Children’s mental health crisis persists after pandemic

Dr. Kiti Freier Randall, a pediatric neurodevelopmental psychologist and head of the Division of Psychological Services at Loma Linda University Children’s Hospital, continues to address the mental health crisis that emerged during the COVID-19 pandemic. She describes this ongoing situation as the “pandemic echo,” highlighting its lasting effects on children’s mental and emotional well-being. Despite the virus’s decline, the psychological ramifications remain significant.

According to Dr. Freier Randall, every child has experienced trauma during the pandemic. Adolescents lost important milestones like proms and graduations, while younger children faced interruptions in essential developmental stages, such as speech and social skills. In 2023, there was an increase in referrals for speech and language delays, contradicting the assumption that issues would resolve as the pandemic receded. “Trauma doesn’t vanish on command,” she stated. “There are long-term consequences, especially for those already at risk.”

A particularly distressing trend is the rise in suicidal thoughts among children. Before the pandemic, the psychology consultation service at Loma Linda University Children’s Hospital typically encountered one case of suicidal ideation every few months. However, during the pandemic’s peak, 80 to 90 percent of mental health consultations involved children expressing suicidal thoughts or attempts. In response to this alarming trend, the American Academy of Pediatrics and other organizations declared a national state of emergency in children’s mental health in 2021.

Girls aged 14 to 16 were among the most affected, with high rates of suicidal ideation linked to prolonged social isolation during formative years. Children with chronic illnesses, who often score high on adverse childhood experiences (ACEs), also exhibited increased psychological distress. “Chronic illness combined with high ACEs during a national trauma creates a perfect storm,” Dr. Freier Randall remarked.

Dr. Freier Randall frequently references the ACE study, which revealed that adverse childhood experiences correlate with long-term health issues in adulthood. Building on this, California has introduced Pediatric ACEs (PACEs) initiatives to encourage pediatricians to screen for childhood trauma and offer trauma-informed care. She noted, “More adversity in childhood increases the risk of mental health challenges and physical illnesses later in life. The pandemic adds a baseline score of one to every child in America. We must treat it as the trauma it was.”

One of the major challenges in addressing post-pandemic mental health is the oversimplification of children’s issues. Dr. Freier Randall criticized the reliance on behavioral checklists that label children as anxious or oppositional without exploring the underlying reasons for their behaviors. “We need to ask: What experiences shaped this child? What burdens are they carrying from the pandemic years?” she urged.

She advocates for personalized treatment plans that consider both observable symptoms and the hidden histories of children’s lives. “Some children act out, while others withdraw. Both behaviors signal a need for help rather than judgment.”

Despite the obstacles, Dr. Freier Randall remains optimistic, particularly when communities prioritize awareness and proactive responses to mental health needs. “Children are incredibly resilient,” she stated. “However, resilience is fostered through support from families, schools, healthcare providers, and a society that recognizes their experiences. We don’t need to dwell in the past, but we must remember it to effectively support children moving forward.”

If your child is experiencing anxiety, depression, or behavioral issues, resources are available. You can contact Loma Linda University Children’s Hospital Mental Health Department at 909-558-9113 or visit their website to schedule an appointment with a specialist.