Millions of Americans moved into crisis mode in response to the outbreak of the coronavirus pandemic and the closing of schools. That includes Fulton County, Georgia, psychotherapist Sharnell Myles and the team of therapists she supervises as they ramped up outreach to students and families.

Using telehealth sessions to provide mental health services to her school-age clients, “we are meeting as much as three and four times a week with students, with their families during family sessions, as much as possible,” says Myles, a child trauma specialist and executive director of JoyUs Beginnings Child & Family Wellness Center in College Park, Georgia.

For Myles, there is a real concern that the pandemic and resulting school closures “pulled away a layer of support” for students, particularly those “who had already experienced trauma or come from trauma within the home.”

Trauma history

Concerns about health and safety, parents’ job security, and food access—compounded by the loss of routine and structure, physical distancing from friends, extended family, and trusted adults such as teachers and school staff—can cause stress and anxiety for even the most emotionally resilient students.

But for children and adolescents with a history of exposure to physical abuse, domestic violence, neglect, substance abuse, and poverty, the resilience needed to adapt to the significant changes like those caused by the pandemic may not be well developed. Research shows that exposure to these adversities, commonly referred to as Adverse Childhood Experiences (ACEs), can interfere with a child’s ability to learn and behave in school and even compromise their physical and emotional well-being into adulthood.

Research shows that the toxic stress resulting from ACEs can impact brain development, says Melissa Sadin, director of the Attachment & Trauma Network’s Creating Trauma-Sensitive Schools program. “Neurobiology is a significant and often overlooked aspect in a child’s social and emotional development,” she says.

It’s important for school systems to reach out and continue supporting these students while schools have closed or shifted online, and to begin making plans for that support once students return to campus, says Sadin, who is also a school board member in New Jersey and formerly served as a special education teacher and as a building administrator. “We need to start mapping out what that might look like.”

There is every reason to have extra concern about the impact of the national health emergency on children who have previous trauma histories, agrees child psychologist Jessica Griffin, executive director of the Child Trauma Training Center at the University of Massachusetts Medical School.

Although none of us has ever gone through anything quite like this in our lifetime, “we do have a lot of research on the impact of traumatic experiences like natural disasters and war on children,” Griffin says. From those situations, we know that children “with histories of previous traumatic experiences or histories of anxiety, depression, or other mental health problems are at greater risk” for being even more destabilized than the general population, she explains.

Consider, for example, evidence showing that child abuse rates tend to increase during disasters and other situations with significant economic impact. “We know that child maltreatment rates go up when unemployment goes up,” Griffin says. At the same time, “we’re seeing dramatic decreases in reports to child welfare agencies” of child abuse complaints “because people don’t have their eyes on children.”

Under normal circumstances, it’s often school counselors or student support services staff who follow state laws and procedures and file a report if a student comes to school with bruises and says a parent was the culprit. Now, however, “we’re not getting those calls.”

And in the cases that are reported, it often involves children who have severe injuries, Griffin says. “That’s what has me worried, because kids who experience trauma often have a lot of behavior dysregulation, so their behaviors are harder to manage. If you put them in a house of stressed-out families and everyone is scared, the risks are much higher.”

Protect children's emotional health

Along with indicators that anxiety, depression, and domestic violence have increased since stay-at-home orders went into place, add to that reports of teen runaways and the risks they face of exploitation, says Myles. “We know of young ladies who are missing, who we have reason to believe may be victims of sex trafficking.” Dangerous situations that threaten and trap young people “don’t stop because of a pandemic,” she adds. “If anything, they increase.”

This underscores the importance of protecting the emotional health of children and adolescents. Districts can begin by encouraging parents to take care of themselves. “Putting their own oxygen masks on first, so to speak,” Sadin says, and finding ways to de-stress, reduce power struggles, and just let some things go.

During an NSBA Center for Safe Schools webinar held in conjunction with the Attachment & Trauma Network (https://bit.ly/2Xwr5jK), Sadin and colleagues suggested other steps for parents to support and protect children’s emotional well-being during the pandemic.

These steps include maintaining a schedule that keeps routines intact (that includes getting up at a regular time) but also allowing for breaks and downtime; offering reassurance about student and family safety and providing age-appropriate information about concerns; ensuring that everyone gets adequate rest, physical activity, and fresh air; and keeping connections strong within the family unit (with family meals, art projects, and game nights, for example) and outside (via phone calls, texting, video phone calls, and video conferencing).

