In his job as a Wichita East High School social worker, Samuel Paunetto knew he’d be dealing with all the traumas teenagers routinely go through.

But he’s been floored by the amount of grief he’s seeing in students every day — not just from the loss of family and friends to COVID-19, but from the loss of something students had already been struggling to maintain.

Hope.

“Those 18 months that they spent outside of school and in their homes — getting back out of that and into the classroom has been difficult for kids,” Paunetto said. “Our kids are grieving.”

Across the U.S., children this fall returned to a relatively normal school year of in-person learning. But school support staff report that students are experiencing unprecedented levels of mental health issues, like anxiety and depression.

It’s a situation that in October led the American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics and the Children’s Hospital Association to jointly declare a “National State of Emergency in Children’s Mental Health.”

And in Kansas, the rise in youth mental health issues is straining a support system that was already seeing shortages in providers.

Mental health needs continue to surge

Even before the pandemic, children’s mental health had been a rising concern in Kansas.

Since the Kansas Communities That Care Survey began asking about mental health in 2016, students have reported increased levels of mental health stress every year.

Dr. Cassi Karlsson, a clinical associate professor in the KU School of Medicine-Wichita’s Department of Psychiatry & Behavioral Sciences, said cases of anxiety and depression in children surged after families lost parents, grandparents and other caregivers to COVID-19.

Another factor is that mental health issues went undiagnosed during the 2020-2021 school year. It was harder for school staff to spot concerns among children they were seeing mostly on  computer screens, said Hilary Trudo, social work services program specialist for Wichita USD 259. 

Trudo said teachers and social workers are seeing an increase in risk factors like attendance and disciplinary incidents now that they’re regularly interacting with students in person. 

“Not having those daily interactions with them left us with a lack of information, and now that we do have daily interactions with kids, we can see (these issues) when they come to school,” Trudo said.

Other COVID-19 factors, like parents losing jobs, also exacerbated social-emotional problems in a district where most students come from lower-income backgrounds, Paunetto said.

Teens are also coping  with broader societal issues like global warming and racial inequities in the U.S., Paunetto said. The socio-political environment has led some students to question why graduation even matters.

“There’s a sense of doom in some of the kids, and I think it’s because they know and see how political figures weaponize the things that are going on,” he said. “They’re disappointed, and I think it’s also informing depression in kids.”

Shortage of services

Paunetto said his role as a school social worker involves connecting students with the services they need, whether in school or elsewhere. But increasingly, he said, students are finding limited options for assistance, especially when they’re referred to services outside the school system.

“We’re seeing an avalanche of kids coming in with mental health needs, or needs related to nutrition or poverty,” Paunetto said. “We’re seeing a welfare structure outside of school that is ill-equipped to respond to kids’ needs.”

Officials at the KU School of Medicine-Wichita estimate the state needs more than 400 child psychiatrists to meet the demand for mental health services, but fewer than 100 work in Kansas.

Fewer than a dozen work in the Wichita area, and that’s led to about 2,000 children and teens going without treatment in Sedgwick County.

“Many states, including Kansas, were already experiencing severe shortages in mental health services,” Karlsson said. “Kansas hasn’t kept pace with the need, and many Kansas kids don’t receive services.”

Karlsson will help implement a new program for the school to begin training four child psychiatrist fellows each year. Those fellows are expected to help provide mental health services to more than 500 children in Sedgwick County annually, with the hope that the fellows remain in Kansas after completing the program.

Still, Karlsson said the program is only a start to dealing with the bigger issue of underfunded children’s mental health services. 

“The next generation of Kansans desperately needs us to invest in them,” she said. “We need to make top-of-the-line, evidence-based mental health care accessible to all Kansas youth.”

How to address children’s mental health

It shouldn’t be alarming that children are dealing with mental health issues in the wake of COVID-19, Karlsson said — everybody has dealt with the pandemic’s mental toll in some manner.

The risk is in not doing anything about it.

Mental health problems that go untreated affect children’s ability to focus in class and to participate in extracurricular activities, Karlsson said.

“We know it increases their risk of substance abuse, and it can affect their ability to go to college or hold a job,” she said.

Some children will need the expertise of a child psychiatrist or other mental health provider, Karlsson said. But she recommended these steps families can take at home to address mental health challenges:

• Talk about mental health — The first step parents should take to help struggling children is to destigmatize conversations about mental health, including subjects like suicide. This allows children to feel safe and comfortable in talking through any problems they may have.
• Model self-care — It’s one thing to talk about mental health, but children are more likely to seek help when the adults in their life do the same.
• Look for behavior changes — These can include irritability and changes in mood and sleep patterns, but there won’t always be clear signs that someone is dealing with a mental health issue.

Karlsson emphasized that it should be expected that children are struggling with mental health. Children should be reminded that asking for help is not only OK but encouraged, she said.

“Kansas is built on generations of hard-working people who have, at times, leaned on each other for help,” Karlsson said.