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Austin parents, are your kids back at school? Watch for signs of mental health struggles

Nicole Villalpando
Austin American-Statesman

The kids are back in school. For many families, that's something to rejoice about, even though there might be worry about COVID-19, the delta variant, who is and isn't wearing a mask, etc.

A return to school can be a good thing, says Dr. Roshni Koli, medical director for pediatric mental health services for Dell Children’s Medical Center of Central Texas. It will increase kids' social interactions and connections to other people and establish routines again.

This year, many schools also are focusing, at least in these first few weeks, on social emotional learning including resiliency and coping skills and how to interact with other people.

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Hays High School students walk to their assigned school buses after school in April. Many kids have just returned to the school building this month after being gone for more than a year.

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For other families, returning to in-person classes might come with different kinds of concerns: mental health worries such as anxiety and depression. 

"None of us know what to expect in this new normal," Koli says.

Kids have experienced social isolation in the past 18 months, and while some kids are eager to be back in school and were struggling during the time at home, other kids with social anxiety actually felt that being at home was wonderful for them, Koli says. "It's going to take time to adjust," she says.

Every kid will be different when it comes to how well they adjust to in-person school. Koli thinks of it like the preschoolers at the start of the school year. Some cry for weeks about being gone from their parents. Others run into preschool and don't look back. Still others have a few bad days and then settle into the routine.

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Dr. Roshni Koli is the medical director of pediatric mental health services  for Dell Children's Medical Center of Central Texas.

Koli says there has not been a slow month this year when it comes to families seeking mental health treatment for their children. In a typical year, there would be a slowdown of requests in the summer months before an uptick once school began. 

"This year, we have consistently seen a really high number of kids and families struggling," she says. The emergency room at Dell Children's has seen "a significant increase" from previous years in kids coming in with a mental health crisis, Koli says.

She is expecting more such cases beginning a few weeks into the school year, as has happened in typical years. 

Parents can help by checking in regularly with kids about how school is going. What are their worries or concerns? If it is the virus, provide information that is based on scientific evidence. Kids pick up on a parent's cues, so try to remain calm about going to school.

Parents can help by modeling healthy behaviors, such as eating well, exercising, taking mental health breaks and having healthy social connections, Koli says.

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With kids, be on the look out for patterns. "Everyone can have a hard day," Koli says, but check for these things:

• Are they regularly irritable?

• Are they on edge?

• Are they having outbursts?

• Are they not sleeping, or sleeping too much?

• Do they continue to be overly tired even weeks into the new school year?  

• Are they not eating?

• Are they refusing to go to school?

• Have they stopped socializing or engaging with other people?

• Are they having nightmares?

• Have they let hygiene slip?  

"These are things we look for that something else going on," says Grichell Pelizzari, a family therapist with Thriveworks.

For younger kids, the symptoms of anxiety can be more physical, like headaches and stomach aches. It's not the one-off ache; instead, it's day-to-day complaints.

If a child seems to be a danger to themselves or others or is having suicidal thoughts, caregivers can call the mobile outreach team at Integral Care, 512-472-4357, which can work with police and emergency medical services to get that kid to a safer place, or parents can take children to a pediatric emergency room.

For kids who are not in immediate danger, caregivers should find them regular mental health services.

"All throughout our community, there are wait lists, which represent a great need for mental health care," Koli says. 

Two state-funded programs were designed to improve access to care.

Caregivers can contact their children's school counselor or school nurse. Through a program called Texas Child Health Access Through Telemedicine, schools can set students up for free telehealth visits. Those visits are limited, but they can provide help until a family can find a psychiatrist or therapist through a different avenue. Schools also have other programs for which students might qualify.

Parents also can call their pediatricians, who can get mental health guidance from a pediatric psychiatrist through the Child Psychiatry Access Network. The network returns a pediatrician's call about a patient within 30 minutes and can offer guidance on medication and treatment needs.

With both these programs, it's an opportunity for families to engage their schools and their pediatricians to be part of the team of people helping their child. 

"We are in a mental health pandemic," Koli says, but families can work on prevention: fostering coping skills, creating routine and making time for mental health care visits.