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Take Note: Desiree Krise and Peter Montminy on kids' mental health during the pandemic

Child psychologist Peter Montminy, left, and licensed school social worker Desiree Krise talk about how the pandemic has impacted mental health for children and adolescents.
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Courtesy of Peter Montminy, Desiree Krise
Child psychologist Peter Montminy, left, and licensed school social worker Desiree Krise talk about how the pandemic has impacted mental health for children and adolescents.

The pandemic has led to increased stress and anxiety for children and adolescents. Desiree Krise, a school social worker in St. Marys, and Peter Montminy, a child psychologist in State College, talked with WPSU about the mental health impacts they have observed and how to address some of those needs.

Here's the conversation:

Min Xian: Welcome to Take Note on WPSU. I’m Min Xian.

Since the COVID-19 pandemic started more than a year and a half ago, people under 18 have avoided the worst of its direct health impacts. But mitigation measures like physical isolation and remote schooling have created stress, leading to increased mental health issues among children and adolescents.

Our guests, Desiree Krise and Peter Montminy, are here to talk about what they’ve observed during this time. Desiree Krise is a licensed school social worker at the St. Marys Area School District in Elk County. She has been in the profession and working in various capacities with children for 16 years.

Dr. Peter Montminy is a clinical psychologist with his own practice, A Mindful Village, in State College. He also works with K-12 schools as a consultant.

Desiree and Peter, welcome to Take Note.

Desiree Krise: Thank you for having me.

Peter Montminy: Yeah, thank you. Glad to be here.

Min Xian: The pandemic has disrupted many aspects of our lives. The most dramatic change for children and adolescents is likely their education. I want to start this question with you, Desiree. What has remote learning or the broader disruption of schooling meant for children’s learning and development?

Desiree Krise: Well, I know educationally, obviously, there's been some gaps there. As much as we've tried to fill in the gaps since the pandemic started, everyone was thrown for a whirlwind in March when the school shut down, and no one was prepared for that to ever happen. So there was obviously definitely some gaps left for that school year.

Luckily, for our school district, we came back last year, full in person learning. However, for our schools, we did have some gaps where we had to close down and do remote learning, which I feel like we were better prepared educationally to help provide the kids but definitely developmentally with just the social interactions not being there. The mental health component of them not being in school with their peers, and the up and down roller coaster of ‘am I in quarantine? Am I not in quarantine? Am I in person learning, not in person learning?’ definitely has been stressful for everyone involved. And I'm sure like we're always identifying those educational gaps and trying to, you know, build more classes and extra help around where those gaps have been for the last year and a half for those kids.

Min Xian: And, Peter, can you tell me about the changes that you have observed in school children that you work with?

Peter Montminy: Yeah, sure, both in my practice, and in my consulting practice with schools, one of the biggest challenges, I think, is the disruption to routine, to familiarity, to predictability, right. And anxiety thrives under conditions of uncertainty and lack of control. And the last, you know, two years going on, you know, two years has been just a tremendous disruption in that level of structure and routine, a big missing thing for kids at home and school.

And that's how kids develop a sense of rhythm and self-regulation, right is through tuned relationships with self-regulating adults and through familiar routines and structure. And parents and teachers are swimming in the same sea of toxic stress and disruption to their lives. And so it's more challenging for us caring adults to provide that clear structure and familiarity and comfort for kids. And so they're all the more kind of just dysregulated is what I'm seeing: attentionally dysregulated, emotionally dysregulated and behaviorally dysregulated.

Min Xian: Are there specific things that you think children are more concerned about? During the pandemic? Whether worrying about getting sick, their families getting sick or in relation to schooling? What am I going to do tomorrow, like Desiree mentioned?

Peter Montminy: Yeah, I'm curious what you're seeing, Desiree. I imagine it may be similar, but right, I think this condition has just aggravated any vulnerability that any of us or any of our kids may have had already.

So we have, in fact, some kids that were very worried about health and safety. And for some kids being home and isolated was more of a stressor. For some kids being home and isolated was a reprieve from some social anxiety and peer pressure and other things. Right. And for some kids coming back into school is like thank goodness, I finally get you know, to see people and interact again. And for some kids, they're stressed out about the return to school right so I'm - we're kind of kind of seeing that whole range of disruption and kids responding to it differently, or at least I am.

