Expert discusses affect of COVID-19
Q&A: Stanford psychiatrist on how isolation during pandemic has affected young athletes
The coronavirus pandemic this year has hit families hard.
Last month, doctors from the Centers for Disease Control and Prevention reported in the Morbidity and Mortality Weekly Report an increase in visits from kids and teenagers to emergency rooms seeking mental health services.
Although researchers have not studied young athletes specifically, some Bay Area parents and coaches have expressed concerns about the effects on their kids as high school sports and youth leagues have been paused since March in the region.
Some families have left California so their children can continue participating in sports they love to minimize those effects.
Dr. Antonio Hardan, Stanford’s chief of the Division of Child and Adolescent Psychiatry, addressed some of the issues and offered solutions in an interview with the Bay Area News Group. Hardan, a professor in the Department of Psychiatry and Behavioral Sciences, grew up playing soccer and running track, activities he said provided lessons that helped him get through medical school.
The answers have been edited for clarity.
Q
How would you describe the mental impact of the COVID-19 pandemic among high school and youth sports athletes?
A
The pandemic is taking a toll and unfortunately, kids are paying the price because these are formative years for them. Playgrounds are closed. Soccer fields are closed. Baseball games are not happening.
And 91% of kids around the world have been affected in a way they cannot go outside. They are limited to their home environments or at best their neighborhoods. There is a significant increase in stress, anxiety and feeling of helplessness.
The younger you are, the more you are affected. Kids with special needs are affected more. If you have a pre-existing mental condition you are going to be affected more. Those economically underprivileged will suffer more. Their homes are smaller. They will have more people living in the house. They don’t have a backyard to kick the ball around. They don’t live near a park.
What we’re seeing in teens is more inattention and more irritability related to being stuck at home. Parents in one study reported kids are a little more uncertain about their future. Image if you are a 17-year-old looking at a college scholarship. You are worried in terms of how you are going to be identified or how you are going to be recruited. That is a major concern for some of the kids.
Independently of that, what we’re seeing is that some teenagers are having some disturbed sleep. To begin with, teenagers have some sleep issues. You add a limited structure from the pandemic because they are not getting up at 8 a.m. or 7:30 to go to school so that has added more disruption in sleep. Sleep is critical for this age group. This is leading to apathy and a lack of motivation to get out of the room.
In the pandemic, we lost two battles with teenagers. The first one is getting them off their screens. Right now they are stuck in front of their screen for schoolwork and homework.
The second one we lost is getting them out of their bedrooms. Now they are stuck in their bedrooms because they are attending school in their bedrooms.
Q
Is there a way to quantify a trend like more high school and youth sports athletes seeking professional mental help since the pandemic began? If not, is there something we can say generally about the overall toll it is taking?
A
The pandemic is wreaking havoc on the populations but more importantly for children and adolescents. Compared to 2019, the CDC report shows there is a significant increase in the number of emergency room visits with kids between the ages of 5-11 and teens between the ages of 12-17.
Personally and professionally here, we are feeling it. The number of referrals we are getting is much higher than last year. We’re getting more referrals to our services from within the Stanford Children’s Health system and from outside. The system here in the Bay Area and across the country has significant access issues for pediatric mental health and the pandemic is not helping at all.
In the inpatient units, we’re seeing a significant increase in the number of patients in the general adolescent psychiatry unit and the eating disorder unit.
Q
What can a parent do if their kid is going stir crazy? What is your advice for parents whose children are dealing with emotional distress because they cannot play sports and be with their friends?
A
A lot of things people have recommended are to maintain a routine and aim for some consistency with bedtimes and breaks. It is important to stay connected with others through FaceTime or online games with other families. Some teens are not as social as others. It is important to gently push them and create opportunities. Some teens are very social. Some could be athletes or high performers and they are isolated. They usually connect with people through sports and now some of the sports are not happening. Facilitating movie nights, virtual playdates, virtual family dinners are important for parents of teenagers.
Q
What is your advice for the athletes themselves?
A
The advice is to try to develop a routine that involves some exercise even though it might not involve your teammates or your coach. We can all run. Fortunately, in California, you can run outside 12 months of the year. They need to create a system for staying in shape. There are a lot of opportunities for strengthening and stretching and they should try to capitalize on that.
Q
Sports usually is a year-round endeavor. It doesn’t allow much downtime. Is this pause perhaps something good?
A
The challenge was the pandemic. One important thing about the pandemic is to try to make the best out of it. This is an opportunity for everyone to look at what they can do to improve their performance.
You can work on weaknesses. Once the season starts again, you won’t get any opportunity to have two or three months on your own to focus on one of your weaknesses.
After the pandemic, it is going to be a life-changing experience for all of us. Once we come out of it we are going to see the world differently, similar to the people who went through the Great Depression. We are going to remember how it affected our lives. It will make us more resilient and allow us to face adversity a little bit better in the future.