Challenges and obstacles create opportunities. Even since before the start of the pandemic, the provider community has dealt with workforce development challenges, especially in the field of behavioral health. As the demand for mental health and substance use disorder services have increased, so have the opportunities for a career in behavioral health for individuals at all experience levels.

Throughout the nation, healthcare workers are experiencing significant levels of burnout due to the pandemic. This once in a lifetime event has impacted the mental health of clinicians and has overly extended the existing provider workforce that was already experiencing a critical shortage. Although this is a widespread problem, rural areas and minority communities are more greatly affected. Many individuals living in these areas don’t have easy access to local primary care or mental health providers.

In Pennsylvania, there are currently a variety of job opportunities available, ranging from clinical, technical, and administrative roles of all experience levels. These roles in behavioral healthcare all provide the opportunity to make a positive impact in the lives of children, adolescence, and adults.

Watch this video created by Magellan Behavioral Health of Pennsylvania to learn more about the benefits of working in the behavioral health field.

As a Medical Director for Magellan Behavioral Health of Pennsylvania, Chris Squillaro, DO, manages many different responsibilities. As a supervisor of the Pennsylvania medical staff, he performs reviews, attends complaint and grievance hearings, and leads various rounds with our care managers. Dr. Squillaro also provides the executive leadership with input on strategy and focusing on prioritizing what’s important to our county customers. Whenever a medical opinion or perspective is needed, Dr. Squillaro, who has been with Magellan since 2021, always provides that medical input into the initiatives and intervention being done in Pennsylvania. Continue reading to learn more about what innovative behavioral health projects and initiatives Dr. Squillaro is currently working on in Pennsylvania:

What sort of innovative projects are you currently working on?

There’s an enterprise-wide movement to develop a common suicide pathway to decrease suicidality. Pennsylvania is heavily involved with that project although it involves more than just Pennsylvania. I’ve been working on this with the corporate and Pennsylvania leadership.

We are also doing a project in Pennsylvania called Project Red, which aims to decrease readmission rates and standardize the discharge process. This is a project that’s being led by two researchers out of Massachusetts who had developed Project Red originally for the medical side, and they want to convert it to the behavioral side.

I’m also involved in a trauma informed care summit because of a Pennsylvania Commonwealth initiative. The goal is to transition all the Commonwealth residential treatment facilities to tiered trauma designations that demonstrate competency in trauma care for children and adolescents in that level of care. Included in this would be consistent trauma screening and treatment, decreasing physical and chemical restraints, having a trauma informed lens as patients move through care and awareness of experiences in the milieu that may be triggering.

We also have a medication adherence project where I clinically supervise the pharmacist who is working on improving medication adherence for some of our more severe patients through direct member education and training.

Why is Magellan Behavioral Health of Pennsylvania the best place to do these projects?

I think we have a holistic view of the healthcare delivery system, not just within individual units across the country but enterprise wide. We have our eyes on national issues through touchpoints with the corporate team. We understand what Pennsylvania’s priorities are, what their initiatives are, and what issues are important to them. We can get even more granular at a county level. Each county is in tune with what are its’ constituents wants and needs. Pennsylvania is very diverse, there are swings in socioeconomic status between regions and resources. We get this population health view at a national level, that then is informed all the way down to the county level so we can see it not only for what’s important from a national perspective, but then in each Pennsylvania community. With that information, we can come up with the best way to approach problems.

I think there’s also a lot of willingness and eagerness to use technology at Magellan. It helps us to sort and track outcomes. Magellan is really getting involved with technology, this is something that’ll be hugely helpful for what we can do in the future.

What are your thoughts on the culture at Magellan Health? How has that culture impacted the projects you’re working on?

Before I worked at Magellan, I was a provider. Magellan has always been willing to try new things. If providers had a good way of solving common problems, in my experience, Magellan was certainly willing to entertain it and develop programming around it. I think that willingness to adapt, change, and try new things is what makes projects successful. The culture of being able to move around problems and to adapt is one of the things I saw since before working at Magellan and has only been reaffirmed since I’ve joined this team.

