By David Woodlock
Published in Modern Healthcare
Much of the public policy debate about re-opening society after months of stay-at-home edicts balances today’s need for health and safety with tomorrow’s need for economic and social well-being. What’s largely missing from these discussions are the long-term implications of the trauma that this crisis has inflicted on children, potentially creating a “wounded generation” of emotionally—and physically—damaged young adults.The landmark Adverse Childhood Experiences Study, conducted some 25 years ago, proved that traumatic experiences—ranging from divorce to abuse to exposure to community violence—are some of the strongest predictors of adult mental health and chronic health problems, such as diabetes, heart disease and drug and alcohol abuse.
Every child in America is at a heightened risk of having an adverse experience today, whether it’s because of the loss of a family member, friend or loved one; serious family distress borne of financial disruption; or repeated viewings of body bags in trailers on their phones. Multiple studies tell us that the likelihood of future physical and emotional problems for these young people has increased exponentially.
And now we can add the trauma of watching another black man die during an encounter with a white police officer, and the unsettling sight of looting and rioting across the country.
We cannot wait to see how the damage to children will play out. We need to do something about it. Now.
Just as physical distancing reduces the spread of disease, emotional supports, coping skills training and behavioral health interventions mitigate long-term health problems stemming from childhood trauma. They also help children become ready to learn and embrace their developmental milestones.
To address every child’s unique needs, we must create a broad-based public health campaign and intervention by parents, schools and primary-care doctors. This effort must be visible on the scale of smoking cessation campaigns and far-reaching enough to engage every child. We need to offer interventions tailored for kids of different ages and cultures, rather than a one-size-fits-all approach.
Our favorite childhood characters have taken on some tough issues before. For example, on “Sesame Street” there’s a Muppet named Alex who has an incarcerated parent, and Julia, who has autism. Seeing characters on TV talk about how they are feeling and coping through this pandemic will be invaluable to young children.
For older kids, we should look to sports and social icons, but also peer-based programs. As a father of six, I can tell you my kids would often rather hear from a peer than a parent, no matter how well-informed that parent is.
And, just as broad-based testing for COVID-19 is necessary to ensure a safer re-opening, so too is broad-based screening of children as schools reopen. Those screenings will need to be conducted for all children, just like mandatory vaccinations.
We will identify many children who have been hit hard by this crisis. We need school-based coping skills programs—run by teachers and guidance counselors—to be available in the same way self-isolation guidelines have been given to people who have self-quarantined. Children who come to us with significant behavioral issues, including self-harm or suicidal thoughts, should be connected to behavioral health providers immediately.
Finally, we should give parents the tools and resources they need to talk to their kids. All people have an innate need to make themselves feel better when they are in distress—and many of us are doing that with alcohol and eating, judging by recent sales numbers. Those coping decisions, while understandable, will lead to bad health outcomes if not balanced by moderation and healthier choices. Adults must help kids make good coping decisions and find positive ways to make themselves feel better. But many parents are overburdened and struggling themselves, and need resources and tools to help guide their children.
As we reopen, we’re going to hear a lot about stockpiling ventilators, test kits and PPE for a possible second wave of COVID-19. There is another critical item to add to this stockpile—emotional resiliency for our children. If we forget about protecting the emotional well-being of our children, the trauma of this crisis will haunt a generation of kids burdened by mental and physical problems for years to come.
