New challenges expected when school resumes

By Martha Rasche
Special to The Herald

With the school year having ended, countless students are looking forward to a break from assignments, tests, projects and e-learning days.

The National Alliance on Mental Illness advises parents, on the other hand, to use summer to do some homework.

Last month, NAMI and the Harvard T.H. Chan School of Public Health came together to present an online panel discussion, “Adolescent Mental Health in the Time of Covid-19.”

NAMI’s associate medical director, Christine Crawford, urged parents and school staffs to prepare for the challenges they will face when school resumes in the fall: Students will be bringing with them to the classroom the struggles they have faced during the coronavirus pandemic.

It’s critical, Crawford said, for parents to have conversations over the summer alerting their kids that transitioning back to a “normal” school year may be difficult. They might even be tempted to compare how their transitioning compares to that of their peers — and become more depressed if they aren’t faring well.

Schools need support in place for that also, she said.

Later, Heather Terwiske, MSW, LCSW, clinical supervisor of psychiatric social work and on-call services at Memorial Hospital and Health Care Center in Jasper, shared with me that any new problems related to transitioning will be added on top of the pressure teens and tweens already face from being constantly surrounded by social media. And that fish-bowl aspect of young people living much of their lives online already comes atop pressure “to get good grades, excel in extracurricular activities, maintain friendships and work” part-time jobs, all at the same time.

Crawford said parents and students should expect some anxiety and even depression with the new school year and should particularly be alert if it starts affecting the child’s life negatively day to day. It could show up as the young person having difficulty attending school or focusing once she gets there, having difficulty maintaining relationships with friends and family members, or having difficulty maintaining oneself, such as getting out of bed, showering and otherwise keeping good personal hygiene, and eating.

“If you start to see those core things fall by the wayside, then I’m really concerned,” Crawford said. “It’s typical and normal to experience anxiety during these uncertain times, but when it starts to get in the way of your daily activities, that’s when I start to worry.”

While a student may have managed her anxiety OK on her own prior to the pandemic, Terwiske said, “throw in the pandemic that comes with school concerns, health concerns, family concerns, financial concerns — and suddenly, they can’t manage as well as they could prior.”

Archana Basu, a research scientist at the Chan School and a child clinical psychologist at Massachusetts General Hospital, called the pandemic “a prolonged stressor” that affects nearly every aspect of our lives.

“In addition to the isolation and unpredictability” that everyone experienced, some suffered the loss of loved ones, adverse economic impacts on their families, and social and political unrest.

“This a very complex landscape of experiences,” Basu said, but for much of the past two school years, typical supports and social outlets were not available as before.

As some young people subsequently expressed their feelings by acting out — exhibiting defiance, anger, destructive behavior, self-harm — and wait times to see mental health counselors grew, many of them ended up in emergency rooms.

The U.S. saw a 31% increase in 2020 in the number of 12- to 17-year-olds visiting the E.R. for reasons related to mental health, according to Chan School Dean of the Faculty Michelle A. Williams.

While the increase in counseling referrals from the ER at Memorial Hospital hasn’t been anywhere near that, the local hospital falls right in line with what Williams said about the rates of anxiety, depression and suicidal thoughts among young people: They have risen steadily over the last five years.

Terwiske said counselors at Memorial also are noticing patients struggling with these issues are “younger and younger each year.”

“No one is immune to the psychological toll of this pandemic, but the truth is, children are uniquely suffering in ways we’ve barely begun to grasp,” Williams said.

Developmentally, the years from middle school to college are when teens and young adults explore their boundaries and sense of identity. Covid has severely disrupted the formative years of teens on the road to independence.

Basu expects repercussions of that, too, to surface as a normal school year resumes.

Garth Graham, director of global healthcare and public health at YouTube, said that just this past April, online searches for “Why do I feel bad?” reached an all-time high.

At the same time, though, people were doing searches related to meditation, walking, virtual therapy and digital detox.

“What you’re seeing is people searching for answers for what they’re feeling and looking for solutions as well,” he said.

YouTube has been working with NAMI to help educate YouTube creators and others with influence on the platform. As a result, the visibility of solutions, including hotlines and apps, has been upgraded, Garth said. YouTube creators are using science and interventions in the lexicon of young people to connect them with help.

As handy and helpful as it can be to have resources in the palm of one’s hand, those online resources cannot take the place of in-person help and communication.

As adults, it’s very important that we validate the feelings of our young people when they come to us feeling stressed, sad or struggling, Crawford emphasized.

One tip NAMI ambassador Aija Mayrock shared is that while not feeling particularly stressed or anxious a young person make a list of her top five trusted adults. Then, write down tactics as to how you might approach talking to those people.

Keep that list with you, Mayrock said, because “when you’re at your worst place, it can be really hard to communicate and to think about the people who do care about you and are there.”

John Anzalone, principal of Sierra Vista High School in Las Vegas, joined the conversation to alert educators that they likely will be needed by students next school year in ways they have never been needed before. He anticipates the challenges will be even greater than those of the past two school years.

“Are we going to be prepared to have them voice their feelings, and then how do we respond with an open mind and an open ear?” he asked. “Many of our teachers have not been trained in that way. … Our kids need us and they need us now. We have to be ready for that. Even if we have to put the content aside for just a bit and focus on the mental health first, we (must be) willing to do that.”

“If a young teen or adolescent comes to you,” Terwiske said, “take it seriously. Validate their fears, concerns, thoughts and feelings. Let them know that it’s OK to not be OK, and it’s OK to get support and help.”

Help Is Available

If your child is showing signs of anxiety or depression that is interfering with daily life — such as a change in sleep, appetite, energy level or interest in activities or hobbies — reach out for help. Contact your school social workers, a teacher or your family physician. In an emergency, call the National Suicide Prevention Lifeline at 800-273-TALK, Memorial Hospital’s 24-hour help line at 812-827-6222 or the LifeSpring 24-hour crisis line at 812-482-4020.

Martha Rasche is a member of the Dubois County Public Health Partnership Mental Health Committee and the local affiliate of the National Alliance on Mental Illness. With funding from the health partnership, she writes about topics related to mental health. Read her blogs at Email her at

More on