Desiree Krise: Absolutely, I would say, that's what we're seeing, those different ends of the spectrum, I would say, I mean, hands down a lot more anxiety we're seeing from the isolation that had occurred.

A lot of kids last year coming in very stressed, with anxiety of at home, I have a harder time getting work done, because I can't manage my time, the anxiety of then back and forth, like you said, time management, they can't regulate their emotions, they're not sure, you know, on a day to day basis how to handle wanting to sit on a computer and doing their work, even though they know they should, but they really could go play with their friends and be with their friends. If they're old enough to be home by themselves, like middle school, they could be sleeping. So then when they get back into school, the anxiety of trying to make up that work and get those grades back up is pretty daunting for them.

Yeah, we're definitely seeing a lot of the anxiety from each of the classifications of the kiddos, whether they like to be home and they're away from the social anxiety, they have to come back into it, because we're in person learning now, or the kiddos that that isolation really was not good for them.

Peter Montminy: If I could just add quickly, in addition to this significant rise in anxiety that we're seeing in kids, we've seen a secondary wave of more depressive down mood, irritability and kind of despair kind of coming over. And just plain simple burnout in kids and in the adults, like everyone wants to be so over this. And we're not over it yet. Right. And so kind of seeing this other real difficulty just managing the exhaustion of all of it.

And we had that, you know, we had the stress of the fast-paced digital information age life before this, this stressor hit and we have other social conditions that are adding, you know, different stressors for people as well. So it's just I'm also seeing exhaustion a lot, like the number one answer for how are you feeling today, the kids I see in my office here, no matter what their presenting problem is tired, right? Youth today tired because just of all the strain that we're all feeling.

Min Xian: And I'll throw this question to you first, Desiree. Why is that loss of routine, of regular structure, of social connections, in many cases, especially hard on K-12 students?

Desiree Krise: I'll say because I'm across the whole school district, you know, the elementary schools, those kids, like Peter had said, they're just learning to regulate their emotions and regulate their bodies. And with that structure every day, at least they know what is going to happen, basically. And with that routine, and structure allows them to be able to regulate those emotions on an age appropriate level and learn to do so and see their peers that model to them. There's so many different things that go into that.

And as far as middle school level, I mean, these kiddos that I primarily work with out of this school, you know, these kiddos, their peers are their life, they are trying to find themselves, they are looking to their friends for help. And when they cannot be near them. I mean, a huge piece of not only educationally, like Peter had said, is being with their friends and being able to be social, so that they can learn all of those things and come to school every day to anticipate seeing their friends. And the high school goes right along with that is they really, they want to have that structure.

I mean, myself, even being an adult. I like my structure, at least I know that I go drop off my kids to school, I come to work at such a time. Although I have so many different things that I do in the middle of a day. I know basically, you know, I will be at this school, I will be at that school, I have a little bit of a rundown of how I like my day and how it's going to go. And during the pandemic that kind of took that off. Like I didn't know where my kids would go day to day or if they'd be at home while I was trying to work. So even as adults, we like at least basic structure. And that's how we work our day and helps us regulate also.

Min Xian: And Peter, it sounds like - you're nodding along.

Peter Montminy: Yeah, just 100%, you know, that's, we all thrive better under again, stable conditions, and we have a lot of instability right now. Now, it doesn't mean we can't rise to the occasion, we can, we must, right? And we need to be, excuse me for the plug, a mindful village of caring elders taking care of one another as well as taking care of these kids. We can get through it. But yeah, we're in a lot of emotional turbulence right now, social conditions turbulence, and physical health care threat turbulence. So how do we again stabilize as best we can?

Min Xian: To follow up with that point, kids may not have the coping skills needed in face of uncertainty and they may not understand their own emotional mental struggles when they first experience that kind of issues. And I want to ask you this, Peter, how do you approach the topic of mental health with young people in need, when they may not 100% understand what really is going on?

