AILSA CHANG, HOST:
Anyone with school-age children knows the last week has been really rough. Thousands of schools around the country have shifted to remote learning, and those staying open are dealing with students and staff out sick, the burden of testing and masking and everything it takes to stay open during the midst of a pandemic. We're going to spend the next several minutes now talking about how this moment and the last two years of disruption have affected the mental health and development of children. NPR health correspondent Rhitu Chatterjee and NPR education correspondent Anya Kamenetz are here with us to talk us through all of this.
Hey to both of you.
RHITU CHATTERJEE, BYLINE: Hi.
ANYA KAMENETZ, BYLINE: Hello.
CHANG: Hey, Anya. So I want to start with you. Can you just walk us through what we know at this point about how kids have been learning?
KAMENETZ: Yeah. So on the school side, you know, all the data we have says that children didn't learn as much when they were home. The impacts have been very unequal, both by race and by class - also want to call out students with disabilities, that they've been quite severely affected. And some of the longest-lasting impacts may actually be in high school students - those who went into the workforce and may never return to their education.
CHANG: Wow. Well, Rhitu, turning to you - how would you say kids have been doing emotionally the last two years?
CHATTERJEE: So the bottom line, Ailsa, is that kids are struggling. Not every kid, but the number of kids with mental health symptoms has increased since the pandemic started, and it's just gotten worse with time. So CDC data shows that even early on in the pandemic, when people were afraid to go to a hospital for fear of catching COVID, hospital ERs began to see a proportionately larger number of kids coming to their emergency rooms for mental health needs. And the situation has continued to worsen. Child psychologists, psychiatrists, children's hospitals, even pediatricians - they're all seeing this. I spoke with the president-elect of the American Academy of Pediatrics, Dr. Sandy Chung. She and her colleagues did a survey of pediatricians in Virginia, where she's located, about their experiences with this, and here's what she said.
SANDY CHUNG: Eighty-eight percent of our pediatricians reported seeing an increase over the last few months - really since the beginning of the pandemic - of the number of children with mental health issues. It's been quite dramatic.
CHATTERJEE: And the kinds of symptoms they're seeing sort of span a range - more depression, anxiety, more kids and more younger kids struggling with serious suicidal ideation and attempts, kids with aggression, oppositional behaviors and also a rise in eating disorders.
CHANG: And, Rhitu, I mean, what is different about this point in the pandemic that is especially having an effect on children's mental health?
CHATTERJEE: Well, the main thing is, Ailsa, we're two years into this pandemic - right?...
CHANG: Yeah.
CHATTERJEE: ...Or almost two years, and there's still a lot of uncertainty, stress, instability. And kids have been struggling since the beginning of the pandemic. Some kids who had mental health diagnoses before the pandemic, who weren't able to get care, worsened. Then there are kids who developed symptoms for the first time, who also weren't able to get care in a timely manner, and, over time, have just worsened and we know - and then you take into account that more than 175,000 children have lost a parent or primary caregiver to COVID-19. And we're still seeing deaths go up. And so we're talking about a huge number of children with major childhood traumas. And I spoke with Dr. Vera Feuer, a child and adolescent psychiatrist at Cohen's Children's Medical Center in Long Island, and here's something else she said.
VERA FEUER: Another basic cornerstone of childhood development is what do they see around them, and how are the adults behaving?
CHATTERJEE: And we know that adults are struggling as well, right? And so it's no surprise that kids are too.
CHANG: Absolutely. Well, Anya, what are you hearing from educators as to what they're seeing?
KAMENETZ: So, you know, I just want to make this personal for a second. My daughter, who's a kindergartner, she has no memories of life before coronavirus or going to any schools without masks.
CHANG: Yeah.
KAMENETZ: And so this has really gone on a long time. And some anecdotes from around the country - we're seeing children that have regressed, so a fifth grader playing alone with a doll at recess instead of with their peers; a high school student cutting class and hiding in the bathroom because they don't know how to be in class. They've had social anxiety. There's reports of more physical fights. And I spoke to Kennita Ballard, who teaches sixth grade in Jefferson County, Ky.
KENNITA BALLARD: We have students who are stressed. We have teachers who are stressed. We have families who are stressed. On top of that, we have behaviors that are spiraling out of that stress that's manifesting like trauma.
KAMENETZ: So, generally, instead of this school year being a dedicated year of recovery as we'd hoped, schools have stayed in crisis mode almost continuously and including in this current surge.
CHANG: Well, what we've been talking about mostly is what people are seeing in the immediate. But, Rhitu, what are you hearing about whether this will have a long-term impact on kids?
CHATTERJEE: Yeah. That's a question I've been asking a lot of child and adolescent psychiatrists, and they say that we don't know because it's still happening. But what long-term research - years of research, actually, into childhood traumas - tells us is that the death of a parent, food insecurity, addiction, violence in the home - these kinds of traumas in childhood increase the risk of long-term physical and mental health problems. Now, I should clarify that not every child has suffered or suffered to the same extent. For example, kids in communities of color have been affected disproportionately...
CHANG: Right.
CHATTERJEE: ...Just because of the disproportionate impact on their communities. But as Dr. Sandy Chung tells me, the whole situation - it's not one that she considers completely hopeless.
CHUNG: The good news is that children are resilient and that with, you know, everyone coming together and focusing on working to improve this and to provide those supports now, I think there is hope.
CHATTERJEE: And I think that's something that everybody is realizing and, you know, trying to address. And the other good thing that's come out of the pandemic is that this mental health crisis in kids has gained more recognition nationally. You might remember the surgeon general's advisory on youth mental health that he put out last month. And there have been some federal dollars invested in addressing access to mental health care. There's still a lot to be done, but a psychiatrist I've spoken to say it's a really good start.
CHANG: Hmm. Well, how about that, Anya? Is there anything else that we have learned from this pandemic that can be applied in years to come well after this pandemic's over?
KAMENETZ: So I really share Rhitu's optimism or the idea that the new focus on these issues may bring good changes. As an education reporter, as a mother, I know the essential services that schools provide, not only socially, educationally - sometimes food and heat. And so more and more of the country now is noticing all of this and all the things that schools do. And so the question now is, is our country willing to do what it takes to make sure that schools stay open even if that means maybe closing other things and giving schools what they need to stay open safely?
CHANG: Yeah. That is NPR's Anya Kamenetz and Rhitu Chatterjee.
Thanks to both of you.
CHATTERJEE: Thank you, Ailsa.
KAMENETZ: Thank you.
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