Social and emotional crises rise in children, along with alarming language

Certain words instantly sound alarms and ring with terrifying clarity.

Statements such as “I wish I was dead” and “I’m going to kill myself” are profoundly chilling – especially coming from children.

“At least daily we have a student who makes a statement like that,” said Oriana Filiault, a social worker at Franklin Middle School, which serves fourth- through eighth-graders. “We have to connect with them immediately” to determine the reasons, their mindset and the potential for self-harm.

It’s a disturbing trend and a weighty responsibility for school officials – and parents. COVID-19’s side effects of isolation and greater dependence on social media increased the frequency of such remarks in school age children – but also made their meaning a little harder to divine.

“We’re finding that a lot of them are using those words to express strong emotions they’re not able to process or tolerate,” said Filliault. “The words ‘die' and ‘I want to kill myself,’ have become common expressions of frustration.”

Throughout the evolution of communication, those expressions have been used to express rock-bottom despair or overwhelming guilt, shame, and anger – all red flags for caregivers and school officials to intervene without delay.

“You have to take every incidence of that seriously. You would never want to discount a serious safety threat,” said Susan Stearns, executive director of NAMI – NH, the state chapter of the National Alliance against Mental Illness. “Talking about feeling hopeless is always a real concern that kids are in a very dark place.”

COVID upped the ante, increasing feelings of hopelessness, and making many children uneasy about their future, their family’s safety and the world. At the same time, children’s everyday language took a darker and blunter turn with a lexicon borrowed from social media, online platforms, apps and tropes, and emotionally charged statements.

With schools back in-person full-time, school officials are serving as watchdogs, screeners, calculators, reporters and responders to signs of suicide risk and self-harm. Social workers like Filiault coach kids on how to use language accurately to express what they feel inside - and to request help when they need it.

Taking the social and emotional temperature of teens and younger children can be a guessing game, and keeping them safe can become a race to discover the truth.

The landscape at Laconia High School

“The pandemic impacted everyone at some capacity whether they show it or not,” and some people, including children, are more prone to internalizing, said Kathryn O’Connor, a social worker at Laconia High School. LHS, like many other schools, is addressing social and emotional student health with wraparound approaches that include individual and group discussions and interventions, and referrals to mental health resources in the community.

In the wake of COVID, a behavioral health counselor from Lakes Region Mental Health has a full schedule of student appointments during her two days each week at LHS.

In children and teenagers, anxiety and depression can show up as acting out, isolating, being angry or having mood swings, increased substance abuse and sleep changes. But internal distress is not always visible, and teenagers are often bottled-up or simply non-communicative. Schools are moving to create more open and connected environments that encourage interaction.

At LHS, new staff protocols such as greeting every student as they enter school in the morning and having more teachers walk the hallways between classes, plus bonding events such Winter Carnival and Springapalooza, which is new this week, are designed to help students feel more at home and linked to school, teachers and each other. The number of affinity clubs and activities has ballooned in response to student interests.

Shifting interaction to in-person means reducing student reliance on technology. COVID greatly increased the dependence on social media in children, according to mental health workers. “For some kids it’s the only way they can connect,” said Mollie Greeley, head of guidance at LHS.

The return to in-person school each day, for six to eight hours a day, also came as a culture shock. Some students experienced sensory overload and sought quiet breaks. Many were finding it harder to maintain stamina in the classroom learning environment, Greeley said.

“We are seeing increased rates of anxiety coupled almost with a decrease in resiliency and ability to overcome hurdles,” Greeley added. Challenges that might have seemed routine or less intimidating before the pandemic are derailing more students, who are now brittle and anxious about school and their place in it.

A collective traumatic event for children

In general, COVID made chronic mental health challenges steeper and anxiety and depression more widespread, but hit children and older people hardest, according to worldwide mental health surveys.

“It’s been a collective traumatic event,” said Stearns at NAMI -NH. "For young people who have not experienced major challenges in their lives, it’s even more traumatic.”