What direction do you see healthcare going in? Have you noticed any exciting trends in the healthcare industry? What lessons are there to learn in other industries that can be applied to healthcare?

I feel we are learning from the way that care is delivered on the medical side. Using outcomes and data to make decisions is one of the things that’s exciting in behavioral health. Some screening tools that have been developed have become more reliable and it’s starting to create a common language that we can have with our medical counterparts. This then creates opportunities to coordinate at key levels of care. There’s also a lot more collaboration between medical and behavioral health. It’s not new information that behavioral health has a significant impact on medical costs overall and medical quality. I see medicine becoming more integrative. On the behavioral health side, we’re catching up on the importance of data-driven decision-making outcomes and managing from a population health perspective.

Another trend is in customer care. We are learning from industries where customer satisfaction is critical to ease of access, utilization, adherence, and adoption of a plan. We’re doing a lot of customer surveys and making sure people are happy with the service that they’re getting.

Lastly, we’re adopting the standardization and checklist mentality that I most associate with the airline industry. This is a public safety concern that has been effectively managed by airlines to assure safety and limit mistakes. We are utilizing and promoting standardized tools and checklists to consistently diagnosis issues. We are then using algorithms to standardize treatment pathways. This assures consistencies across providers and assures that the most appropriate evidence-based interventions are being utilized to treat people.

Introduction

When disasters or tragedies occur, people seek information from traditional news sources and social media. Staying up to date is part of being an informed citizen, and while consuming media can be beneficial in moderation, “doomscrolling” — exposing yourself to a never-ending stream of distressing information — could be negatively impacting your overall wellbeing.

If you find yourself overwhelmed by the constant flow of negative information but can’t bring yourself to turn away from Twitter, you are not alone. For 50 years, Magellan Federal has helped more than three million civilian employees and their families enhance their emotional wellness and reduce stress. The following information and tips can help you to avoid doomscrolling if your social media usage is getting in the way of your wellness.

Doomscrolling Defined

Doomscrolling (also known as doomsurfing) is the term used for persistent and excessive reading of negative news online. It was popularized by Quartz reporter Karen Ho in 2020 during the lockdown at the height of the COVID pandemic. Like many of us,  Ho struggled with compulsively reading upsetting news about the ongoing pandemic. She would send nightly tweets (pictured right) to her followers encouraging them to take a break from doomscrolling bad news and to get a good night’s sleep (8).

Doomscrolling Characteristics — What to Look Out For

Doomscrolling differs from regular social media usage and has four main characteristics that makes it a distinct activity.

• This is a persistent activity that becomes habitual.
• It is caused by environmental factors.
• The sessions are multiple hours, and the user often loses track of time.
• The content viewed is negative, distressing, and timely.

While typical social media usage may have one or more of the above-mentioned factors, all factors are present for doomscrolling. Further, a study used to create a doomscrolling scale found the activity was highly associated with “online vigilance, problematic internet/social media use, and FOMO” (fear of missing out) (13).

Reasons for Doomscrolling

Fear of the unknown is the primary motivator driving people to engage in doomscrolling, however, multiple factors may contribute to and perpetuate their fear.

Biological Imperative

During times of crisis or tragedy, people gather information to reduce uncertainty, create a plan, and attempt to exert some measure of control over the situation (17). This behavior is rooted in survival instincts related to paying more attention to negative information than positive and scanning the environment for danger to protect one’s family (14).

Fear of Missing Out (FOMO)

While FOMO typically refers to anxiety experienced as a result of seeing an exciting or interesting event happening elsewhere, FOMO also applies to doomscrolling. With no end to social media posts, there is always one more piece of information that could be read.

Perpetuating the Cycle

With doomscrolling, the information collected on tragedies and disasters that was meant to reduce uncertainty and allay feelings of anxiety instead increases these feelings, particularly when the events are beyond one’s control. As we scroll, we’re flooded with information that for the most part, we can do nothing about, except to keep scrolling and sharing, perpetuating the cycle. As a result, we feed the paralyzing loop of information that can lead to feelings of helplessness and despair (11).

