Pediatric Mental Health Care is in High Demand
In Chicago and across the United States, there is increasing evidence of the serious impact the COVID-19 pandemic has had on the mental health and well-being of children and adolescents. A survey by Ann & Robert H. Lurie Children’s Hospital of Chicago has found that more than 4 in 10 children and adolescents have experienced an increase in one or more mental health symptoms over the last six months.
These findings follow the declaration in October 2021 of a national emergency in children’s mental health by the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association. Before the pandemic, 1 in 5 U.S. children experienced a mental health condition. Now—almost two years into the pandemic—these findings from the latest VOICES of Child Health Parent Panel Survey indicate growing mental and behavioral health challenges for Chicago’s youth, and highlight the critical need for access to pediatric mental healthcare.
“These findings build on what we have heard from parents in Chicago about their children, earlier in the pandemic. As the pandemic continues, even with most children now back in school and daycare in person, many parents are clearly concerned that their children’s mental well-being is getting worse rather than better. We are clearly experiencing an epidemic of higher children’s behavioral health needs, which must be addressed in a comprehensive way,” says Matthew M. Davis, MD, MAPP, Chair of the Department of Medicine at Lurie Children’s, Executive Vice-President and Chief Community Health Transformation Officer at the Patrick M. Magoon Institute for Healthy Communities at Lurie Children’s, and Chair of Pediatrics at Northwestern University Feinberg School of Medicine.
Adding to this urgency, on December 7, U.S. Surgeon General Vivek Murthy issued a rare public health advisory on the mental health challenges of youth across the country. The Surgeon General’s call to action noted that youth mental health challenges have intensified during the pandemic: 25 percent of youth are experiencing depressive symptoms and 20 percent are experiencing anxiety symptoms. In addition, there was a 51 percent increase in emergency department visits for suspected suicide attempts among adolescent girls, as well as increases in negative emotions and behaviors such as impulsivity and irritability.
In Chicago, findings from the Lurie Children’s VOICES report suggest similar concerns are being experienced by the city’s young people. Based on survey responses from parents in all 77 community areas in the city, key findings included:
Although signs of mental health difficulties can show in a variety of ways, the most prevalent mental health symptoms cited in the survey for children 2-11 years old were tantrums (23 percent), clinginess (19 percent), and headaches (10 percent). White children were affected the most, followed in order by Latinx, Asian/other race, and Black children.
For children and adolescents 4-17 years old, who are better able to express their feelings verbally, the most prevalent symptoms were trouble concentrating (18 percent), feeling anxious or “on edge” (18 percent), and being sad and unhappy (16 percent). Young people in this age group impacted most by new mental health challenges followed the same racial pattern as the younger children.
The survey also found that when someone in a household had been infected with COVID-19, this also had a negative impact on the mental health of children and adolescents in the household. For children 2-11 years old who had someone in their household with COVID-19, 54 percent had an increase in one or more symptoms of mental illness, and 61 percent of youth ages 4-17 in the same situation also showed more symptoms.
“The need for children and adolescents to access pediatric mental health care is dire. Lurie Children’s is working closely with policymakers, advocates and community partners to develop new models of care delivery and improve the system for care throughout Illinois,” says John Walkup, MD, Chair of the Pritzker Department of Psychiatry and Behavioral Health, and Professor of Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine.
Multiple solutions are being developed and implemented to address the short-term crisis and the longer-term need that began even before the pandemic. Lurie Children’s is working to expand and create training programs to enhance workforce capacity and educate pediatricians to screen, identify and treat patients for mental health issues such as mild to moderate anxiety, depression, ADHD and disruptive behaviors. Lurie Children’s, along with other pediatric healthcare providers, also advocates for increased Medicaid reimbursement for children’s psychiatric outpatient therapy, which will open critically needed access to care for children.
Importantly, Chicago families are responding to support their children in a variety of ways. The most common coping strategy was increased family time together so children feel secure and comforted by parents and siblings. Parents also said that they connected virtually with family and friends and dedicated time to answer their children’s questions and concerns.
This report is based on data from the Voices of Child Health in Chicago Parent Panel Survey. The survey is administered to a sample of Chicago parents by Lurie Children’s and NORC at the University of Chicago via internet and telephone. The survey is administered to the same panel of parents three times each year. The data in this report was collected from May 2021 through July 2021. The sample consisted of 1,620 Chicago parents, step-parents, or guardians who had at least one child under 18 years of age in the household (referred to as “parents” in this report). Parents were from all 77 community areas in Chicago and are weighted to be representative of households with children across the city.
Population-focused child health research at Lurie Children’s is conducted through the Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center at the Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of new knowledge. Lurie Children’s is ranked as one of the nation’s top children’s hospitals in U.S. News & World Report and is the pediatric training affiliate for Northwestern University Feinberg School of Medicine. Last year, the hospital served more than 221,000 children from 47 states and 30 countries.