There’s good news in that this generation of “digital natives” typically feels “the same level of connection and support with someone on the other end of a phone or video chat” as when meeting face to face, says Sadin. That is not necessarily the case for some older people.

Ultimately, what is at stake is the “psychological well-being of a generation of children that will look back when they’re adults and point to this as an unbelievably influential time in their lives,” says Griffin. “We have what could be seen as an obstacle for children but also is an opportunity, if we get the right policies in place, to safeguard kids’ psychological well-being or at least mitigate against the potential damage. Science shows that the No. 1 factor in recovery is the presence of a supportive caregiver, and it doesn’t matter what the trauma is.”

Kids of concern

Child Trends, the national child welfare research center with which Griffin collaborates, recently highlighted the need for greater attention to several groups of “forgotten children” who face unique obstacles, often compounded by poverty, during the national health crisis. They include:

• 7 million infants, toddlers, and children with disabilities who, with their families, struggle with the sudden absence of health services and learning accommodations as providers close, and schools grapple with providing remote instruction to all students.
• 2.8 million children living in the care of grandparents who are also at increased risk of complications associated with the virus. 
• 437,000 children currently in foster homes who may face challenges visiting with family and siblings or lose critical reunification services.
• 43,000 youth living in juvenile justice facilities, where viruses can spread more easily.
• 5 million children living with at least one unauthorized immigrant parent, because families of mixed legal status are less likely to apply for social services, more likely to have breadwinners employed in industries hit hard by COVID-19, and less likely to have health insurance.

In addition, 700,000 adolescents ages 13-17 (1 in 30) reported some form of homelessness (running away, being kicked out, couch surfing) over the course of a year, according to a national survey by Chapin Hall at the University of Chicago.

“The policy implications here are enormous,” says Griffin. “We know we have so many vulnerable populations, kids who have experienced trauma, kids in foster care. What concerns many of us in the field is that behavioral health disparities, education disparities, all of those disparities are going to be even more magnified by this pandemic.”

The health emergency “is a social justice issue, an equity issue,” says Myles. One way to better protect the most vulnerable populations in schools is for districts to have a contingency plan that prepares for the continuity of delivering mental health services, “just as there is a contingency plan for delivering teaching and learning,” she says. School systems often have such a mental health plan prepared for summer breaks, but they also can benefit from having a plan ready to go for unexpected situations like the pandemic.

At some schools she worked with, counselors and social workers had a roster of students and families identified as high-needs or at-risk. “They were able to pull up names, contact information, and knew what resources they needed, such as connection with mental health support. We were able to reach out to those families quickly.” Other schools, unfortunately, were not as prepared. And when developing that mental health strategy, it would be worthwhile also to consider how to support the mental wellness of teachers and staff, Myles says. Many teachers are carrying considerable stress from juggling their remote teaching responsibilities and concerns for their students, right along with their own family needs and obligations.

Relatedly, as school districts look to the day when they welcome students back to their brick-and-mortar locations, Sadin encourages them to begin now by mapping out a reentry plan that is sensitive to students’ mental health. One suggestion: meet-and-greet events that allow students to be reintroduced to school in a safe, inviting manner. The events could resemble what is often done at the beginning of the school year for new students or kindergartners, she explains. “Teachers are paid to be there, parents are encouraged to come, and students are given an opportunity to see their classrooms and meet their teachers, who, in many cases, will not be the teachers they left in March.” With proper planning, students’ former and new teachers can be paired up to give students a vital sense of continuity and familiarity.

Equally important, she says, is having counselors and student support staff get together and identify “Who are our KOCs [kids of concern]? Who are we most concerned about?” and reach out to them. If parents are not available to bring a student to the meet-and-greet because of work, transportation, or other issues, have a school bus provide transportation.

“We are already experiencing kids who are not showing up for online learning if the district has been able to provide that, or who aren’t coming to drop-off points to pick up school meals. They should be on the KOC list now,” Sadin says, with teachers, counselors, and student services contacting families and guardians with regular check-ins to determine what assistance a student or family may need. “Anything we can do for our students now will improve their ability to reenter when schools resume.”