Algorithms

It’s no secret that the goal of social media titans like Facebook and Twitter is to have users interact with their products for as long as possible. To that end, these platforms create algorithms to learn their customers’ habits and then customize the online experience to them (15). The more a user interacts with the platform, the more the algorithm “learns” what content to provide, without concern for possible user harm (8). As a result, the curated content displayed for each user plays on their emotions to keep them engaged—even negative ones. Naturally, repeated exposure to distressing content can have a negative impact on mental health.

Risk Factors

Current research findings show that certain individuals are more likely to engage in doomscrolling than others.

• Men and younger adults regardless of ideological beliefs (13)
• Those with anxiety or depressive disorders
• People who score high in neuroticism
• Those who are addicted to social media (12)
• Individuals with previous childhood maltreatment experiences

Effects of Doomscrolling

Since the start of the pandemic, there have been multiple studies on the mental health effects of doomscrolling. Recent research findings suggest doomscrolling is associated with:

• Increased anxiety and psychological distress
• Lower mental well-being
• Increased depression
• Increased phone use
• Post-Traumatic Stress Disorder (PTSD) symptoms
• Decline in sleep quality

Prevention & Coping Techniques

As with most harmful habits, the best time to address them is before they start. Many of the techniques and tips provided below can be used to both prevent doomscrolling (or any excessive social media use) and also to help reduce doomscrolling once it has become a habit.

Technology Tips

• See no evil: Provide feedback on social media posts with negative content by using the “hide post” or “block/mute” features. This will provide information to the platform algorithm to provide less of this type of content (9).
• Set a time: Reduce the amount of time online by using screen timers and stick to no more than 30 minutes as any more has been connected to increased levels of anxiety (3, 17).
• Scroll with purpose: Picking a specific subject to get information on will not only help meet the new scrolling time limits, but it will also create a sense of accomplishment when the information is obtained (17).
• Subdue screen colors: As all casinos know, the more flashy and colorful something is, the easier it is to keep someone’s attention. Changing social media settings to “gray–scale” will make the screens more monotone/less visually appealing and can make it easier to stop scrolling (3).
• Search for the happy: Known as “hopescrolling,” this can lead to more positive thoughts and can help “reset” social media algorithms to show you more positive content.

Beyond Online

• Connect with others: Share the burden with loved ones and others within your social networks to reduce anxiety (17).
• Connect with yourself: Perform regular self-check ins by listening to your body and paying attention to how you are feeling to understand when it is time to take a break (16, 17).
• Connect with the outdoors: Engage in hobbies that involve the outdoors including exercise and fresh air while leaving technology, and feelings of anxiety behind (17).

Clinical Support

• Nonmedical counseling: Qualified counselors can help create a plan to address the problem. Non-medical counseling is short-term and addresses general conditions of living, life skills, improving relationships, and stress management.
• For Clinicians: Since clients also consume social media for entertainment as well as coping measures, it may be helpful to work with them to identify alternative hobbies or activities they will enjoy that will not involve social media or other digital technology (10).

Summary

In a global society with a 24-hour news cycle and social media that offers infinite scrolling, there is always more news to consume. People can fall victim to doomscrolling when distressing events occur, leading to increased anxiety and stress, creating a self-feeding cycle that can be difficult to break.

For those wanting to stop doomscrolling, it is important to first acknowledge the behavior, be honest with how it may be affecting your mental health, and be proactive in your approach to modify your actions. No matter what your relationship is with the news, this technique will help maintain a healthy relationship with social media and overall digital wellness.

The new 988 Suicide and Crisis Lifeline launched on July 16, 2022. With 988, it’s now easier than ever for anyone experiencing mental health-related distress–whether that is thoughts of suicide, a mental health or substance use crisis, or any other kind of emotional distress–to seek immediate help.

The new 988 dialing code operates through the existing National Suicide Prevention Lifeline (the Lifeline) network of over 200 locally operated and funded crisis centers across the U.S. People can now access a strengthened and expanded Lifeline via 988 or the existing 10-digit number (which will not go away).

In this post, we’ll continue the introduction of the new 988 Suicide and Crisis Lifeline and provide additional resources for you to learn more and be prepared if you or someone you know experiences a mental health crisis.

