Mental Health

Managing a child’s mental health can feel like an uphill battle with no end in sight. Often times, parents and caregivers feel lost when it comes to navigating through their child’s emotions when they are experiencing a mental health crisis or mitigating a situation before, during and after a crisis occurs.

Some of the best resources to help parents and caregivers better understand their child’s mental health are the same tools providers routinely use for any patient coming into Seattle Children’s with a mental health issue. Developed by pediatric mental health experts at Seattle Children’s and used in clinic for over a decade, the escalation cycle is one such tool that parents and caregivers can easily adapt to use at home.

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Dr. Yolanda Evans and social worker Erik Schlocker of Seattle Children’s Adolescent Medicine Clinic bring you this post as part of our Supporting Mental Wellness and Family Life During COVID-19 efforts.

The COVID-19 pandemic has changed the way humanity lives. We are sheltering in place, changing our patterns of social interactions, and relying on virtual connections to maintain relationships with people in our lives. The changes have been stressful for all of us.

For teens, the pandemic has meant school closures, missing normal, close personal connection with peers, inability to give hugs to friends as high school graduation season approaches, and potential for increases in anxiety and depression symptoms. Read full post »

Adria Cooper, 17, shares her experience dealing with the COVID-19 pandemic.

Being a teenager isn’t easy by any means. With school, friends, and extracurricular activities, along with added the pressure of increased responsibilities and desire for more independence, teens are battling a load of complex emotions on a day-by-day basis.

Now, top off their struggles with a global pandemic that’s completely transformed their lives, and they’ve got a whole new set of challenges they must navigate ahead of them.

“Being away from school and friends feels very weird,” said Adria Cooper, 17, a junior in high school. “Sometimes I am happy to be on my own and not have to worry about what other people think. I can do what I want, but other days I feel very isolated and lonely.”

As a society as a whole, it’s not surprising that the COVID-19 pandemic has brought about increased feelings of loss, grief, uncertainty and loneliness.

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Parents are facing some high expectations right now. The COVID-19 pandemic has brought a wave of uncertainty to our homes, impacting finances, food security, health and safety. And while that would have been plenty to worry about, many parents are also required to work from home while managing their child’s education at the kitchen table.

It’s a lot.

“We know there are direct correlations between parental stress and a parent’s ability to give their child the one-on-one positive interaction that kids need to thrive,” said Dr. Megan Frye, a child psychologist at Seattle Children’s Odessa Brown Children’s Clinic. “We also know that the brain is super flexible. When we are going through stressful experiences, we as parents can learn and implement concrete skills and practices that will help us manage our own stress, connect better with our children and model what it looks like to be resilient when things are challenging.”

Reducing anxiety can feel impossible if your child care is obsolete and you don’t have time for an hour-long yoga class. On the Pulse has collaborated with Seattle Children’s experts to identify practical tips to help parents manage their stress during the COVID-19 pandemic and long after.

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In recognition of Autism Awareness Month, On the Pulse is shedding light on the COVID-19 pandemic and the impact it has had on children, teens, and young adults with autism spectrum disorder (ASD) and how we can support them through these uncertain times.

As a society, we often rely on routines. With the COVID-19 pandemic uprooting our daily activities, we are being challenged to adapt to what we’re considering the “new normal.”

This is an especially challenging time for those with autism. Routines are critical for individuals on the spectrum, as they thrive on structure and consistency.

In recent data from March 2020 released by the Centers of Disease Control and Prevention (CDC), autism now affects 1 in 54 children. According to the CDC, ASD is a developmental disability that can cause significant social, communication and behavioral challenges. Individuals often repeat certain behaviors and might not want change in their daily activities. Many also have different ways of learning, paying attention or reacting to things. Signs of ASD begin during early childhood and typically last throughout a person’s life.

James Mancini, a speech and language pathologist with the Seattle Children’s Autism Center, and Tammy Mitchel, program director of the Alyssa Burnett Adult Life Center, share ways individuals with autism and their families can cope during this unique time.

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As coronavirus disease 2019 (COVID-19) continues to spread, adults, children and teens are trying to make sense of what the outbreak means for their families and communities. Those with anxiety disorders may feel more worry than usual.

On the Pulse asked Dr. Jennifer Blossom, a psychology postdoctoral fellow at Seattle Children’s Psychiatry and Behavioral Medicine Clinic, how to share information with the children and teens in your life in a way that helps prevent too much worry. The good news is that just as there are steps you can take to help you and your loved ones try to avoid the illness, there are steps you can take to help your child or teen cope with the situation.

