Anxiety and stress is fueled by the unknown so it’s not a surprise that the unsettled situation surrounding COVID-19 and the start of the new school year is causing some mental health challenges.  

Information is power and can often help to alleviate stress. The supervisor of Psychology and Psychotherapy Services at Gillette Children’s, Erin Tentis-Berglund, in consultation with members of the psychology/psychotherapy team has some advice to provide support as the school year gets underway.  

To make an appointment with a member of the Gillette psychology team please contact your primary care provider to get a referral. 

What are some things kids might be experiencing as we try to figure out the school situation during this COVID-19 shutdown?  

There is likely a mix of emotions currently – for youth, caregivers, and the rest of the community. To some degree, these jumbled emotions are typical of any school year: a mix of excitement paired with some nervousness. This year is different, though, with the added component of COVID-19. Likely, there is uncertainty regarding changes in place for safety purposes, and how students and teachers alike will adapt.   

At the forefront is likely the mixed thoughts and emotions related to deciding whether to enroll in online school programming for the year or to participate in whatever level of in-person schooling will be available. That is tough to answer – and there is no single answer that works best for all families, as a myriad of factors play into that decision. To that end, each family should weigh the pros and cons of the options, talk with their education and healthcare teams, and make the best decision that they are able to make for their family. It will be important, as well, for families to lend each other grace and acceptance – what is the best decision for one family is not the same for the next. There is no need for parent shaming. 

Depending on the age, a variety of questions may be present. Many of us simply want to know general information such as when class assignments will be shared by the district, or what model of school is being offered. While some younger children may not be entirely aware of the changes that will go in place to enhance safety, it is important to share with youth across the age-span the changes that they might experience during in-person learning:  that masks and face shields will be worn, that social distancing will be expected, that lunch and recess will be different, that passing time in the hallways may change.   

This is compounded further by the uncertainty of the spread of the virus; we cannot predict exactly what will happen in terms of spread, or how and when school set-up may need to change. However, we can share with youth that it is possible school will change throughout the year, and that the adults (e.g., school administration and staff, state officials in the Department of Health) will be able to guide us. 

What are special concerns for our Gillette families and patients? In particular, what about Individualized Education Program (IEPs) and special education programs?

It will be important for youth with special education needs to continue to have strong communication with their special education team. Rather than waiting for a problem to arise, ongoing problem-solving and collaboration is key. 

If a service cannot occur in the same way as prior to COVID-19, families are encouraged to talk with the team to determine alternatives which may include activities to do at home, incorporation of tutoring, or other services outside of school. In addition, for families in Minnesota, PACER (Parent Advocacy Coalition for Educational Rights) may be a wonderful resource for information and ideas; other states have similar organizations as well, such as WI FACETS (Wisconsin Family Assistance Center for Education, Training, & Support) in Wisconsin. 

What are some tips and advice for parents? 

Recently, Gillette’s associate medical director of pediatrics, Madeleine Gagnon, MD, was on KARE 11 television and one of her messages provided great support for families: “Whatever you decide for your family is what is best for your family.” 

There are so many factors that go in to decision making related to school. Not only are families considering risk related to contracting COVID-19, there are a variety of other factors at play including social and emotional functioning, general learning, balancing parents’ need to work and youths’ need for education. There are health, educational, and financial factors, and each weighs differently for each family. 

Families should talk with their teams – gather information from the medical team to gain understanding of the risk associated to a particular diagnosis or condition, and talk with the education team to gain understanding of the impact for the child’s educational, emotional, and social development. It is important that each family weigh the various elements for their family and make a decision the best they can – and, similarly, for families to show grace to one another, knowing that each family’s circumstances are different.   

It’s important to remember that children and teens look to parents and caregivers and mimic what they see and hear. In essence, parents and caregivers serve as a barometer – if the adult is panicked, the child will be too; if the adult is dismissive, that will be seen in the child. Parents and caregivers should aim to be responsive rather than reactive, gathering information and making thoughtful, information-driven decisions regarding school. 

Children and teens will look to the important adults in their life regarding how to respond to such culture shifts as mask-wearing and social distancing. Parents and caregivers would do well to model these behaviors and demonstrate an attitude of acceptance of these changes that aim to help our broader community. 

The Gillette psychology and psychotherapy team also receives questions regarding how to help kids adjust to these changes. COVID-19 and the necessary related safety measures are a part of our lives now; it is important that youth are able and allowed to talk about this, and to have their questions answered in a developmentally-appropriate way. Similarly, having their feelings acknowledged and validated will go a long way; it is OK to be scared, or sad, or mad, or confused. Practicing such things as wearing a mask, talking with a mask on, asking someone to give more space if they get too close, and the like can be helpful, as well. Parents would also do well to be prepared for change, and aim to show resiliency through change. Modeling teamwork – with school, healthcare providers, and the child or teen – is also an important task. 

Finally, parent self-care is often under-emphasized. Parents and caregivers are often very focused on caring for others; in order to do that well, parents/caregivers need to be doing well themselves, as well.  Parents and caregivers should ensure that their own physical and mental health care needs are met, that they get sufficient sleep and meals, to have time set aside for exercise and other enjoyable activities (e.g., various hobbies), and ability to time with others – whether in person when safe, or virtually. Not only does this give parents and caregivers the opportunity to manage their own stress and rejuvenate, which allows them to be best able to meet their child’s needs; as well, engaging in these activities models the importance of these activities to the children and teens which will likely improve the likelihood that they will do these things too. 

How can Gillette be a help and a resource for parents?  