What is 988?

Beyond being an easy-to-remember number, 988 provides a direct connection to trained, compassionate and community-based crisis counselors for anyone experiencing mental health-related distress–whether that is thoughts of suicide, a mental health or substance use crisis, or any other kind of emotional distress.

Who can use 988?

988 services are confidential, free and available 24/7/365 for anyone experiencing a mental health, substance use or suicidal crisis. And 988 isn’t just for you. People can also dial 988 if they are worried about a loved one who may need crisis support.

How are 988 services accessed?

The 988-dialing code is available for call (multiple languages) or text (English only), and chat services (English only) can be accessed at 988Lifeline.org. 988 services are available through every landline, cell phone and voice-over-internet device in the U.S.

 How is 988 different from 911?

The focus of 988 is to provide easier access to the Lifeline network and related crisis resources, which are distinct from 911, where the focus is on dispatching Emergency Medical Services, fire and police, as needed.

Why was 988 created and where can I get more information?

Congress designated the new 988 dialing code in 2020 to improve access to crisis services in a way that meets our country’s growing suicide and mental health-related crisis care needs. The Substance Abuse and Mental Health Services Administration (SAMHSA) is the lead federal agency, along with Vibrant Emotional Health (operational home of the National Suicide Prevention Lifeline), in partnership with the Federal Communications Commission and Department of Veterans Affairs, to make 988 a reality in the U.S.

SAMHSA provides comprehensive resources for anyone to learn more about 988, suicide prevention and mental health crisis services at   SAMHSA.gov/988.

Is my state ready for 988?

States are at varying degrees of readiness for the volume increases expected from moving to the 3-digit code, 988. The federal government is responding to resource challenges with unprecedented levels of funding and an all-of-government approach to partner with state and local leaders to improve system capacity and performance.

Find additional information and materials on suicide prevention at MagellanHealthcare.com/Prevent-Suicide, and stay tuned for our September Suicide Prevention Awareness Month campaign and free webinar.

Sign up to receive updates a few times a month from Magellan on free behavioral health resources you can use and share with family, friends and colleagues here.

Sources: SAMHSA and the National Action Alliance for Suicide prevention

Kristen Ford, vice president of product innovation and development for behavioral health, has led many new innovative products being developed at Magellan Health. In her position, Ford is responsible for the product innovation and development activities for behavioral health solutions. Ford, who is based in Oregon, has worked for Magellan Health for 12 years on various innovation strategies focused on best-in-class services that help members live healthier lives. She is a Six Sigma Black Belt and a clinician who’s passionate about driving human-centered product development that changes lives. Most recently she’s helped to launch a full continuum population health wellbeing solution to improve population engagement into evidence-based care and improve the quality and accessibility of healthcare for those that are thriving, struggling or suffering. Continue reading to learn more about Ford’s work on these innovative products:

What cool, innovative products are you currently working on?

My responsibilities focus on new products that drive growth, leverage Magellan Health’s thought leadership, and enhance the lives of the people we serve. One example is the development of a comprehensive autism strategy where we are creating new mechanisms for timely access to autism screening with faster diagnosis to improve early intervention. We are laying the groundwork for new clinical models that intertwine technology, diagnostics, therapeutics and facilitate better coordinated care for the whole child.

We’re also working on other complex areas of healthcare such as suicide prevention. We care deeply about the recent increase in population suicide trends and our mission is to make suicide a never event. We do that through creating solutions that empower individuals with knowledge, education and tools in an environment of uninterrupted and supportive care.

Medical integration is another area of focus with our new collaborative care product which improves medical and behavioral health integration by making it easier for primary care physicians to diagnose and treat members’ behavioral health condition in the office. We’re looking at ways to solve important challenges in the delivery of behavioral healthcare by working on solutions that enable navigation, digital engagement, transform the delivery system and offer new models of care.

Can you expand on the work you’re doing with projects like Mightier, NeuroFlow and DUOS?

