Michigan Association of Health Plans

Michigan teens’ anxiety increased during COVID. Resources to help did not.

In the Upper Peninsula, a rural school superintendent fears he might have lost scores of adolescents to the pandemic.

Of the dozens of students in Munising Public Schools who opted for all-virtual learning over the past year, about half all but dropped out of sight.

“They failed multiple classes,” Superintendent Pete Kelto told Bridge Michigan.

“I wish I could predict the future. The unknown is what will happen to these students in the coming year.”

A recent Bridge series documented the rise of untreated severe mental illness in Michigan children, spotlighting a patchwork safety net and lack of pediatric psychiatric beds in wide swaths of the state.

But it’s a crisis that runs deeper than just those with the most severe mental illness ─ it’s reflected in anxious students struggling to stay in touch with school, with their friends, or simply get up and face another day. Resources to help this group can be just as scarce.

In suburban Grand Rapids, a mental health clinician at Kentwood Public Schools saw a greater impact over the past year than just academic failings among the teen students he counsels ─ depression, outbursts of anger, verbal fights at home with family members.

“There is no question certain mental health problems became worse for some,” said Bradley Wallsteadt, who’s been stationed at the high school since the fall of 2019.

“There are a lot of different things that happened during the pandemic, with students isolated at home. A lot of students go to school because they would rather be a school than home.”

And a busy emergency room at Helen DeVos Children’s Hospital in Grand Rapids was a further sign of the pandemic’s toll on teens, as officials reported that ER mental health admissions for those under 18 jumped from fewer than 100 in March 2020 to more than 140 in March 2021. Psychiatric admissions tripled over the same months.

“There is an impact from the social isolation of the pandemic. There’s evidence to show that’s the fact,” said Dr. Matthew Denenberg, vice president for medical affairs at Spectrum Health.

“But with that said, the reason we are seeing more and more adolescents over the last decade is the lack of resources to get them treated before they have a crisis.”

Of all age groups, experts say, teens are especially vulnerable to the psychological toll of the pandemic. It struck at a critical stage in their development as they’re easing away from dependence on their parents, as their relationships with peers become paramount. The pandemic ─ with all its disruptions of school and normal social gatherings ─ pulled the plug on that.

“It’s an absolutely critical developmental period,” said University of Michigan psychology professor Marc Zimmerman.

“It’s a period where they are trying to create their own identity, to test their identity against their friendships. If you were somewhat predisposed to mental health issues before, this was a potential tipping point.”

But there were warning flags for teen mental health well before the pandemic, as a 2019 analysis by the Journal of the American Medical Association Pediatrics found that one in seven U.S. children ages 6 to 17 had a mental health disorder like depression, anxiety or attention deficit-hyperactivity disorder. Nearly half received no professional counseling or treatment.

Suicide among young people in Michigan by then had been building for years, as it now ranks as the second-leading cause of death for those between the ages of 10 and 24.

At the same time, mental health agencies across the state were straining to fill job openings ranging from case managers to therapists to peer support specialists ─ in many cases, leaving children untreated.

At Arbor Circle in Grand Rapids, CEO Kristin Gietzen is grappling with more than a dozen job openings for adolescent and children services, out of a staff of about 110. The West Michigan nonprofit behavioral health agency serves about 5,000 children and adolescents, in addition to adults.

That shortage looms just as the pandemic’s hit on the emotional health of teens becomes clearer. A national survey found that 50 percent of parents said their child or teen showed signs of a new or worsening mental health condition during the pandemic. One in three girls and one in five teen boys experienced new or worsening anxiety.

Gietzen said agency therapists are dealing with everything among adolescents from threats of suicide, to self-harm to struggles with isolation. Their job has been rendered more difficult by the pandemic’s shutdown of in-person therapy and home visits.

“That’s really an important part of treatment with kids. We go into schools and we go into homes and do lots of observation and that was missing,” she said. “We were fearful we were missing something critical because we couldn’t see the body language.”

COVID also laid bare the state’s limited investment in school mental health supports. Michigan continues to rank near the bottom nationally for elementary and secondary school counselors.

According to a 2018-19 survey by the American School Counselor Association, Michigan schools had a student-to-counselor ratio of 691 to one — second worst in the nation, ahead of only Arizona. The national average was 430 students per counselor.

Experts agree that counselors and other mental health professionals can be vital to student psychological wellbeing, especially as the pandemic adds layers of stress and social isolation to their lives.

This article originally appeared in Bridge. Read more here.

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