How Pediatricians can Promote Their Patient's Mental Health
Since the beginning of the pandemic, in late 2019, the rate of mental health problems has been on the rise all over the world. Children have seemed to
be the most effected group during the pandemic, as resulting isolation, loss of routine, limited social contact, grief, hardship, and stress have all
contributed to the rising anxiety levels, and depression, pediatricians are noticing is being developed in young children. Devising an approach for
pediatricians to address mental health concerns in brief office visits may feel overwhelming. The sections below offer practical pandemic relief to help
manage mental health concerns brought by families. During office visits, pediatricians can discuss the pillars of well-being by including these 5
priorities.
5 Ways to Promote Your Patient's Mental Health
1) Validation
Elena Man, MD, who writes for contemnporary pediatrics writes "parental mental health significantly impacts children, so remind parents that their
own self care is important for their own and their children's wel-being. Help parents acknowledge how much their children are missing from their
usual lives. School no longer includes the favorites of lunchtime chatting and playful recess interaction. Children are not likely having much
opportunity online to solidify new friendships. Their favorite activities are likely limited or on pause. Encourage parents to set aside time to devote
their full focus on their children. Emotional support from parents can be protective"
Man would continue to state how pediatricians should speak privately to their patients themselves to hear concerns, validate their struggles, and share
guidance for those whose home life is affected by substance use or other dysfunctions. Peers have become teenagers top priority, yet their current
environment is blanketed by a large dose of family. Family members can negatively affect children's mental health in numerous ways, that include but
are not limited to, a lack of support for a child's LGBTQIA identity, or holding opposing cultural beliefs or sociopolitical values. Pediatricians should
find out if their patients are facing rejection at home and ensure they are coping with that difficulty. Consequential stress from these conflicts and/or
the presence of domestic physical, verbal, and/or emotional abuse may have a lasting impact that could be mitigated if identified.
Man Stated these 4 conditions contribute the most to increasing children's stress levels during the pandemic.
When a circumstance is NEW.
When an event is UNPREDICTABLE as to when or how it may occur.
When competence is being THREATENED (challenged/threatened).
When lack of control forces SURRENDER of your autonomy.
2) Focus on what they can control
Pediatricians should help their patients understand what steps they can take to exercise. Children who control their own health and wellness have the
ability to combat feelings of fear and vulnerability. Share information with them about how mask wearing, hand washing, and social distancing all
reduce the spread of cOVID-19 and helps keep them healthy.
3) Practice safe social contact
Pediatricians should teach their patients that they can be part of the solution by following guidelines governing social contact. A common
misconception is that social distancing means self-isolation. Children don't need to be cut-off from the outside world. Seek creative ways/ideas for
your patient to have outdoor contact with friends and have fun with members of your household. We are social creatures, and safe social contact is
critical to keeping up spirits and resilience. Remember during this pandemic, that social media is your ally. Children can keep in safe contact through
texting, Instagram, twitter etc., that way even though they cannot physically keep in touch with their loved ones, they can still feel connected and have
a sense of normalcy'.
4) Create a guideline for your patients to have routines
Lindsay B. Jernigan of Psychology Today, writes that "kids thrive on predictability, and this pandemic has brought the destruction of structure and
certainty. Scheduled activities which help kids feel grounded and secure, have largely been cancelled. Creating a rhythm to the days will reduce the
anxiety, and increase motivation. Pediatricians should encourage their patients to go to bed at the same time each night, and to wake up at the same
time each day. Help your patients break down the days into chunks of time dedicated to work or play. And encourage your patients to have some form
of physical activity every day. Not only do these routines create structure and predictability that promote mental health, they also encourage biological
stability in appetite, sleep, and energy
5) Teach your patients that being spontaneous is a good thing
While humans crave structure, they also crave spontaneity. As Jernigan states that with the security of structure and routine around us, kids and adults
alike enjoy novelty, surprises, and, well, breaks in routine. Encourage patient parents to offer up small surprises, like serving up dinner in different
areas of the house, spontaneous outdoor hikes, movie/game night, or even something as small as eating dessert before dinner. Look for ways to have
novel experiences, like traveling to somewhere you have never visited in your home state or trying exotic foods. "Novelty is stimulating for the brain
and produces a rush of feel-good endorphins that boost mental and emotional resilience".
In Conclusion
When someone is diagnosed with a mental health disorder, by definition their impairment is causing significant suffering. How severe, is different in
each individual. However, evidence does support the inclusion of psychotherapy in the treatment plans. In pediatrics, this may include parental
guidance and intervention. When conditions are extreme enough, pediatricians may recommend a combination of psychotherapy and medication, to
provides the best outcome for their patient's health.
Finally: Man states "As caregivers, your role is to both support wel1-being and address common reactions during these historic threats. Additionally,
we must remain vigilant and prepared to initiate treatment when challenges have progressed into significant impairment and suffering4".
Pediatricians looking for more ways to positively impact their patient's mental health, can do so through this webcast.
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