Mightier is a biofeedback gaming solution that teaches children emotional regulation to help them manage big emotions and teach calming strategies. This is important because it offers a bridge to care for children and families that are struggling. It’s been shown to be highly effective in randomized control trials for children with autism, ADHD, OCD or other similar conditions. It’s improved oppositional behaviors in children and decreased caregiver stress. We’re currently working with Mightier on a study through the National Institute of Mental Health to show that using this type of intervention can improve quality and cost of care.

We’re also working with NeuroFlow to deliver a collaborative care product, which expands Magellan’s value proposition with the ability to manage total cost of care. NeuroFlow brings the technology, and Magellan provides the clinical management which has resulted in a solution that is highly appreciated by our clients. We also launched the NeuroFlow population health app which provides digital wellbeing and self-care tools, including our digital cognitive behavioral therapy modules, to help members improve overall health and wellbeing, manage stress and build resilience in a confidential manner.

DUOS is an opportunity for us to address the social determinants of health and needs of older populations. DUOS provides a personal assistant for aging – a DUO – to help older adults stay healthy and age independently in their own homes. We connect older adults with social support and resources to manage social isolation, healthcare access and behavioral health needs. In our pilot results, we found that 97% of seniors were linked to resources to meet their needs and has high satisfaction with a net promoter score of 88.

Why is Magellan Health the best place to build new innovative products?

We are fortunate to have an executive leadership team that developed a culture that supports innovation. It’s part of our DNA. We have been successful in evolving our innovation strategy that positions Magellan as a thought leader and innovator in the behavioral health and wellbeing space. Our executive leadership believes that innovation is essential in treating the whole person, achieving growth and moving our business forward.

What are your thoughts on Magellan’s culture? How has that culture impacted the products you’ve worked on?

I think it’s a highly collaborative and team-oriented culture. Everyone is willing to roll up their sleeves and help achieve the best outcomes. The Magellan culture is purpose and mission driven. Everyone you encounter is focused on the best ways to support our customers, ensure members have the best experience and they’re getting the best care possible. I think that’s the picture of Magellan and it’s a wonderful place to work and drive innovation.

Currently, we have a pipeline of over 44 different products or product enhancements that we’d like to explore. People are familiar with Magellan’s culture of dedication and innovation. As a result, they are willing to collaborate and advise us as we drive towards solutions that can improve the lives of those members we serve.

What exciting trends in the healthcare industry have you noticed? What direction do you see healthcare going? What lessons are there to learn in other industries that can be applied to healthcare?

There are new trends in the field of autism related to clinical advancement and how we work with children on the spectrum as well as exciting developments and solutions in managing the total cost of care. There are new approaches that allow us to combine technology and clinical acumen deliver new care models. The pandemic created an environment where members and providers used new technologies and tools out of necessity which now provides us opportunity to continue to build and accelerate the adoption of new care models through technology. We are also seeing new and exciting opportunities to engage and activate members while reducing stigma.

Some industries can market directly and successfully engage the end user. We can learn from those industries and drive growth through that engagement.

We are fortunate that the Magellan leadership team and culture supports us in exploring those recent trends and solving for some of the most difficult challenges we see in service delivery.

Swarna Ramachandran is bringing a new digital experience to the world of behavioral health. As vice president of digital and contact center solutions for Magellan Healthcare, Ramachandran is leading a team that is redesigning the online digital experience for members, making it more intuitive when finding the necessary resources. Digital transformation, including technology, experience and Contact Center modernization, has been core to where she is today, and navigating the whole realm delivery & PMO come natural to her, says Ramachandran. Keep reading to learn how Ramachandran and her team are creating a new digital experience for Magellan Health members.

Q: What kind of projects are you working on right now?

A: Digital transformation is a key area of focus for Magellan Health. Engaging and enabling members digitally for care and self-service, helping reduce the stigma around mental health, and enabling self-service for providers and clients digitally are some of our key transformation goals.

The COVID-19 global pandemic has increased awareness and need for mental and behavioral health care for all of us. Several products have been released in the market that are either point solutions or solves for a couple areas of mental health, leaving the member with a myriad of apps and tools, leading to a dissatisfied member. One of Magellan Health’s core strengths is mental and behavioral health and with our diverse population of members across our products, we are in a unique position to provide our members with a guided approach to accessing care and address issues at their root by understanding the stressors, specific resources and community support.

