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Lisa Black

ITASCA, IL-- The American Academy of Pediatrics has updated its guidance on supporting the emotional and behavioral health needs of children, teens and families to describe new challenges that undercut resilience and demonstrate the urgent need for improving mental health care.

While some initial challenges of the pandemic have eased, such as quarantining and social isolation, families are now coping with the complexities of in-school attendance and impacts of remote schooling. There is also an increasing reliance on social media for communication, the guidance observes. 

Additionally, many young people are suffering the loss of a loved one. Recent data show that more than 140,000 U.S. children have experienced the death of a primary or secondary caregiver during the COVID-19 pandemic, with children of color disproportionately impacted.

“These are difficult times, and I know that many people are hurting, even as we enjoy a traditionally festive holiday season,” AAP President Lee Beers, MD, FAAP, said. “Pediatricians are in a great position to help families identify signs and symptoms of stress and offer resources and reassurance. We know your children and can help navigate questions about whether new behaviors or emotions are typical or need more evaluation. We are in this together.”

The "Interim Guidance on Supporting the Emotional and Behavioral Health Needs of Children, Adolescents, and Families During the COVID-19 Pandemic" provides an overview of the most recent research, including the finding that 1 in 4 youth globally are experiencing clinically elevated depression and 1 in 5 are experiencing anxiety.

Experts have noted with alarm the pandemic’s devastating impact on the mental health of children, teens and young people. The AAP, the American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association recently declared a national mental health crisis among children and teens. Earlier this month, U.S. Surgeon General Vivek Murthy issued an advisory calling for a swift and coordinated response to the mental health crisis. On Tuesday, Dr. Beers spoke about the national emergency declaration and the mental health needs of children and adolescents at a congressional briefing.

“We know effective ways to buffer the impact of trauma and stress, and support positive social-emotional development,” Dr. Beers said. “For many, it is very difficult to find and access mental health care that offers this help. We need to improve timely access to evidence-based mental health treatment. This means integrating mental health supports within our primary care offices, school and other settings.”

The numbers of teens arriving at emergency rooms and primary care clinic for behavioral and mental health problems and suicide attempts have increased significantly during the pandemic.

The guidance includes recommendations such as:

  • A continued need for pediatricians to integrate emotional and behavioral health into standard care, checking on the wellbeing of both children and caregivers.
  • Evaluating for social health determinants that cause additional stress, such as family housing, employment or food insecurities.
  • Providing guidance on developing healthy habits, such as balancing time spent on screens with the need for sleep, nutritious food and physical activity, as well as coping mechanisms for dealing with uncertainty.
  • Advocating for the mental health of children and adolescents, as highlighted in the AAP-AACAP-CHA Declaration of a National Emergency in Child and Adolescent Mental Health

Much remains unknown about the impact of interrupted socialization and learning during critical developmental stages. But the guidance notes positive developments, such as schools that have incorporated wellness activities into their daily flow.

“The need for urgent action on a national scale can seem overwhelming, yet we can each help with small acts of kindness and efforts to improve relationships within our own families and communities,” Dr. Beers said. “We have never backed away finding a way forward, even in times of strife. Now is the time to listen to each other, have compassion and work on collective solutions.”

Resources include:


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

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