“There are a number of ways parents can successfully help their child stay on track during this time,” Blossom said. “In general, the goal is for parents to encourage their child’s participation in routine activities, such as going to school (as informed by the most recent public health recommendations or decision by your child’s school district), while helping their child think realistically about the risks.” Read full post »

This past December, Nataly Cuzcueta was brought to tears by a word from her 4-year-old daughter, Kira.

With her little arms outstretched, Kira looked up to her mother and said “up.” It may seem like a simple request, but for Cuzcueta, it was a major milestone and cause for celebration. Immediately and happily, she obeyed. She lifted her daughter into her arms and excitedly twirled around the room, a smile beaming across her face.

“Today has been a day I’ll never forget,” she said.

Miles away at Seattle Children’s Autism Center, Dr. Mendy Minjarez, director of the Applied Behavior Analysis Early Intervention Program and interim executive director of Seattle Children’s Autism Center at Seattle Children’s, celebrated as well. Cuzcueta had captured the moment on her camera and had sent a note of gratitude to Minjarez and her care team.

“It was monumental for our whole team,” Minjarez said. “I remember getting the email and running down the hall excitedly to tell our team. It’s been a long time coming.”

Today, Cuzcueta says the team at Seattle Children’s Autism Center is like a second family. Her twin daughters have come a long way since they first started receiving treatment more than 2 years ago. Read full post »

Microaggression may not be a term that most are familiar with.

Without knowing it, you may have been the recipient of a microaggression, or may have committed a microaggression.

That’s precisely why it’s important to understand what microaggressions are, so we can address and challenge our own biases, be aware that disparities exist, and assess the significant impact it has on our society.

On the Pulse sat down for a Q&A with Dr. Roberto Montenegro, a psychiatrist from Seattle Children’s Psychiatry and Behavioral Medicine clinic, who studies microaggressions.

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Seattle Children’s Zero Suicide Initiative helps identify and treat children ages 10 and up who are at risk for suicide.

A teenage boy arrives at Seattle Children’s Emergency Department (ED) with an increased heart rate. His parents are scared and unsure of what could be causing their son’s pulse to spike. While the nurse takes the patient’s vitals, she asks him a series of questions about suicide — prompting the patient to share that he tried to overdose on prescription medication the night before. The nurse informs the provider, and an immediate plan is set in motion to further assess not only the patient’s physical health, but his mental health, as well.

A 10-year-old girl enters the ED with a sprained elbow after taking a tumble on the soccer field. Her parents have been taking her to therapy to help with her anxiety, and the therapist communicates his findings with them often. Because she is so young, the therapist has never directly asked the patient if she’s ever had suicidal thoughts. After the ED nurse initiates suicide-screening questions, the girl admits that she has had thoughts about harming herself in the past. Prior to discharging the patient, a mental health evaluator shares resources and information about suicide with the family, and the provider contacts the patient’s therapist and asks the girl’s suicidal thoughts be addressed in their next appointment.

These are just two stories of the more than 500 children who have screened positive for suicide risk in Seattle Children’s ED and inpatient settings over the past six months who presented for concerns unrelated to their mental health. These crucial “catches” were made with help from a new clinical pathway known as Seattle Children’s Zero Suicide Initiative (ZSI), a universal screening method to help identify and treat youth at risk of suicide.

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When Sam Duenwald, 18, was in seventh grade, he got sick and had to miss a couple of weeks of school.

However, a couple of weeks of missed school turned into three, then four, then five.

“It became a vicious cycle,” Sam said. “I was getting really anxious about going back to school because I knew I had missed a ton of homework and that was causing my grades to drop, so I decided to avoid going to school altogether. This of course spiraled into missing even more homework, making my grades suffer further.”

Naturally, the situation caused tension between Sam and his parents.

“There was a lot of stress at home, and I was fighting with my parents all the time,” Sam said. “They knew I needed help.”

Sam’s anxiety became so severe that his parents took him to see a psychiatrist at Seattle Children’s midway through seventh grade. He was prescribed anxiety medication, which helped Sam finish up the school year.

“Over the summer, I kept telling myself, ‘I need to go back to school regularly; I’m going to be in eighth grade and everything is going to be great,’” Sam said.

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