Peter Montminy: I think we want to just take a look at the universal human condition, right? And with every child being able to say, hey, what's going well for you this week, what's not going well? I just normalize the idea ‘what's going well today, what's not going well for you?’ normalize the idea that we all have, we all have strengths and weaknesses.

So then we can get to what are the ways in which you know, the stressors, you're dealing with? What's working for you, what's not working for you, right? And to increase the self-awareness first for the kids to normalize the idea that we're all going to have strengths and struggles.

And then when we have the awareness of that, when we can make peace with it, and have the acceptance and the self-compassion. Yeah, I'm nervous. I'm confused. I don't know, I'm having a hard time concentrating. Yeah, you know what that makes you? It makes you human right, and helping kids to understand you're having a human moment, a human condition of difficulties concentrating under extra stress, right? Or being able, you're getting extra emotional, whether it's anxious, sad, depressed, angry, we just kind of normalize that, name it, and then we work towards how are we going to respond to that not react to it right?

How can we reengage the upstairs frontal lobes and thoughtfully respond to our stress and anxiety? Rather than just downstairs emotional reaction, downstairs brain, the part of the brain that's just is set for survival that triggers the immediate fight flight or freeze reaction, how can recognize that, normalize the idea that this happens to all of us, and then pause, breathe and reconnect to our rational thinking coping brain and thoughtfully respond to these things rather than just emotionally react to it.

Min Xian: I have the same question for you Desiree, and I'm especially interested in hearing how you have those coversations sometimes perhaps, when the kids are having exactly that ‘I'm not well’ moment in school, and then how do you approach that conversation?

Desiree Krise: One thing I'm really proud about at the St. Marys Area School District, is that we really try to normalize anyone's feelings and how you're feeling and that it's okay to ask for help, we all ask for help. We're always gauging even especially this year, there's been huge initiatives to, in every classroom to just have a conversation at the beginning of class, just to kind of gauge the mood of every single kid and connect with every single kid.

We also talk a lot and educate our kids a lot on the different services that we have, you know, whether it be mental health or different educational services that we have here, that they all tend to blend together. So there's not as much of a stigma of oh, well, I need help in this area, or I need help in this area. It's just all under the roof of the school. We're all a family. And we're going to talk about the good, the bad, the ugly.

Min Xian: You mentioned at the beginning of class, maybe a teacher would ask student questions about how they're doing. What - can you give an example what kind of questions would a teacher ask?

Desiree Krise; I know one class that I've seen has different poster boards around the room and they can just kind of put a pin or kind of stand by you know, happy, sad, mad, don't want to talk about it today. And the kids just kind of you know go there and stick their name on it or I've seen other ones in the middle school. I know we handed out like mood meters and actually saw that the elementary school too they were using different mood meters of a positive versus negative and all the feeling words in between where the kids can just kind of put a little pin with their initials on it.

Even without having to take a lot of class time to really go over it. There's a visual that the teacher and other classmates can kind of see of ‘Ooh, okay, half the class is really angry today.’ You know, maybe we should take a couple minutes to talk about that. Or not. They don't put the pressure on a lot of the kids, okay, well, you said you're mad, so we're going to talk about you being mad. They know that after class, you know, do you need to chat? Yes or no. So it at least puts some framework around how the kids are feeling. But they don't necessarily have to talk about it. Because sometimes just being able to let it out that you know what I am mad today, and somebody cares enough that I get to say it is enough.

Min Xian: If you’re just joining us, we’re talking with Desiree Krise and Peter Montminy about how the pandemic has affected children and adolescents in unique ways. Desiree Krise is a licensed school social worker at the St. Marys Area School District in Elk County. Peter Montminy is a clinical psychologist in State College and works with K-12 schools as a consultant.

Peter, I wonder, what are some ways that perhaps you have adapted to work with children since the pandemic began? How has it impacted your work?

Peter Montminy: Just really practically, in terms of going to more telehealth and you know, some of the practical kind of aspects like that, and working our way through that.

