PolicyLab

Editor’s Note: This is part of our Mental Health Awareness Month blog post series, which focuses on how COVID-19 impacts child and family behavioral health. We invite you to check back for new posts or to follow along for updates on Twitter at @PolicyLabCHOP.

Over the past several weeks, it has become increasingly clear that striking disparities exist in diagnoses, treatment and, ultimately, deaths related to COVID-19. The disproportionate rate at which African American and Latinx communities are being impacted by this disease has been headline news for some time. There have also been concerning reports of racist and xenophobic attacks on Asian and Asian American communities, as well as increased attention on the significant loss of life of many Native Americans and the suffering happening on reservations.

All of this coverage echoes the same refrain that black and brown people are at the greatest risk from COVID-19. People of color are overwhelmingly experiencing significant amounts of distress, as well as disproportionate rates of death in the face of this pandemic. Given this, we need to ensure we understand the impact of COVID-19 on diverse youth’s behavioral health, and create innovative ways to address and support their emotional well-being going forward.

The Realities of COVID-19 for Diverse Youth

As this crisis continues and families spend more time at home, it is not unexpected that children and adolescents are increasingly exposed to adult media content, as their parents and caregivers anxiously absorb the news. The outcome of this hyper-focus is that youth may overhear adult conversations and worries and, depending on their developmental age, may try to interpret those snippets of conversations, developing their own conclusions. This is particularly worrisome for young children, as they will not have the ability that teens may have to research their concerns or ask their parents/caregivers questions about what they’ve heard. In the case of children of color, their worries may be based in the reality of profound health disparities that are being laid bare in the daily news and/or based on their own lived experiences of loss during this time.

For adults talking with youth during this time, being honest about the circumstances and having developmentally appropriate discussions may allow children and adolescents to share their worries and fears. However, how does one discuss structural racism and the long history of health inequity in the United States with a young child, in the midst of a pandemic where the reality of this history is impacting communities of color, with little abatement in sight?

For native and indigenous children, how can we allay their justifiable concerns when Native American communities are being left out of the data gathering, while all evidence points to the staggering losses across tribes. For Asian American children, how can we address their concerns of racism and xenophobia, when they are bullied not only on the street but online? With the mounting evidence of the differential ways in which children of color are being impacted by this pandemic, during Mental Health Awareness Month in particular, one can’t help but wonder what impact all of these negative occurrences will have on diverse children’s mental health.

We’re beginning to see emerging accounts of the effects. Initial reports out of China for example, show distinct changes in children’s levels of distress, as well as depressive and anxiety symptoms while they’re confined at home. We know that children and adolescents are acutely aware of events that occur, and while most youth are still confined to their homes, their awareness of health inequities readily seen during this pandemic may have significant impacts on their mental health and well-being.

Innovating to Support & Ensure Healthy Development

When dealing with the uncertainty of this pandemic and the rapidly changing national and international landscapes, we must immediately create innovative ways to support children who are witnessing the disproportional impact in their communities, and to understand how children of color are being differentially affected by ensuring they are enrolled in the research studies that will surely come. Throughout this pandemic, many have relied on teleplatforms with informational and educational programming aimed at both children and adults. However, with knowledge of the digital divide and disparities that exist in access to technology, we need to create strategies that provide a sense of community for children including low-tech solutions that don’t require access to a computer or tablet, as well as options that leverage the ability to create community online.

Pediatric providers need to take into account how diverse children may be responding differently to this pandemic and the disproportional impact on communities of color, building on community partnerships to check on children’s well-being. This includes collaborations with families and schools, as well as community organizations that have long been trusted and integral sources of information, to successfully engage and support diverse families. Engaging radio shows with hosts trusted by families to create a “Kids Chat,” or setting up tents in parking lots where physical distancing can be observed, while still allowing for activities that educate and alleviate fears and concerns of children and adolescents, are potential ways to “check in” with diverse youth. Only by understanding diverse community’s concerns, as well as their levels of distress, can we respond with plans that are nuanced, individualized and continue to ensure healthy development.

We know that all children are leading very different lives than they were prior to the pandemic. While the world continues to navigate the “new normal,” we must ensure that children are supported through a variety of means, particularly those youth who historically have been most at risk and underserved. With heightened awareness, increased vigilance and thoughtful planning, we can ensure that the tragedies witnessed during the height of this pandemic don’t derail healthy development of children of color. Working across organizations, disciplines and even states we can create systems that help diverse children and families navigate these new stressors.

Through shared commitment to the mental health of all children we can continue to address health disparities and health inequities, learning from our shared grief to create a more just future.