Our vision is a holistic approach to member wellbeing and care. Our approach starts with member engagement and navigation to help remove the stigma towards mental health by helping the member to approach mental health and wellbeing as part of their whole health. We do this by promoting annual digital wellbeing checks in a self-service mode.

Q: How did you and your team come up with this idea? Why is Magellan Health the best place to work on this project?

A: Digital is everywhere and in everyone’s hand today in the form of mobile apps, websites and internet.  Ideas are plenty but solving for the real need is key. We conducted various design thinking sessions with members and studied the need thoroughly from the member perspective.

Magellan Health’s core strength is mental and behavioral healthcare, and we have a significant population of behavioral health members. We have members from our other products like Employer solutions, State and Federal, which puts us in a unique position to capitalize on our strengths and serve this large group of members at their doorstep and to get them healthy mentally and physically.

Learn more about the digital experience here.

Behavioral health is an important indicator of a society’s overall wellbeing, as it interacts closely with physical health. Unfortunately, most individuals do not receive the behavioral health treatment they need. Fear of treatment, shame, and embarrassment keep many from seeking care. More than one-third of Americans live in areas lacking mental health professionals.[1] Fifty percent of individuals who receive a behavioral health referral do not follow through or have only one visit.[2] Collaborative care addresses these problems by providing physical and behavioral health care in the primary care setting.

What is collaborative care?

Collaborative care is a specific type of integrated care developed at the University of Washington’s AIM Center that treats common mental health conditions, such as depression and anxiety, that require systematic follow-up due to their persistence. Based on principles of effective treatment of chronic illness, collaborative care focuses on defined patient populations tracked in a registry, measurement-based practices, and treatment to target. Trained primary care providers and embedded behavioral health professionals provide evidence-based medication or psychosocial treatments, supported by regular psychiatric case consultation and treatment adjustment for patients who do not improve as expected.[3]

Principles of collaborative care

Developed in consultation with a group of national experts in integrated behavioral health care in 2011 with the support of the John A. Hartford Foundation, The Robert Wood Johnson Foundation, Agency for Healthcare Research and Quality, and California Healthcare Foundation, five core principles define collaborative care and should inform every aspect of implementation to ensure effective collaborative care is practiced.[4]

• Patient-centered team care—Primary care and behavioral health providers effectively work together using shared care plans that include patient goals. Being able to receive both physical and mental health care in a familiar location provides patients with comfort and reduces duplication of assessments. Increased patient engagement often leads to a better health care experience and improved patient outcomes.
• Population-based care—Care teams share a specific group of patients that are included in a registry. The registry is used to track patients and ensure that no one falls through the cracks. Patients who do not show improvement are outreached, and behavioral health specialists offer caseload-focused consultation.
• Measurement-based treatment to target—Each patient’s treatment plan includes personal goals and clinical outcomes that are measured using evidence-based tools, such as the Generalized Anxiety Disorder scale on a routine basis. If patients do not improve as expected, treatments are adjusted until clinical goals are met.
• Evidence-based care—Patients receive treatments with sound research evidence to support their efficacy in the treatment of the target condition, including various evidence-based psychotherapies that have proven effective in primary care, such as problem-solving treatment, behavioral activation, and cognitive behavioral therapy, and medicines.
• Accountable care—Providers are responsible for and receive reimbursement for the quality of care and clinical outcomes, not just the volume of care provided.

Collaborative care has been proven to double the effectiveness of depression care, improve physical function, and reduce health care costs. Magellan Healthcare’s evidence-based Collaborative Care Management product, enabled by NeuroFlow, provides care management and psychiatric consults for primary care patients and augments physical health providers’ staff with Magellan staff to facilitate integrated physical and behavioral healthcare. Learn more here.

