for protecting our overall health and well-being,
is to give your emotions some space.
It's okay to not be okay.
And, in fact, by avoiding those strong,
negative emotions and just stuffing them down deeper,
is ultimately gonna create a volcano of emotions
that are gonna come out at some point.
So it's okay to take some time to acknowledge those emotions
and to cry and to be frustrated or be angry.
Just to avoid bottling them up over time.
-: Oh, that's great, great advice.
Thank you Katie.
Perhaps there's some other things that you've been,
that you were thinking about
as you were preparing to talk with me today?
Is there anything else that you'd like to tell us?
-: Yeah, so there's some great resources out there
if you're feeling like your emotional experience
is crossing into mental health territory
and you need some extra support,
and I just wanna make listeners aware of these things.
So, not only does UNL have an employee assistance program
which you can reach out and receive services,
Telehealth has really revitalized
and created some unique and great opportunities
to get some professional support if needed.
And the benefit is that
you don't have to leave your own home.
You don't have to drive some place and find parking.
You can do it from the comfort of your own home.
So, if you feel that you need some support
from a professional, I encourage you to reach out.
SAMHSA also has a disaster distress line
that's available 24/7, 365 days a year.
It's available in multiple languages, it's free,
so if you are hitting a high emotion
and you're having a hard time coming back down,
I'm really encouraging people to reach out
and use that free service as much as needed,
because it's there and that's what it's there for.
-: Those are great suggestions.
Been talking today with Dr. Katrina, Katie Cordts,
who is a faculty member of the department of psychiatry
at the University of Nebraska Medical Center.
Katie, thank you so much for joining me
in this conversation today.
-: Thank you for having me.