Mental Health of the Household During COVID-19

May 18, 2020

These are definitely challenging times and almost everything about our daily lives looks different. Before COVID-19, people had their routines and schedules. Now, parents and children are dealing with major life disruptions, including school closures and social distancing, which has been difficult for everyone in the family.

Parents are balancing remote work, home schooling their children and providing childcare while keeping their worries about jobs, health and finances under control. Children are not in school, not able to hang out with friends and missing sports seasons and graduations.

Life might look a little messy right now, but Dr. Caroline Boxmeyer, a psychologist at University Medical Center, said that’s ok.

“It’s really an unprecedented and an historic time where we’re all just kind of figuring it out together,” she said. “This has been a really challenging time for all of us.”

How has covid-19 impacted parents and children who are experiencing social isolation in their homes?

Boxmeyer said it’s important for parents to know that “if you have felt this time to be stressful, or you’ve been more short with your children than you would like to be, or you’ve just found it very complicated and confusing to juggle new schedules and new routines, you are not alone.” She said there are families facing financial hardship and worries about their health, but families “have also have found that they enjoy having more time together and having the busyness of life stripped away and a reminder of what really matters, which is often the people we love the most and having each other.” Boxmeyer said COVID-19 has affected people in all kinds of ways “and I think one of the things we can do is to acknowledge that and support each other and put our heads together in creative ways about how we can come through this time as strong as possible.”

What can parents do to help improve the mental health and coping mechanisms for their children during this time?

Parents should be aware of what their children need, Boxmeyer said. “One of the things that children need the most is to feel like they matter, that they’re loved and supported and to have someone paying attention to their needs and making an effort to consistently provide for those needs.” She said if parents and caregivers are even coming close to doing these things during this complicated time, “you’re doing great and that goes a long way.” She said there have been a lot of change and a lot of losses and knowing the important activities that your child might be missing out on, and ways of talking with them about that, can really help.

One of the things for high school seniors, obviously, is no graduation ceremony, or prom. How do you help your child through that?

Boxmeyer said people have described these as losses for their children – prom, high school graduation, sports teams and missing their friends – and that dealing with those losses is like going through a grief process. “It can help to remember how that feels for your child and acknowledge those feelings and put your heads together because it’s important to mark that as an important milestone in your life.” She suggested thinking about safe and healthy ways to mark those milestones.

We’re starting to transition to getting out more and being with people. Do you see that potentially giving children more anxiety?

“I think that has the potential to go both ways,” Boxmeyer said. She said some children are probably excited at the prospect and can’t wait to see their friends, “and we might need to hold them back a little bit.” But other children might find that frightening and worry about what they might be exposed to, or if mom or dad are going to be at risk if they go places, she said. “We’ve all made an effort to wrap our families in bubble wrap, nice and tight to protect them, and now we start that unwinding process and in doing that we need ways of knowing that we’re making wise choices and going at a pace and with a plan that we think makes sense for our family and our family’s wellbeing,” she said.

Children have been sequestered with their family. How will children, and parents, handle being away from one another?

Boxmeyer said a lot of parenting is emotional coaching – being aware of how your child is feeling, letting them see you deal with similar feelings and giving them a process for working through their feelings. “You can say something like, ‘We’ve been at home for a while, we’ve felt safe at home, we’ve felt safe with our family, and now we’re going to start slowly going out more. Here are the steps we’re going to take to feel like we’re safe in that process. We’re going to wear masks, we’re going to keep our distance from other people, we’re going to wash our hands really well when we get home. If we do those things, we have a good reason to believe that we’ll stay healthy and, importantly, that we’ll keep others healthy as well.’” She said the hard part for parents will come when children want to do what their friends are doing. Boxmeyer said if friends are doing things that don’t fit with the current health and safety standards “that’s where you really have to be a leader as a parent and say, ‘I know it’s hard to not get to do everything your friends get to do, but let’s look at all the information that’s been put out by experts and let’s follow that and that’s how we can feel best for our family right now.’”

Do you anticipate a rise in Post-Traumatic Stress Disorder from people worried about leaving home and not feeling safe going out?

