Supporting Kids’ Mental Health During COVID-19

This piece was co-authored by NIMH director Joshua Gordon, M.D., Ph.D., and Rachel L. Levine, M.D. , Assistant Secretary for Health, Department of Health and Human Services

It’s September, and kids are going back to school with their pens, pencils, books, and laptops—but this year, back-to-school is anything but ordinary. In addition to their school supplies, kids are also carrying the stress and uncertainty of the COVID-19 pandemic.

The pandemic has been challenging for many children, with some having experienced loss—be it the loss of a loved one due to COVID-19 or the loss of economic, food, or housing security. Many are experiencing the indirect effects of caregiver stress, which we know can impact children substantially. Kids are also dealing with the cumulative social effects of hybrid and remote schooling and the need for physical distancing, which may leave some feeling less connected with their peers and teachers. 

As we recognize the many disruptions and stressors that children have faced over the last 18 months, we must also acknowledge that some children have been more affected than others—children from minoritized and underserved communities hardest hit by the pandemic are likely feeling the greatest impacts. For some youth, these impacts will be significant. The cumulative effects of these stressful experiences, especially if combined with other adverse childhood experiences, can pose serious risks to children’s mental health.

Emerging data from the pandemic suggest that many children are experiencing an increase in stress and other mental health concerns, including symptoms of anxiety and depression. Other serious illnesses may also be increasing. For example, initial reports indicate a greater number of teens have been experiencing challenges associated with eating disorders during the pandemic, and while larger studies are needed, these early findings are concerning. 

September is Suicide Prevention Awareness Month. With this in mind, and consistent with the Surgeon General’s Call To Action on suicide prevention , we wanted to make you aware of what we know about the impact of the pandemic on youth and what you can do to support children during this difficult time.

The risk to children’s mental health posed by the pandemic is real, according to data published in the Centers for Disease Control and Prevention ’s Morbidity and Mortality Weekly Report .  Amidst the stay-at-home orders and other public health measures instituted early in the pandemic, adolescent suicide-related visits to emergency rooms decreased through the spring of 2020. As the pandemic has continued, however, the number of youths presenting to emergency rooms for suspected suicide attempts has increased significantly. This is especially true for teenage girls, who showed  a 50% increase in emergency room visits early in 2021 compared to the same period in 2019.

Just like the general mental health impacts of COVID-19, there is concern that some groups of kids may be at particular risk for suicidal thoughts and behaviors. In many communities of color, suicide rates were already increasing significantly  prior to the pandemic, especially for Black youth . Data suggest that LGBTQ youth are also at risk; a survey by the Trevor Project  conducted during the pandemic revealed that 42% of LGBTQ youth respondents and over half of transgender and non-binary youth respondents had seriously considered attempting suicide in the past year.

Fortunately, research has demonstrated that there are effective ways to reduce children’s suicide risk. First and foremost, it is important for caregivers, parents, teachers, and healthcare providers to ask kids how they’re doing and to not be afraid of asking them if they’ve thought about suicide. Study after study has shown that asking “are you thinking about suicide?” doesn’t lead children to think about killing themselves—on the contrary, it can help kids talk about what’s going on and provide an opening for them to ask for help. So, if you are worried that a child might be thinking about killing themselves, ask. If you’re a parent and you need help, reach out to your child’s healthcare provider or their school—they may be able to help you determine the best course of action.

We can also help kids cope with the stress and uncertainty of the pandemic by ensuring that they have strong connections with trusted adults—at home, at school, and in the community. In fact, solidifying connections to trusted adults can build children’s long-term resilience: one study funded by the National Institute of Mental Health (NIMH)  showed that supporting relationships between middle-school kids and trusted adult mentors reduced mortality over the next decade.

In addition to what parents, teachers, and health providers can do individually, nationally available American Rescue Plan  funds are supporting a broad range of mental health services in schools and communities, broadening access for all students, including those in the hardest hit communities. In another national effort, the Substance Abuse and Mental Health Services Administration (SAMHSA)  supports a number of community-based suicide prevention efforts, many of them through The Garret Lee Smith State and Tribal Youth Suicide Prevention and Early Intervention Grant Program .

National crisis hotlines are another valuable resource available to anyone who needs immediate help during a mental health crisis. Hotlines, such as the Suicide Prevention Lifeline (1-800-273-8255 or suicidepreventionlifeline.org ), SAMHSA’s Disaster Distress Helpline (1-800-985-5990), the Crisis Text Line (text “HOME” to 741741), or the Trevor Project (aimed at LGBTQ+ youth, 1-866-488-7386), are available 24/7 for immediate support and treatment referrals.

NIMH is committed to supporting research that builds on existing suicide prevention efforts to help improve support for current and future generations of youth. Through a number of funding opportunity announcements and notices (PAR-21-287 ; NOT-MH-21-225 ; NOT-MH-21-330 ), NIH will be funding dozens of studies investigating interventions aimed at reducing the mental health impacts of the COVID-19 pandemic on youth, with a focus on underserved communities. NIMH also issued calls for research (RFA-MH-21-185 ; RFA-MH-21-186 ; RFA-MH-21-187 ; RFA-MH-21-188 ; NOT-MH-20-055 ) aimed at detecting and reducing suicide risk among Black communities and other underserved populations. To prioritize how best to help youth in the future, NIMH recently held a series of research roundtables on youth suicide that included suicide prevention experts from across the country and around the globe.

We know our kids need everything we can give them to help face these challenges, from support, to treatment, to research. Together, we can help them weather these uncertain times.