In the wake of the Texas school shooting tragedy, your young patients–and their families–may be experiencing anxiety that can affect normal functioning. That anxiety can manifest in many ways, from reluctance to go to school to increased aggressive tendencies.
In fact, pediatric primary care providers (PCPs) have been observing the effects of news consumption on their young patients for years now. The spike in anxiety at the beginning of the Covid pandemic is another example. Families may be experiencing trauma as they watch scenes of devastation and displacement in Ukraine. Every act of terrorism or mass violence inspires more fear. The examples go on.
As your families’ trusted PCP, you can influence how patients and families deal with anxiety over recent events and the continuous barrage of bad news that characterizes today’s media culture.
Children with mental health diagnoses may need special accommodations in order to succeed in school. Patients with attention-deficit hyperactivity disorder (ADHD) or autism come immediately to mind. However, children with depression and anxiety disorders may also struggle in the classroom.
Pediatric primary care providers (PCPs) and therapists can help families get the school accommodations their children need. Mark Wolraich, MD, REACH faculty member and retired professor of pediatrics at the University of Oklahoma Health Sciences Center, emphasizes that children are best served when professionals take a team approach to mental health care.
“In some ways the holidays this year will be harder than last year for many people,” said Deborah Buccino, MD, pediatrician and REACH board member. “Earlier, we had pretty clear-cut rules about what you could and could not do safely. This year, we have a lot more gray areas.”
We don’t have to tell you that virtually everyone feels anxious about the spread of COVID-19. An appropriate level of anxiety can be helpful if it inspires people to follow CDC recommendations on hygiene and social distancing. An unnecessary level of anxiety, however, can impair both mental and physical health. Many of your patients and families are suffering from unhealthy anxiety–whether they present with possible COVID-19 symptoms or come in for an unrelated complaint.
According to the National Center for Education Statistics, 92% of public schools had formal active shooter plans in 2016, and 96% conducted lockdown drills. These measures are intended to keep children safe, but they may do as much harm as good. The title of a September 4 New York Times article sums it up: “When Active Shooter Drills Scare the Children They Hope to Protect.” We asked REACH faculty member Jasmine Reese, MD, MPH, about how students react to active shooter drills and what pediatric primary care providers (PCPs) can do. Dr. Reese is Director of the Adolescent and Young Adult Specialty Clinic at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida. “We have yet to see data on whether these drills are causing more anxiety and other mental health issues among students,” said Dr. Reese. “But it seems clear in practice that they can either cause anxiety and depression or exacerbate existing issues.”
“This course has made me more comfortable in dealing with my patients with mental illness As the PCP, I would normally refer to psychiatry or psychology, but I would now feel more capable to handle the more straightforward cases.”