Boxmeyer said it is possible that people are already experiencing “acute stress,” especially parents worried about finances and trying to juggle a full-time workload while also being their child’s teacher at home, and essential workers with young children and few options for childcare. “Those are very stressful things, so there may be some elements of trauma or PTSD involved,” she said. She said these situations also provide opportunities for resilience “and ways to show that we care about other people. Those can be really protective as well. We’re seeing all kinds of creativity from families coming up with ways to help others. I don’t think we want to assume that children are going to remember this time in a really traumatic way; it’s certainly a possibility, especially for more anxious children and for families more deeply affected. But we want to be aware of that possibility and do as much as we can to keep this time as routine and safe as we can for them.”

Although it’s coming to a close, parents are still doing home schooling. What kind of mental health effects have you been seeing because of home schooling?

Boxmeyer acknowledge that it is challenging to for parents to serve as homeschool teachers while trying to work a full-time job from home. “I think the best we can do is acknowledge the complexity of the situation and draw upon whatever levers we might have, whether it be a partner we can split a schedule with, or a flexible work schedule so that we can be there during those core instruction hours,” she said. And know there’s probably going to be a lot more screen time than you typically would prefer, she added, “but those screens are serving an amazing use right now to help children learn and also connect with their friends.”

How do parents cope with subjects they may not know?

Boxmeyer recommends making use of available resources. “Reach out to the teacher to see if he or she can provide assistance, or to family members who may be stronger in that area. And now we’re fortunate with so many online resources that can provide extra support.”

What about the fall, if schools don’t open, or open at half capacity with different schedules? How do you anticipate that affecting the emotional of children and parents?

“I think that’s a question we’re all looking at and wondering about,” Boxmeyer said. “Fortunately, we still have a couple more months for people to keep working on the science and looking at that.”

How do you calm their anxieties if they’re afraid about going back to school?

Boxmeyer said if officials make a decision that it is safe to go back to school, “then I would talk to my child about the school district’s plan to protect them and keep them safe.” And she would include good news – “you’ll get to see your friends and keep learning and having activities” – but with the caveat that friends might not all be there at the same time “and you may sit farther apart from each other and you may wear a mask.”

Do you find that we have decreased the hecticness of our lives?

“Many folks have found that and have noticed the ways it helps us be present with our children,” Boxmeyer said. She said being present is one of the most important things we can do as parents. “Our children crave our attention and that loving connection and, in some ways, this time has offered more opportunities for that,” she said. But Boxmeyer acknowledged that it’s also harder to have those moments of connectedness as parents are working from home and serving as homeschool teachers. “One of the things you can do is plan at least a little bit of time each day, even if it’s 20 or 30 minutes, that you set aside that you know you’re going to give your child your undivided attention, and do an activity that they would enjoy. And the rest of the day, even if you have to close the door and take your conference call or do your work and you feel badly about that, at least you know you’ll have that time again with your child.”

Are you seeing an increase at University Medical Center for use of mental health services?

Boxmeyer said there has been an increase in patients seeking mental health care during this time. “Fortunately, we already had experience with telehealth, so we were able to ramp up pretty quickly and are serving a lot of patients using video conferencing, or phone if they don’t have access to video conferencing.” She said COVID-19 has been a difficult time for people. “If we’re worried about supporting our family, or feeling stuck inside all day, not moving our body or not connecting with loved ones, those are the things that can really affect our mental health and wellbeing.”

What are advantageous and disadvantages of doing counseling by telemedicine?

Boxmeyer said an advantage is a better understanding of a patient’s home environment. “That can be beneficial to understanding their needs and how you can best support them.” She said telemedicine also eliminates some of the issues that patients experience in West Alabama, with a lack of public transportation service. “It’s made it easier for some folks to access mental health services who may not have been able to before. I’ve really come to appreciate those elements as well.”

Any concerns with privacy?

“I’ve talked with folks who are locked in their car with the air conditioner on or the windows down because it’s the only place in their home they could have privacy,” Boxmeyer said. “Or outside with earphones in, or in the closet. We have to be really resourceful during these times – wherever you can find a minute of peace and quiet to yourself and a confidential place to talk. And we are respectful on our end to make sure the technology that we’re using meets HIPAA and high standards for privacy and that the location that we meet in is very private as well.”