Youth struggle in isolation as COVID-19 drags on

WINDOW ROCK

Stay home and safe from the coronavirus and risk your mental health or go back to school and risk catching the disease.

Last year when the pandemic reached the Navajo Nation, the 2019-20 school year was a few weeks away from ending. Many school officials assumed the pandemic would end by fall, when most schools begin a new school year.

By July 22, the Navajo Nation had extended the state of emergency and closure of all tribal offices. The 57-hour weekend lockdowns continued.

Based on two surveys for parents and school principals, on July 31, 2020, the Department of Diné Education OK’d a resolution to recommend that all schools on the reservation provide virtual and online learning opportunities.

The Bureau of Indian Education was in the process of reopening BIE schools to in-person learning. The tribe voiced opposition to this to U.S. Assistant Secretary of Indian Affairs Tara Sweeney and Bureau of Indian Education Director Tony Dearman.

Flattening the curve

By August, 2020, NDOH reported the so-called “flattening of the curve,” a term used to describe the downtrend in COVID-19 positive cases, was on its 48th day with less than 100 new cases per day.

The Nation also continued to follow guidelines released by the Centers for Disease Control and Prevention to wear masks, be socially distant, wash hands and stay home, which keep infection rates down.

After months of testing COVID-19 vaccines, the first experimental vaccine was developed by Pfizer-BioNTech.

The biopharmaceutical companies announced on Nov. 9, 2020, that the drug is more than 90% effective against the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection and would be authorized for emergency use.

Parents were told it isn’t authorized for children under 18.

Schools began issuing tablets and laptops and setting up Wi-Fi hotspots for reservation students with the intent of getting kids back into a routine of educational normalcy they were accustomed to before the pandemic.

Instead, they got a dose of another kind of normalcy that is usually swept under the rug – poor to no connectivity to internet service.

Many parents with kids in a reservation school don’t recall last school year too fondly. One mother of two students said the previous school year “sucked.”

There isn’t anything schools, parents or the tribal government can do to fix connectivity speeds.

But what the tribe did do was highlight plans to lay more than 2,261 miles of fiber optics across the reservation that would bring faster broadband speeds to all 110 chapters.

On April 7, the Navajo Nation Cyber Team, or NCT, presented its plan and requested $552.6 million.

Of that, NCT suggested more than $89 million would go toward distance learning and telework.

A Fish Point, Arizona, father went as far as building a makeshift classroom for his children and extended family members on top of a hill next to their home where they could get enough data to text with his children’s teachers.

While his enthusiasm for his kids’ education may have inspired others, a more concerning issue emerged: the mental health of kids.

Seventeen months of isolation, the state of fear, losing loved ones to COVID-19 and getting sick and recovering, have taken a toll, especially for children.

Before the pandemic, mental disorders were already on the rise in the U.S.

Mental disorder affects 1 in 5

According to the National Institute for Health Care Management, one in five children had a diagnosed mental health disorder that began increasing between 2004 and 2019.

Adolescent girls were two times more likely to have an episode of major depression.

Suicide rates were already increasing before the pandemic, and 54% of LGBTQ youth who wanted help with their mental health problems did not receive it.

Dr. Michelle Stam-McLaren, a pediatrician at Rehoboth McKinley Christian Hospital, said she’s seen more depressed patients and has prescribed more antidepressant medication in the last 18 months than in the previous five years.

“And kids are coming in a little bit more withdrawn, not as interactive,” she said. “I think it’s probably the middle school and upper that are having problems.”

Stam-McLaren said that while younger children are dealing with the pandemic a little better, those in middle school and higher had to stay home to care for their siblings while trying to homeschool and learn virtually.

“So I think that they had a lot more responsibility,” she said, “in taking care of the household and making sure the other kids were getting things done.”

COVID-19 created a perfect storm of stressors for children and their families such as uncertainty, social isolation, school closures, family challenges, economic instability and losing a family member to the illness.

Stam-McLaren said despite younger children seeming more resilient to the pandemic’s impacts, she’s noticed them becoming more introverted too.

“The younger kids, in terms of the socialization, that has hindered their being able to get out and be with kids their own age and to interact,” she said.

“I’ve seen a lot of these kids being more shy when they come into the clinic,” she said, “not wanting to talk, having more separation anxiety when they have to leave their families because they haven’t had to in the last year.”

Stam-McLaren said she isn’t sure what brought the change. She said children kept in isolation are not seeing or interacting with friends and seem quieter and more depressed.

“Being an adolescent and being a teen and being even in elementary school, their friends are very important,” she said. “And when you’re not being able to see those people and interact with them, it takes a toll on them just as the adults.”

Depression, according to Stam-McLaren, is an overwhelming sense of sadness, not enjoying life and feeling hopeless.

If a person becomes constantly depressed, she said, it could lead to sleep deprivation or sleeping too much. It could cause a person to overeat or not eat enough, she said.

“Depression can actually cause physical pains too,” Stam-McLaren said. “Kids will come in with stomach pains or increased headaches.

“And maybe not totally depressed but those can cause your body pain,” she said. “That could be a symptom of depression.”

Calming fears

Dr. Yvonne Mandagaran, a licensed clinician and counselor at Rehoboth McKinley Christian Hospital, said parents have been apprehensive about letting kids go back to school despite giving every indication they want to return.

“A lot of the kids are anxious to go back to school or they need that social contact with their friends,” she said. “That was probably the cause of their anxiety and depression. They were tired of staying home.”

The pandemic also limited telehealth access. Children had fewer mental health screenings because of school closures and delayed pediatric care, NIHCM reports.

Stam-McLaren said there aren’t many counseling services for kids – even for adults – around the area.

“It’s a really high need in this area and there’s not a lot of people that are doing it,” she said, “but I think that’s in any small community, rural community, but even nationwide. There’s a big need for mental health.”

The Navajo Division of Social Services has six clinics – Crownpoint, Shiprock, Chinle, Tuba City, Fort Defiance, and Kayenta – that cater to mental health treatment for children and their families. The clinic in Fort Defiance does not have a family therapist.

The service is called the “Navajo Treatment Center for Children and Their Families.”

The NTCCTF provides outpatient mental health services “to all Native American children within the Navajo Nation.”

It offers treatment such as sessions in school, at home or in one of the clinics. This includes outpatient counseling and after-care services to individuals, couples, groups, and families.

Even as Stam-McLaren and other professionals welcome the increase in mental health services, she said kids are tough and can bounce back as long as they are supported and helped.

“Kids are pretty resilient in terms of what they go through,” Stam-McLaren said. “We go through different life traumas, death, divorce, illnesses, things like that so this is definitely going to put more kids at risk for having problems later on with mental health issues.

“But for the most part, kids are pretty resilient,” she said. “Most kids generally will do OK.”

Information:

Navajo Treatment Center for Children and Their Families, Antoinette Miller, amiller@navajo-nsn.gov or 928-871-6818.
Chinle, Beau Harvey, bharvey@navajo-nsn.gov or 928-674-2201.
Crownpoint, Mavis Smith, msmith@navajo-nsn.gov or 505-786-2333. Fort Defiance, 928-729-4441.
Kayenta, Kenny Victor, kvictor@navajo-nsn.gov or 928-697-5561.
Shiprock, Adam Begay, ambegay@navajo-nsn.gov or 505-368-1193.
Tuba City, Lynn Fowler, lworker@navajo-nsn.gov or 928-283-3270.

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