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N.H.’s Child Advocate: The pandemic has exacerbated a mental health crisis among children

A photo of Moira O'Neill, N.H.'s office of the Child Advocate
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"The kids that we've been talking to are really frustrated with adults," New Hampshire's Child Advocate Moira O'Neill says.

It’s been a difficult time for families throughout the pandemic, with school closures and so much uncertainty.

A new report from New Hampshire’s Office of the Child Advocate highlights how children, in particular, have been harmed by the pandemic. NHPR’s Morning Edition host Rick Ganley spoke with Moira O’Neill, the state’s Child Advocate, more about those findings. Below is a transcript of their conversation.

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Rick Ganley: We've heard a lot about how the challenges the pandemic has placed on the state's education system has been affecting children overall, but this report goes beyond school. Can you talk about how the child welfare system has been strained during this time?

Moira O'Neill: So we often have sort of talked through the past two years that children weren't at the greatest risk, because they didn't have to get hospitalized and that their death rate was very low across the country, but they were impacted in many ways. We don't know what the long-term effects are of infections, even when they're not symptomatic. But we have seen children lose their caregivers. We've seen children lose levels in school because they've been out of school. And we've seen a massive effect on the mental health side of things for children, where there's been an increasing number of kids showing up in the emergency rooms, in acute psychiatric distress. There was a bit of an epidemic in children's mental health before the pandemic, and the pandemic has just really had the opportunity to exacerbate that for kids.

Rick Ganley: Yeah, the ongoing ripple effects of this pandemic. Can you give us an example of a story that you've heard that illustrates some of this?

Moira O'Neill: What we hear most about are children at the deeper end of the system. You know, those are the kids that are most vulnerable because they're not home with their families. So the children who are placed in residential care, because of the nature of a congregate setting, you have to protect all, not just one. So very early when the pandemic started, those kids saw the doors close. They weren't visiting with their parents. They weren't visiting with their prospective adoptive parents. So everything sort of came to a standstill for them. You know, you just don't know when you're going to go home. You don't know how you're going to be harmed. You don't know what's happening next. And that was sort of elevated during the pandemic. So we saw one little boy recently who was doing okay in a residential setting. But when the pandemic happened and he couldn't visit with his mother any longer, he really couldn't cope with that. He had a special way of communicating with her. She understood him. And, you know, did he feel abandoned by [her]? We don't know. He's not a kid who could communicate. And from that experience of not being able to see his mother, everything just spiraled and he's really not in a good place today.

Rick Ganley: It's just heartbreaking. Another concern outlined in this report was the crossover of children in the state's child welfare system to the juvenile justice system. What kind of reforms would you like to see from the state on that?

Moira O'Neill: Yeah, I think that there's been a lot of reform in juvenile justice happening. You know, we're seeing some legislative changes coming into effect in the coming year to be more responsive to kids on an individual level and in pro-social positive youth development way so that we're responding to kids in the juvenile justice system individually and in a more supportive way, as opposed to a more punitive way. So we should be able to catch some of this.

But what the concept of crossover means is that there are children who are referred to the agency for suspected abuse and neglect. Sometimes they're referred for abuse and neglect. They have really bad experiences. Parents are just not able to either meet their needs or are not willing to meet their needs. And it's very chronic and the department is not able to resolve this and the families aren't able to resolve it. And while the kids are waiting, you know, things get worse and there may be altercations because no one's making things any better for a kid. And somehow, instead of helping the family and helping the parents, there's a shift over to the juvenile justice system. So even, we've seen at times people will suggest to parents, like next time when he's acting out, just call the police because then, you know, we could file charges and we could get them into the system to get the care that we haven't been able to get him otherwise. And so you end up with kids who are in the juvenile justice system where accountability lies with the child. In the child protective system, accountability lies with the parent.

Rick Ganley: Has the pandemic made you think any differently about some of these systems and how they could be more equitable? I'm thinking about some of the reforms you've instituted. Are the current systems in place really serving everyone under your purview?

Moira O'Neill: Well, I think that there's always a lot more work to do. You know, we have a lot of systems, particularly in the system of care in the community, that's just barely rolling out. We've been waiting for years for those to happen, even though funds were allocated some time ago for them. I think specifically pandemic related, you know, just the basic public health of the pandemic has been very frustrating for us and chiefly for children. You know, we talk to children all the time. When you hear arguments in the news, when you guys talk about arguments, if you notice it's really a slant towards adults’ opinions and you don't hear children's opinions that often. But the kids that we've been talking to are really frustrated with adults. They want to go to school, they want to see their friends, they want to resume their activities, and they really don't mind wearing masks. You know, they really don't mind doing the social distancing stuff. They miss their friends more when they can't be together because there's a shutdown, because people weren't wearing masks. And they're very uncomfortable with the arguments. Parents are showing up when kids are getting off the bus. The things that are happening at school board systems. I think it's really time that people stop and pull back and talk to kids themselves. And so adults really do need to get out of children's way. They need to do what they can to prevent the spread of the infection. They need to wear masks. They need to wash their hands. They need to social distance. And anybody who's eligible for a vaccine should get vaccinated. And we should just move on and keep our political arguments to other matters because this is really affecting children in a terrible way.