We know students are struggling with their mental health. Here's how you can help

According to the CDC, between March and May, 2020, hospitals across the country saw a 24% increase in mental health emergency visits by kids aged 5 to 11 years old, and a 31% increase for kids 12 to 17.
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Most kids around the country are back in classrooms by now, but this school year isn't quite the return-to-normalcy that everyone had hoped for. Covid-19 cases are surging again, and many school districts have already closed due to outbreaks. Others are offering remote learning options. This school year is already feeling uncertain and anxiety ridden for many students.

"Teacher, kids, everybody thought we were going to come back this year and everything would be back to normal," says Dr. Nicole Christian-Brathwaite, a child and adolescent psychiatrist and a senior vice president at Array Behavioral Care. "And now that it's not, how do we prepare kids for another potentially challenging year?"

That's a question she's been getting a lot from schools in recent weeks. So what do you do? Christian-Brathwaite and other mental health experts gave NPR some tips that parents, teachers and all adults can use to help kids cope better in these uncertain times.

1) Adults, take care of your own well-being first.

"There are no healthy children without healthy adults," says Christian-Brathwaite.

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It's important for adults in charge of kids to take care of their own mental health, she says, so they are able to better manage whatever comes their way.

Practice things that will support your resilience, advises child and adolescent psychiatrist Dr. Vera Feuer, the associate vice president for school mental health at Northwell Health.

Feuer suggests doing calming activities like yoga and meditation. In fact, any physical activity can help, she adds, like hiking, dancing or playing sports. It will help you manage your emotions better and stay calm during stressful times, she says. And in the process you can teach your kids or students these important skills, too.

"Kids and parents should understand that we all have anxiety and stress in our lives, and the goal is not to eliminate it, but to learn to manage it," adds Feuer.

Christian-Brathwaite suggests incorporating calming activities like meditation into the school day — either at the start of the day, or during transitions between classes.

"Something as simple as a regular practice of meditation or mindfulness, it decreases our stress response," she says. "It brings kids out of that fight, flight or freeze, and it brings the adults out of it as well."

2) Talk to kids about their concerns — and validate their feelings

It's important to start talking to kids about their emotions and their mental health early, and before things reach a crisis point.

Families should "provide kids with open spaces to discuss their concerns," says Feuer. "This generation is changing in terms of their view of mental health. And there is a positive shift in the stigma issue in terms of kids being more willing and able to come forward and talk about things. And really, adults need to continue to support that."

The same advice goes for schools, too, says Dena Trujillo, interim CEO of Crisis Text Line, which has created a toolkit called Mental Health School Supplies to help kids cope better during these times.

"Some of these things seem basic, but they're really important," she says.

And when kids express their concerns, say about being back in school, or fear of infections, parents and teachers need to accept their concerns as valid, says Feuer, and then teach them tools to manage their anxiety and stress, like yoga, meditation and mindfulness.

Even better: practice these skills as a family.

"Combining that with family time to give parents the opportunity to implement these practices, but to open the door for dialogue," says Christian-Brathwaite.

And be on the lookout for changes in behavior like sleeping and eating patterns, she adds.

"Just being aware of those behavioral changes: Is there a decrease or increase in eating? Is there a decrease or increase in exercise? Who are they hanging out with? What are they doing?"

All of those can be indicators of a child starting to struggle emotionally.

3) Be ready to provide extra support to students and teachers

"I really recommend that you just assume that everyone has experienced some level of pain," says Chirstian-Brathwaite. "Every child that you engage with has some level of trauma."

But children's pain and emotional struggles often come out in the form of behavioral problems, like being disruptive in a classroom or inability to focus and learn.

For kids being disruptive in class, she advises against disciplinary action.

"I'm really asking schools not to implement suspensions or detentions immediately and to really take a more trauma sensitive lens," says Christian-Brathwaite. "Instead of focusing on the behavior, disciplining them, sending them out of school, leading to more disruption in education, let's focus on what's behind that behavior. Where is this pain coming from? What was the catalyst for this child to act out? What's happened at home that may lead this child to misbehave?"

School administrators should take a similar approach toward teachers, she adds. If a teacher is late, or having a hard time, she suggests that the school principal or superintendent ask the teacher what additional support they need to be successful.

4) Help kids embrace structure and routine

In a world filled with so much uncertainty, structure and routine are one's friends.

"Some of what is helpful is actually making a schedule," says Trujillo. "As you go back into this new way of living, structure is helpful. Writing down that schedule or having it in your calendar so that you have that sense of control and stability."

Feuer suggests working ahead of time with your child to come up with a structure and stick to it. "Be consistent," she says.

And if a child is worried about past experiences that have stressed them out, she suggests "collaborative problem solving."

"Just talking to kids about what they [can] do if that were to happen and how to manage it and how to talk about what skills they can use in terms of managing it," says Feuer.

5) Know where to turn for help

If a child is struggling emotionally, or in crisis, know beforehand where to reach for help, suggests Trujillo.

The easiest option for kids or their teachers or families is the Crisis Text Line, by texting HOME to 741741 and connecting to a trained counselor.

If you know a child struggling with thoughts of suicide, you can call the Suicide Prevention Lifeline at 1(800) 273-8255.