[1] https://usafacts.org/articles/over-one-third-of-americans-live-in-areas-lacking-mental-health-professionals/

[2] https://aims.uw.edu/collaborative-care

[3] https://aims.uw.edu/collaborative-care

[4] https://aims.uw.edu/collaborative-care

For our kids, disruptions caused by the COVID-19 pandemic are likely more than just that – temporary inconveniences, varying in severity, until life goes back to “normal.” Besides missing out on once-in-a-lifetime events, like graduations, birthdays and other milestones – at least in a way they would traditionally be observed – regular human interactions, part of social and emotional development, have changed. While adults may be experiencing a serious blip on the radar, children may be experiencing an interruption in brain development and/or lack the ability to fully cope in this unchartered territory.

In this post, we will contemplate these issues and draw on knowledge from Magellan Healthcare’s recently updated clinical monograph, Understanding and Meeting the Needs of Children and Adolescents at High Risk, which highlights evidence-based prevention and treatment approaches for problematic behaviors and various types of behavioral health challenges in children and adolescents.

As we think about the significance of childhood development, the following points from Magellan’s monograph provide insights:

A growing body of scientific information has confirmed the importance of the first five years of life, when the ongoing construction of brain architecture impacts youth social and emotional development, the ability to learn new behavior and skills, and how the youth evolves into adolescence.

Advances in neuroscience have contributed new understanding of adolescent development. During adolescence, the brain experiences a period of major development comparable to that of early childhood.

With much changing in our kids’ lives and environment – virtual schooling, modified in-person play arrangements with friends and reduced time with extended family – the responsibility falls on parents and caregivers, as it always does, to ensure their child’s wellbeing and adjustment. Magellan’s monograph offers the following to ponder:

While genes determine when specific brain circuits are formed, experiences actually shape their formation and are fueled by a self-initiated, inborn drive toward competence. This phenomenon depends on appropriate sensory input and stable, responsive relationships whereby adults respond to a child’s natural reaching out for interaction.

However, when parents are under unprecedented stress and often just trying to make ends meet, attending to their child’s increasing needs can understandably be overwhelming. In addition to the role of parent and full-time employee, many adults have taken on the additional roles of teacher, daycare worker and entertainer, to name a few. In some cases, however, a parent’s struggles may lead to neglect of their children. Magellan’s monograph highlights the following of child neglect:

While child abuse is more widely acknowledged and publicized, child neglect is, in fact, the most common type of child maltreatment, which frequently goes underreported. Expanding on the earlier discussion of impaired brain development, it is now understood that lack of stimulation and necessary care early in life may cause children to remain in a state of “hyperarousal” (i.e., constantly anticipating threats and/or experiencing dissociation) rather than a normal state of attentive calm. This phenomenon leads to a decreased ability to benefit from social, emotional and cognitive experiences and results in other psychosocial consequences. Together with insecure attachments, this state of hyperarousal can significantly affect normal growth and development.

Many parents are also managing their own mental health conditions and substance use disorder during the pandemic, which adds to the impact of what children and adolescents are experiencing themselves. The monograph outlines the risks for children of these parents:

There are many serious risks to children and adolescents who have a parent or both parents with mental illness. The American Academy of Child and Adolescent Psychiatry (AACAP) calls attention to the strong genetic predisposition in children for inheriting bipolar disorder, an anxiety disorder, attention deficit-hyperactivity disorder (ADHD), schizophrenia, alcoholism or other SUD, or depression. Recent studies have also demonstrated delayed brain development in young children of depressed mothers. Further, the AACAP notes the additional stress that mental illness places on a marriage and parenting abilities of the couple, and the risks that stem from an inconsistent, unpredictable family environment that can contribute to psychiatric illness and developmental delays in children.

It’s also appropriate to consider the older children and young adults who may lack the ability to cope with increased stress and instability. Magellan’s monograph calls attention to recent research:

A CDC report on mental health, substance use and suicidal ideation during the COVID-19 pandemic shows that while 11% of adults seriously contemplated suicide in June 2020, the same was disproportionately reported by young people aged 18 to 24 (26%).

During these difficult times, we’re all doing the best we can. And we know that brighter days are on the horizon. Until then, and always, as we’re helping ourselves and our children through, let’s remember that “information is power,” as they say. To that effect, we encourage you to learn more in our full children’s clinical monograph here.