Facebook Live 7/15- Answers

Hi everybody, thank you for being here. We’re going to talk about mental health and COVID today, we’re going to specifically focus on our kids. We’re still talking about schools, getting back to school, and what it means for our kids. We’re going to talk about why the American Academy of Pediatrics came out and said it’s more risky for our kids to stay home than to go back to school. With the surveillance our teachers and social workers do with our kids at school is a big part of safety, but also being able to get them services is big.

To do a brief overview of COVID and where we are, Virginia still remains well below the threshold for percent positive. We’re doing a good job. I know the Governor came out and said there will be greater penalties for not wearing masks. I think there is something really important in our data, which is how we live with COVID side by side going forward, and how we protect ourselves. The important part of the data that I cannot find is the age group of the people that are now becoming positive with these spikes.

Here’s the scientific fact: as people mingle and interact more, we are going to see more positive results. But if those positives are in the age group that have significantly lower risk, we can say that is not necessarily a bad thing, as long as we’re protecting the at risk groups. In fact, it may even be a means to get closer to herd immunity.

Some other important data that’s come out in the last week: the idea that we had no immunity in the population for this SARS-COVID 19 virus is mistaken. We do have cross-reactivity with previous SARS and COVID viruses, which is why people aren’t getting symptoms even though they have the virus. That is now thought to be attributed to those who have cross immunity. As we look at some of the other states, the best I can tell you from the statistics coming out of other states is that none of them are nowhere near hospital capacity. As we go forward and look at living with COVID, we’ll have to determine which data points matter. This includes the age group, who’s getting this, are more people dying from this? There are some areas that have had spikes in deaths, but we need more demographic data on that as well. We need to evolve the way we’re looking at this, so we can make more substantive decisions for who can be out in public, and what’s at risk for them, which brings us back to schools.

We’ve seen a lot going on in the last few weeks about schools making decisions. The Richmond School District has decided to go fully virtual, which is to say I cannot get over the fact that the evidence is so strong that children need schools. I’m going to read you a few statistics that came from a Wall Street Journal article, looking at relative risk for having COVID. In a typical year, 190 kids die from the flu. We don’t shut down schools for the flu. In a typical year, 436 die from suicide, and 625 from homicide, which can be related to violence in the home, 4,114 die from unintentional deaths such as drowning. In fact, more kids have died from shootings in Chicago than have died from COVID. When you do a relative risk model on COVID for children, the risk is incredibly small. They should be in schools so we can focus on other things that may be detrimental to their health, including falling behind on education and not being able to read on a school level.

Today, we’re lucky to have Kristin Lennox from ChildSavers. She’s part of the immediate response program, she’s one of their supervisors, and a licensed clinical social worker. We also have Sean Blair who is the COO for one of the providers for our kids who are getting services through our schools. They’ve had to make that transition to do that more in the home. His organization is NCGCare, which is coordinated, appropriate, responsive and effective.

We’ll start with Kristin. I just talked a little bit about the risks for kids, that supersede any risk they may have from COVID. I’d like for you to tell us a little bit about what you’re seeing, and what your concerns are.

Kristin: Thanks Siobhan. You mentioned some of the challenges that families are encountering right now. One of the biggest stressors right now is the loss of routine, and the loss of emotional engagement and support for kids. We’ve switched all of our mental health services to telehealth, which means therapy through the phone or Zoom. There are some challenges there including scheduling, or lack of confidentiality due to lack of space. But we’ve also seen many strengths and strides. This includes physical safety, no travel so we can reach more difficult areas, and there are many more parents who are involved in the services. Normally parents may not be able to participate as much because they’re in school, or working.

Senator Dunnavant: Are you able to reach everybody with challenges of broadband and access? How are you dealing with screen fatigue?

Kristin: We tailor the treatments to what the families need at the time. We recognize that may just be a phone call to keep them connected to mental health services. We give support and advice to parents who are doing a lot of the work that we’d be doing, or that teachers would be doing. We also make sure to know what to look out for in terms of symptoms of depression or anxiety, and how to manage those.

Senator Dunnavant: Tell us a little bit about how the kids are? How are their levels of anxiety? How are they responding to COVID? I know, as a physician in my office, that we are seeing more people come in who are anxious and irritable, and they are actually starting medication because they are not themselves. Here are some more statistics from that Wall Street Journal article: 45% of people with COVID are feeling isolated within their homes, and they are having more emotional responses to that, and needing treatment.

Kristin: I would say that at the initial outset of the pandemic there was a lot of concern that the crisis would spike right away. A lot of us were focusing at the beginning of this pandemic on physical safety and resources. Now that we are months into the pandemic, resources aren’t being given the way they were, and experiences of stress and anxiety are pieces of a larger puzzle. This raises questions of whether families are really getting what they need to survive to mitigate stressors at home.

Senator Dunnavant: Are you seeing more depressed teens?

Kristin: I would say that everyone’s anxiety and depression levels come in waves. We all experience that the longer this drags on. The warning signs to look for are isolation, separation anxiety, defiance and opposition, and agitation. These are some things we’re seeing in children, and in parents as well.

Senator Dunnavant: Sean, tell us what you’re seeing, and how your services are going, and what you’re seeing in your world.

Sean: Thanks Senator Dunnavant. We’re seeing some positives and some challenges when it comes to telehealth. Some of those positives that Kristin mentioned are real like speed and staff having greater access with flexibility. There are also challenges with broadband and with individuals not having access to the internet or to computers, or access to platforms that make telehealth easier. These things are more difficult on phones and small screens versus computer monitors with broadband. I think we’re all trying to navigate our way through, and one thing I am pleased to see is that providers have really come together in this time. Legislators have come together, and the state has come together to see how creatively we can come together for individuals. For example, in the past there have been regulations against telephonic and telehealth services, and some of those regulations have been opened up in terms of flexibility which is nice to be able to deliver that service. Hopefully that trend will continue past this pandemic. I also want to highlight some of the challenges, individuals in the school environment is how mental health issues have been identified in the past, with school counselors and a variety of professionals interacting with kids on a daily basis who have been trained to look for the signals and signs to get them help sooner. We’ve been able to see those individuals walking through the hallways with their head down. It is a challenge as individuals don’t go back to school to get them the help they need because their symptoms are not being identified by professionals.

One very real thing we are seeing is the number of calls to child protective agencies has decreased. On the surface that is a good thing and hopefully that is the case, but the question comes from professionals that those issues aren’t being identified because professionals are not around kids to identify those symptoms. Those are some of the biggest challenges that we are running into going forward, and especially if children aren’t going back to school.

Kristin: I’m glad you mentioned that Sean, I think that is definitely something that helping professionals have leaned on the schools to report on because they are mandatory reporters. But I am also curious to build a culture and community of care, so what if other folks are trained or more knowledgeable about what to look out for. Everyone goes to the grocery store, what if there was a table at the grocery store with training about mental health so folks can learn about the symptoms to look out for with regard to abuse and neglect. There are lots of other avenues for opportunity to learn more and engage the community. What if it wasn’t just on the schools but instead this is an invitation for society at large to be more aware of what to look out for.

Sean: That is very well said and I agree with that. With mental health, it takes a village. Opportunities for parent education is also so important, and opportunities to reach individuals in the community is so powerful to be