By Heather Wright

Even before the pandemic, the decline in the mental health of adolescents was concerning. Between 2009 and 2019, the share of U.S. high school students who reported persistent feelings of sadness or hopelessness increased by 40%, to more than 1 in 3 students, according to the Centers for Disease Control and Prevention (CDC). Some studies attribute the decline in mental health, at least in part, to dramatically increased social media exposure and smartphone use among teens. 

MR Team SY2021 22
Staff members of Mi Refugio, a program based at Northwestern High School that supports the school’s immigrant and Latino populations
Courtesy of Susana Molina/Mi Refugio

The pandemic has made it worse. In May 2020, emergency visits for suspected suicide attempts began to increase among adolescents aged 12–17, according to the CDC. And the Maryland Youth Pandemic Behavior Survey 2021 indicated that approximately 1 in 5 Maryland teens reported seriously considering suicide in the past year.

We were already in a mental health crisis before COVID[-19], but it just wasn’t being talked about,” emphasized Dr. Linda McGhee, a clinical psychologist and president of the Maryland Psychological Association

Jonaki Sanyal is a counselor at Chelsea School, on Belcrest Drive, which serves middle and high school students with language-based learning disorders. In an email, she said she observed considerable grief, depression and anxiety among her students, “as teens had to make sense of the very fraught years preceding the pandemic.” She noted that students’ struggles intensified when the pandemic hit: “Those who were learning to manage anxiety now had to toggle to find an appropriate amount of anxiety to feel!” 

Teens especially susceptible 

McGhee said that adolescents have been particularly impacted by the pandemic for several reasons. “They’re developing resilience. They’re developing organizational skills. They’re developing a sense of who they are as individuals. They’re starting to think about their place in the world … about their careers,” she explained. “And all of these things have now been interrupted by the pandemic.” During the pandemic, adolescents have missed countless opportunities for social interactions and to practice trial-and-error decision making.

“[Adolescence] is a precursor to the ‘launch phase,’ a time of developing independence just before our maturing children leave home and face the world,” said Sean Delehant, a local psychotherapist. “With the restrictions brought on by COVID[-19] … instead of having increased opportunities to be with their peers, they are offered less.”

Increasing severity, need for support

Dr. Sarah Wayland is the founder and owner of the Riverdale-based Guiding Exceptional Parents, and she works with local families, educators and therapists. “The mental health crisis that our teens and young adults are facing right now cannot be overstated,” Wayland wrote in an email. “Kids are really struggling. I’m seeing more school refusal than I have ever before seen. More admissions to hospital psychiatric units. More severe depression. More suicidal ideation. More self-injury. Our kids are navigating so much uncertainty right now, and they are afraid about the future.” 

Folake Aloba, a psychiatric nurse practitioner and director of services at Covenant Psychiatric Services, on Hamilton Street, observed, “I’ve seen a surge in teenage depression, anxiety and even psychosis.” Delahant said the concerns and symptoms he has seen most in his adolescent clients during the pandemic are substance misuse, emotional volatility, feelings of isolation and sadness, family conflict and struggles with school.

Aloba said that Covenant has seen more than a 50% increase in teenage referrals. Sanyal increased the length and number of sessions for her Chelsea School students and included additional sessions for crisis support. She has also offered more virtual support outside of office hours to better meet students’ emotional needs. 

Delehant, along with several other practitioners, noted that many clinicians have had full case loads. “I’ve had difficulty referring clients to other clinicians because so many professionals are maxed out,” he said, noting that he was spending as much as three to four hours a week with some clients to help them avoid hospitalization. 

Highlighting inequities

McGhee emphasized that the pandemic has hit some families particularly hard, including families of color, those earning less than $75,000 and those with only one caregiver. 

Susana Molina is a mental health therapist with Mi Refugio, a program based at Northwestern High School that supports the school’s immigrant and Latino populations. She said that most students in the program have few, if any, family members in the U.S. Molina observed that students were hit particularly hard in the early stages of the pandemic. “A lot of them were coming with that worry, and, in some instances, with the news that they had lost parents, grandparents, siblings, close relatives,” she said. “So we were dealing with the grief that came with anxiety, that came with depression, it came with PTSD, and, overall, just emotional instability.” 

“The pandemic highlighted existing inequities and different access to space and need for in-person support,” Sanyal noted. “When going virtual, some [Chelsea School] students had to adapt quickly to new responsibilities, now in charge of getting themselves to virtual school and keeping on task, sometimes getting siblings logged in and on task as well.”

Developing resilience, coping skills, awareness

Most responding clinicians have observed their clients developing more coping skills and resilience. While some of Mi Refugio’s clients have experienced considerable family conflict during the pandemic, Molina noted, “We have had cases where the students have strengthened their relationships with their siblings, with their parents or their guardians.”

Sanyal and Delehant also described teens developing closer family connections. Sanyal pointed to a host of other ways her students have coped. “My artists and writers of the bunch channel their feelings and experiences through their mediums,” she explained. “Some learned to meditate, some began running, others started their own at-home cosmetics and nail salon businesses.”

Sanyal and Molina both noted that students have become more willing to seek help. “Some just started talking!” Sanyal said. She added that students have been developing “the coping skill of knowing when to reach out to the counselor … learning to use their voices and express themselves.” 

McGhee recommends that parents of adolescents prioritize their children’s mental health over academics for now. Encourage them to reconnect with friends or to replace relationships that have been severed during the pandemic, she said. She also recommended that parents think creatively about plans for the summer in ways that can bolster mental health and increase socialization.