There are a variety of ways Gillette can support return to the school year. Medical providers can be resources to talk through important factors for a particular child or teen. Rehab therapies can work with youth to meet goals and also to problem-solve; for example, a child in occupational therapy may work with their therapist to brainstorm best places to sit in doing distance learning to promote core control. Ultimately, anyone on the care team may have help to offer depending on the need for a particular family.  

Our psychology and psychotherapy team is also available to help meet emotional and behavioral needs. The Gillette team can provided guidance for:

• Emotional struggles (depression, worry, adjusting to all of the changes)
• Learning ways to promote behavior change (parenting, general compliance, or improving mask wearing)
• Disability or diagnosis-specific topics (adjusting to a new diagnosis; talking to friends about why a particular child/teen does not wear a mask) 
• Addressing conflict in the home (general family dynamic struggles; challenges that may stem from simply being together for long periods of time especially during times of stress) 
• Plus, a number of other possible topics

What are some ways to ensure mental health needs of children and teens are being met?

Schools will certainly be doing their best to meet the emotional and behavioral needs of the student body. With either hybrid or distance learning models, this is more complicated; as well, with the ongoing stressors currently present, the needs are likely increased. Families are encouraged to work with their school-based and healthcare teams to identify needs and determine plans for intervention.   

Creating a safe place at home to talk about mental health is a wonderful gift parents and caregivers can give to youth. Talking about feelings – even the uncomfortable ones – and feeling heard is incredibly empowering and healing. Brainstorming coping strategies, and providing room to engage in these activities can be helpful too. 

The Gillette psychology and psychotherapy team suggests modeling these skills – saying aloud, “I can’t believe I burned dinner. I am so frustrated. I need to take a deep breath” – shows youth that all feelings are okay, what to do with those feelings, and – perhaps most importantly – that even the most important person in that youth’s life has that experience, too. 

Sometimes, additional outside help is needed. Given the number of stressors that have been present in our culture over the past several months, this would not be unexpected. During the current pandemic, mental health needs have shown an incredible increase across the country. Seeking mental health intervention is highly encouraged in a variety of situations; Gillette’s Psychology/Psychotherapy team can be a resource, and families can also ask their school, medical, or insurance providers for other resources. 

This stress is not only felt by younger kids—it’s also challenging for teens and families facing the start of college. What are some ways Gillette can help with these concerns?

At Gillette, we see individuals across the lifespan, and our adolescent and adult-aged patients have different needs and experiences. There might be added challenges related to college, employment, or transportation. For example, some adults may have certain accommodations established at the workplace (e.g., a desk that is a certain height) that is not available working from home. Or, for our adults who live independently, there may be increased loneliness. Again, working with family members, healthcare team members, school teams, and employers to brainstorm and problem-solve is crucial. In addition, seeking additional support in meeting mental health needs is highly encouraged. 

Gillette now has virtual care options to help many children, teens and parents. How can this type of appointment help?

At Gillette, one of the gifts COVID-19 has given is opportunity to expand our provision of virtual care services in a very rapid way.  Specific to the Psychology and Psychotherapy team, psychotherapy (counseling) can occur virtually much of the time for a number of referral reasons. Concerns such as emotional struggles, improving behaviors, learning new communication styles, and a number of other topics can be addressed virtually.   

There of course are limits to this. There are some psychotherapy needs that are not addressed adequately through virtual care; for instance, some very young children may not tolerate this well. Access to adequate technology can also be a barrier for some families. Finally, there are some location challenges based on state regulations; executive orders in the spring that allowed us to see patients in other states are expiring. The psychologist or psychotherapist will work with a family and provide appropriate guidance. 

How can parents and patients make appointments for both in-person care and virtual care?  

Currently, the Psychology/Psychotherapy team offers both virtual care appointments as well as in-person appointments at St. Paul, Burnsville, and the Phalen Adult Clinic. That said – to promote safety – we are aiming to provide services virtually whenever possible.   

If a family would like to seek psychotherapy services through Gillette, they are encouraged to reach out to their medical provider and communicate this desire, and request a psychotherapy referral. Once that referral is received by our team, we will enter appropriate orders for scheduling, and our patient access team will reach out to the family to schedule.   

If a family has general questions, they can also contact Child and Family Services at 651-229-3855, and we will aim to answer questions as best we can. 

What are some of the safety precautions Gillette has in place to ensure safety when patients come in for a face-to-face appointment?

Gillette has made many adaptations related to COVID-19. Gillette staff members are wearing masks as well as eye protection (face shields or goggles). We are screened daily upon arrival to work. Similarly, families will be expected to wear masks and be screened upon arrival as well. 

The Gillette psychology and psychotherapy team has changed some of the materials used with patient care – replacing some items with similar objects, toys, or activities that are easier to clean, laminating items made of paper, identifying items that are patient-specific rather than shared across patients, and using barriers between our patient and the items being used. For example, crayons are no longer re-used but instead each patient will have a baggie of crayons specifically for them; when playing a board game, the game board will be covered by clear plastic. 

The start of this school year is different but some things remain the same…

It’s important for parents to remember kids are likely to be excited and nervous as they prepare for the start of the new school year.

Some of these concerns are similar to the start of school in past years. For example, a child wanting a specific teacher, hoping their best friend will be in their class, looking forward to the pizza school serves, or wondering what the Homecoming Spirit days will include. Students are excited to shop for and use new school supplies, try new technology apps, and to learn new things. We should be conscientious of this, and make sure that the “usual” questions and feelings be addressed as well! 

PACER

National Alliance on Mental Illness, MN Branch

MN Psychological Association

Fred Rogers Center

To make an appointment with a member of our psychology and psychotherapy team please contact your primary care provider for a referral. If you have questions please call Gillette at 651-290-8707.