But at the core, it's, we were dealing with facing stress before and all the skills and tools we had before, it's not like we had to throw them out the window and invent some new COVID stress coping thing, we just needed to take stress coping skills that we know are helpful and apply it to this current stressor. I again, try to bolster both kids, parents and teachers in reminding themselves that we're not as helpless in the face of this as we might feel when we're in overwhelm mode. So I really keep coming back to and kind of playing off what we're all talking about, again, increasing this awareness and acceptance, and then what's your choice going to be.

And no matter what it is, it's good to know. What do you notice? Good to know. What do you need? What do you need to take care of yourself and get back on track? And then we still hold kids accountable. What will you choose? This isn't about you know, just oh, we're coddling kids. This is how we're creating skillful means to face stress. This is how we build resilience in our children. And we scaffold that just like we scaffold academic skills, we can scaffold social emotional skills.

Min Xian: You mentioned telehealth. That is one of the ways that has helped since the pandemic to expand or maintain some access to services. Has there been any silver linings or positive lessons in general about improving care for children with mental health needs for you, Peter?

Peter Montminy: Yeah, I think there's a general de-stigmatizing of, you know, and a general increasing appreciation of taking care of our mental health needs and especially our mental health our children, so if anything is silver lining, we've all gotten to the breaking point and we can't like BS our way through this anymore and it's okay to say ‘hey, I'm hurting or I need help’, like, Desiree was saying earlier. And so, the good news is people are acknowledging it and reaching out for help.

The downside and challenge side as mental health professionals is that, you know, demand is far exceeding supply right now. And that's another stress or strain on me and for all of us kind of in the trenches, so to speak.

Desiree Krise: Absolutely, I think that we all had to get familiar with using like telehealth and, you know, I was actually a therapist in March of 2020. I hadn't started at the school district yet. And it was like, ‘What do you mean, I got to talk to, I have to talk to a first grader on the computer?’ like, this is not going to work. Things that I never thought I'd be doing over a computer screen and billing for it. And, and the progress and the de-stress that I saw from that child and those parents were really remarkable, and I probably never would have seen them. And I'm sure, you know, the kids never would have probably tried that per se and been as confident as they would have, if we wouldn't have all just been thrown into it.

So, you know, I think the positive lining is that we now know how to engage kids even more so using technology that we may have been a little scared of because it wasn't in our normal routine and how we do it. And change is hard. So as hard as it was to be thrown into it, I think that all of those positive skills that we didn't know we had, or that would work, and did work, we can use now into our schooling, mental health, and all those things.

Min Xian: Desiree, I am thinking about a point you made, you were making about how even as adults, we are all also sitting in all these uncertainty. And we're all trying to manage through this ongoing pandemic as well. For parents out there wondering how they should talk to their kids about this continuation of uncertainty, do you have any suggestions? Is there a good way for them to talk to kids about what they're feeling? And what are the ways for families to kind of stick together and maintain good mental health together?

Desiree Krise: I think it's really important because there are such different sides of, you know, masking and not masking and rules about this and rules about that. I've really just tried to say, you know, to talk with kids, they're going to have their own opinion, just as parents are going to have their own opinion, and right or wrong, they can come together, they have on their household their own rules that they're going to follow to stay safe. And we've been going through this long enough that as far as those type of talks, really they've been established with parents of hopefully age appropriate information, and there's been you know, websites galore and everyone being able to provide that information, but as far as like just staying healthy mentally within their home. You know, I really encourage families that whatever you choose, whether it's staying in more, whether it's doing activities outside, you know, with more so your family or if you're gonna go and do every family vacation just as you have, to just remember to increase the communication skills and have those healthy communication skills. You know, try to value the time that you're together and being aware of safety, obviously, but being able to enjoy that family time, being able to, you know, try to pick your battles and enjoying whatever it is that you're doing. Just enjoying that with their families.

Min Xian: Same question for you, Peter. We are seeing a lot of heated arguments around just policies in schools right now. And I think there's a point to be made, people were talking about how even just having those arguments among parents could negatively affect kids. So what are your suggestions for parents when it comes to talking through all of these ongoing changes?

