Nadia Maglara, Child Psychiatrist & Eleni Lazaratou, Professor of Child Psychiatry
In the last few days, societies have been faced with an unprecedented crisis, one which does not only affect health but also spreads rapidly to all levels of the social fabric, namely to education, employment, leisure time, individual freedoms and personal choices. The 1st Psychiatric Clinic of the National and Kapodistrian University of Athens and more specifically the Children and Adolescents Service of the Vyronas-Kesariani Mental Health Community Center, acknowledging both the seriousness of the situation and their duty to protect the mental health of children and adolescents, undertook immediate action. In particular, they have put into operation a psychosocial support helpline for families, which is available to the public daily, from 9 a.m. to 2 p.m. At the same time, they drew up a brief guide for children and families on dealing with the restrictive measures taken due to the epidemic. Guidelines on mental health protection for the general population have already been issued by health protection and promotion organizations, the first of which was the World Health Organization. Especially as regards the population of children and adolescents, complying fully with the guidelines relating to the general population and with a view to focusing them on the special needs and developmental challenges of the pediatric population, we suggest that:
- We protect children and adolescents from overexposure to news, images and information regarding the COVID-19 pandemic. We give to older adolescents appropriate advice on controlled exposure to one or two media sources, whose reliability and safety we will have discussed together beforehand. We avoid direct exposure of younger children to the news flow.
- However, we should inform children and adolescents of the real facts in an age-appropriate manner. Concealing the crisis and trying to keep it a “secret” between adults can have multiple complications. Children are able to perceive major changes in their daily lives from the outset and adults need to interpret the facts so that the task of interpretation is not left solely to children’s imagination. Therefore, complex notions, and mainly the chain of events which made it necessary to impose restrictive measures on their freedom need to be explained in simple and comprehensible language.
- We ensure that appropriate and adequate stimuli are provided and we particularly encourage play continuously and actively. We facilitate children to develop their creativity and to manage their leisure time. It is important to search for a certain number of educational activities for children without, however, attempting to replace the school curriculum.
- We help children find effective ways to express their feelings, such as anxiety or fear. Playing or drawing may sometimes facilitate this process. Children feel relieved when they express and share their feelings in a safe and protected environment. We offer children a perspective for the future by explaining to them that epidemics have a beginning, a middle and an end.
- We seek to create a new daily routine for children, in particular for as long as they abstain from school’s organized educational procedure. For example, adhering to a fixed time of morning awakening, lunch, afternoon rest, educational activity and bedtime helps the children adapt to the new circumstances that are unfolding.
- We ensure that children follow a balanced diet, maintain a good sleep hygiene and perform the minimum physical activity that is necessary, depending on their age. It is recommended that children avoid eating large quantities of sugar and ready-made meals, that they are directly exposed to the sun for a while and that they take moderate to vigorous physical exercise three times a week for 60 minutes, in accordance with the guidelines of the World Health Organization.
- We try to maintain the child’s social network via alternative ways of communication which will, at this stage, replace face-to-face contact, for example via the telephone, the social media, videoconferences, etc.
- We look for opportunities to tell children positive and optimistic stories from the community, such as those of people who have recovered or who have assisted a person that was infected. We instill in children feelings of respect, gratitude and trust in health care professionals caring for patients with COVID-19.
- We ensure that children stay close to their family and parents if it is considered safe. We avoid by all means to separate children from their primary carers. If, however, it is deemed necessary, we secure for children proper care, as well as regular communication with their parents, e.g. telephone communication twice a day, etc.
- During stressful periods, children often become more strongly attached to their parents and may turn out to be more demanding. If your children feel uneasy, talking to them will alleviate their anxiety. Children observe adults’ behaviour and emotions in order to draw conclusions on how to handle their own emotions at critical times.
- In case we notice intense emotional reactions or behavioural difficulties; we first contact on the telephone a mental health specialist for children and adolescents and express our concerns.
- Moreover, it is recommended that, in the case of children with developmental difficulties who follow an intervention programme, their therapists are contacted in order for the latter to seek solutions to continue to support them with their difficulties either through carrying out videoconferences or through sending suitable material to parents.
- We protect our health. Children need to have beside them an adult who remains as healthy as possible. At the same time, parents who care for their personal health will also serve as a role model for the protection of children’s own health.
Psychosocial support helpline (09.00-14.00): 2107600100