That translated to worrisome statistics in New Hampshire. Data indicate the scope of pandemic’s effects on kids - and the critical nature of remediation that is necessary now.

According to state Office of the Child Advocate, 161 children statewide lost a parent or primary caregiver who died from COVID between the pandemic’s onset and June 30, 2021.

In Franklin, between September and the end of March, school counselors screened three fourth- and fifth-graders, 14 sixth- through eighth-graders, and 37 students in grades nine through 12 for suicidal ideation, which includes making comments or acting in ways that might indicate thoughts of killing themselves and how to do it.

On three separate days in September 2021, January 2022 and March 2022, three or more students in Franklin schools were screened for suicidal ideation based on their behavior or remarks. 

It’s uncertain how many of the 54 screenings resulted in psychiatric admissions, said Barbara Slayton, the school district’s coordinator of school wellness. “Anecdotally, there seems to be an increase in the acuity of the suicidal ideation expressed.”

The most recent statewide statistics on youth suicide risk and mental health, including substance abuse, are from 2019, and data collected in fall 2021 will likely not be available until later this year, Slayton said  

But early numbers are providing an inkling to the magnitude of children’s despair, distress and disconnection.

Statistics tell a story

For instance, in the wake of COVID-19, enrollment in NAMI-NH’s mental health support programs for children has spiked. FAST Forward, a wraparound family-peer support system, served 175 children within serious emotional disorders in Febuary 2020. That number vaulted to 450 in January 2022, and approximately 100 families are now on the wait list and receiving interim help, said Stearns.

Emergency mental health hospital visits also skyrocketed, with the number of children boarding in hospital emergency departments reaching a record high of 51 across New Hampshire on Valentine’s Day 2021. Since August 2020, the daily tally has remained in the double digits, said Stearns. Before COVID, it was frequently less than ten.

The state’s new rapid response call system, which rolled out in January this year, received 1,565 mental health and substance abuse related calls during its first month, 290 of them involving children under age 18. Of those, 121 were identified for intervention by mobile crisis support teams – a service that expanded statewide in January, after being delayed by COVID. The goal is to quickly reach and stabilize adults and children in mental health crises, without overloading emergency rooms, where they have historically waited for days or weeks.

According to the report by the Office of the Child Advocate, the pandemic stressed children with isolation, fear and uncertainty – which exacerbated trauma and further dysregulated children with chronic conditions who require consistency and connections.  This increased the potential for aggressive and harmful behavior in children with developmental disabilities or other serious mental illness, according to OCA. Records from Hampstead Hospital, the state’s only mental health hospital for children, show that 52% were not recorded as admitted from the wait list during the months of August and September 2021.  

COVID’s social and emotional isolation and blows to connection and self- esteem were especially pernicious for girls, according to current data.

A 2021 report from the NH Women’s Fund indicated that more girls have engaged in self-injury or suicide ideation in the last two years than prior to the pandemic. According to a report from the Centers for Disease Control, as many as one in four girls have tried to kill themselves or contemplated it – a dire and shocking percentage that rose in the wake of COVID.

As schools shift to deal with the more fragile and incendiary social and emotional health of students, responsible adults – including parents, teachers, and caregivers – are urged to keep conversations about mental health open, ongoing and direct.

“Being able to talk about depression and anxiety and seeking help is an important life skill that will stand our children well in years to come,” said Stearns at NAMI. “It’s an important tool in the toolbox to be able to call someone for help. If mental illness is to come out of the shadows, you seek health care for it and don’t hide it,” she said. “The social aspect of COVID was debilitating. The vast majority of people with mental illness function very well. It’s important to understand that these are health conditions and seeking help for them is the appropriate response,” said Stearns.

For immediate mental health help, including in a substance use crisis, call or text the NH Rapid Response Access Point at 833-710-6477 or chat by visiting nh988.com.