Peter Montminy: There have always been school rules, state laws, federal laws and there's always been some people who agree with them and some people who disagree with them. So how can we just all take a deep breath and remind ourselves, we may have these differences. And we can learn how to respectfully agree to disagree across these lines. And if right now, your school district or your state is drawing the line here, how do we teach our kids to follow the rules as best they can. And if people have strong conscientious objections, figuring out how to respectfully and lawfully lodge those and leave room for some individual variability, it's never one size fits all. It's never 100%. But how can we go back to respecting our individual rights that only come with respect and responsibility to the greater good as well.

And so there's an honest - room for a lot of honest disagreement about how to do that balancing act, or where to draw those lines. So I hope we can just keep reminding our kids, let's think about this as rationally and respectfully as we can. And if we draw the line here, and the school or your neighbors drawing the line differently then let's figure out just how to do the best we can with that.

Min Xian: I have this question stemming from what you said earlier, Peter, for some kids, it might be entering the pandemic that would be the most difficult thing for their mental health because they're going into isolation. But for some kids, perhaps this idea of returning back to normal could create another type of anxiety for them, too. So I'll start this question with you. When the pandemic ends, do you expect any kind of lingering effects on children? Or do you feel like they would be able to go back to normal the way they were before? Or perhaps it's a matter of how do we approach that idea of going back to normal?

Peter Montminy: How do we move forward to a new normal, right? Maybe the first thing is to reframe the idea of going back to anything, you know, time is always moving forward.

So we can say what did we learn from this? What do we learn about how we are stronger? What did we learn about how we did even with the ugly moments? How did we get through this together? And how are you stronger now and what's your takeaways from this? What are you going to use from this moving forward with whatever new life stressors are going to come? We can't live a life without situational stressors arising. So we're not being naive to real difficulties. We're acknowledging real difficulties, and then we're saying and how are we stronger? How are we able to take care of ourselves? We've gotten through this. Let's celebrate that we're ready to move on and I fully believe we will rebound and move on.

Min Xian: What do you think Desiree?

Desiree Krise: Absolutely, I mean, with our small town per se or small towns that encompass the St. Marys School District, and thank God last year, we were in person for so much of it, this year, I can already start to see a rebound of, you know, we've put so many things in place, which has been fantastic, like more social emotional learning.

The kids that I see every day, most of them are thankful in some way, shape or form to be here in school. And they value that, whereas it was kind of a given before, they liked it okay, we have to be here. But there are so many kids that truly value and are truly happy to just be in school.

So I think with those positives we are already seeing, you know, families stronger together, although they've had major struggles, you know, a lot of our parents have been back to work and have been, you know, trying to make up for lost time that happened during the complete shutdowns. We are lucky in our community that things are slowly improving in those areas, and the kids are very resilient in that. Okay, at least now I know, okay, if I have to be put in quarantine, this happens, I go home, this is how I get my schoolwork. This is who I can reach out to, this is who I can do a Google meet with, and this is my safe person. So because we've been doing it now for over a year, we have those same things put in place from last year. So it's kind of a routine. Unfortunately, in some areas, if people are in quarantine, but they at least know you can see on their face as disappointed as they are. They know who they can reach out to. I have several kids, if they, you know, would be out for an extended period of time, they will send me an email immediately and say, Hey, can we have a Google meet just so I can see a familiar face? Absolutely. Let's schedule that. And if you need any help with work, I can help get you connected to who you want.

So those positives that we just continue to build, and looking at, okay, we did this and this and the things that we've all overcome. I think that, as Peter said, that's one of the greatest things that these kids have.

Min Xian: I appreciate your conversation today.

Desiree Krise and Peter Montminy, thank you for joining us on Take Note.

Desiree Krise: Thank you.

Peter Montminy: Thank you.

Min Xian: Desiree Krise is a licensed school social worker at the St. Marys Area School District in Elk County. She has been in the profession and working in various capacities with children for 16 years.

Dr. Peter Montminy is a clinical psychologist with his own practice, A Mindful Village, in State College. He also works with K-12 schools as a consultant. Previously he worked as the Coordinator of Child and Adolescent Services at Penn State’s Psychological Clinic.

You can listen to more Take Note interviews on wpsu.org/takenote. I’m Min Xian, WPSU.

Min Xian reported at WPSU from 2016-2022.
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