COVID Chronicles: Bradley Hospital is Seeing an Uptick in Pediatric Anxiety and Depression

We caught up with Dr. Marge Paccione about how to help kids stay mentally strong through COVID-related isolation.  
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Since the start of the coronavirus outbreak, Bradley Hospital in East Providence — the nation’s first pediatric psychiatric hospital — has noted an increase in reported anxiety and depression among children.

“We’re hoping it will be situational,” says Dr. Marge Paccione, Bradley’s director of clinical innovation, in a telephone interview. “But we’re definitely seeing an uptick.”

A major contributor, Paccione says, is the isolation children and teens are experiencing due to social distancing and school cancellations. To combat this, she recommends that parents help kids stay connected with friends, family and their extended network of adult mentors, including coaches. She also stresses the importance of routine, ideally a collaborative one between adults and children.

“A well-paced and thoughtful routine does wonders — and that includes us older kids as well,” she says. “The routine is extremely, extremely comfortable for kids because their routine has pretty much been taken away.”

Paccione notes the current disruption will affect children differently, depending on their individual temperament and their resiliency.

“Some kids will pick up where they left off and life will go one,” she says. “But there will likely be some other kids where returning to a routine will be a struggle.”

Paccione, Marge Phd 2017

Dr. Marge Paccione. Image credit: Lifespan

Paccione says the distance learning model in Rhode Island could serve as a helpful observational tool, as parents can watch how their children are faring in a controlled setting. She says parents should keep an eye out for any stark changes, from emotional expression to eating habits to sleeping patterns to hyper-vigilance around handwashing and germs.

“That’s when it would be a red flag for parents,” she says.

Should an issue arise, the first point of contact is your child’s primary care provider. Lifespan hospital system also has a pediatric mental health hotline called Kids’ Link RI, where health care providers offer triage and psychiatric referrals to families in need. Many mental health care professionals now book telemedicine appointments, too.

“There’s no doubt that we’ve been tossed into a whole new normal of social distancing and watching the disease counts rise,” says Paccione. “The kids are naturally going to be feeling that.”

Paccione also recommends limiting childrens’ exposure to the news.

“Whereas technology could be very positive in terms of staying connected, it can also be very overwhelming,” she says. “We as adults need to limit the exposure of kids to that kind of TV watching or screen time.”

It’s also important for parents to convey realistic confidence in their kids’ safety, but it’s especially crucial for younger children.

“The little ones need to be told they’re safe and life is going on,” she says. Tweens and teens, particularly those on social media, may need to be reminded of the proliferation of misinformation on the Internet.

“Kids that have a little bit of a background in media literacy will know that maybe all they hear is not all the truth, the whole truth and nothing but,” she says. “But others feel if they see it on TV or read on social media it must be true…. Parents need to spend a fair amount of time making certain the information they’re sharing with the child is correct.”

Another thing parents should do: Carve out some time for self-care.

“The single most important factor on how a child reacts is how you handle a situation,” she says. “Know what’s good for you and make an absolute pact with yourself that you’re going to do that on a regular basis, because if you take care of yourself that extends out to the kids.”

For one person, that might mean yoga; for another, meditation or a long walk.

“For me: If I eat a pepperoni pizza, everything’s cured,” Paccione says.

If your child is experiencing stark behavioral changes, call Kids’ Link RI at 1-855-543-5465.

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