by Erin Beck, Kids’ Health Correspondent

As I interviewed child therapists about the effect of the pandemic on children in West Virginia, it struck me when several spoke of children experiencing feelings of instability and insecurity.

That’s because I knew many West Virginia kids already lack the structure and consistency they need for healthy emotional development. 

We have the highest rate of kids in foster and kinship care, who shuffle from facility to facility with few belongings to call their own. We have the highest rate of kids in households affected by opioid use disorder, so many are living with dead or incarcerated parents and with the constant chaos that often comes with substance use disorder. We also have one of the highest rates of child poverty, so even pre-pandemic, many kids didn’t know where their next meal would come from or whether they’d have a roof over their head that night.

Mental health professionals told me that some kids returned to school this year with more anxiety after spending long periods of time without socializing with peers. Some repeatedly switched from virtual school to in-person school and back again. Some lost their social connections when parents pulled their kids from school completely.

Lisa Zappia

Lisa Zappia, CEO of Prestera and a licensed therapist, said some kids who returned to school this year had spent the prior year with no schooling.

“I mean, they did nothing,” Zappia said. “They missed a whole year of school pretty much because they just didn’t turn their computers on.”

School enrollment has declined, and that can’t be chalked up to population loss.

As of the April 1, 2020 Census, West Virginia had 1,793,716 residents, and about 1,500 more people than the Census Bureau estimated for 2019. 

But according to the West Virginia Department of Education’s website, school enrollment declined from 261,633 kids in the 2019-2020 school year to 252,357 in the 2020-2021 school year. That’s a drop of more than 9,200 kids, about 3.5 percent.  The number declined again for the 2021-2022 school year, to 250,899 kids. 

Prestera offers treatment services in eight counties and some services in two others. They offer services in every school in Cabell County and several in Kanawha.

Zappia said many of their child patients were stressed and anxious about returning.

“It was almost like they were five years old again, going back into school for the first time,” she said. “They didn’t want to go back.”

Morgan Blatt

Frequent quarantines and confusion about mask requirements also contributed to the lack of consistency for children, according to Morgan Blatt, a licensed counselor and Prestera’s program director for the WV Regional Partnership Grant for Boone, Kanawha, Raleigh, and Wyoming Counties.

(State and school officials didn’t help by starting the school year without any mask requirements in place, resulting in widespread quarantines, then later implementing those requirements.)

Kids with cognitive delays, in particular, were more likely to be frustrated by disruptions, according to Blatt. It’s been harder for them to understand why they can’t visit a friend or why they have to spend the whole day with a grandparent.

Blatt noticed that children have been more hesitant to participate when she held outreach events at county fairs. They are more shy and withdrawn. 

And when in-person school resumed, Blatt took calls from parents who said their kids were experiencing panic attacks.

Blatt noted that social anxiety was already prevalent among kids. She blames some of that on reliance on electronics, like video games. And kids are more likely to make mean comments to and about each other behind screens vs. in person, she said, which can also lead to anxiety.

She works to help them learn to be “assertive, not sassy back to them.”

But she also noticed that as children have spent more time with guardians, those adults got to know their children better. They noticed their kids struggling with focus, or that their kids had specific learning styles. They realized “what teachers go through all day.”

Parents and guardians finally accepted their kids had learning disabilities. Some are now seeking IEPs for their kids at school.

“That was the first positive,” she said.

(Update 6 pm 12/15/21: Briana Warner, spokeswoman for Kanawha schools, helped me look into whether more parents may be seeking individualized education programs for their children in West Virginia. In the 2019-2020 school year, 17 percent of kids were enrolled in special education classes, meaning they had disabilities, according to the West Virginia Department of Education definition. For the next two years, that number was 18 percent. That means the number of kids identified as having a disability did increase slightly. It could also potentially mean parents of kids with disabilities were slightly less likely to pull them from school.)

How to Help

To be clear, I don’t believe efforts to keep kids safe from the coronavirus created the mental health crisis, and a global crisis of this scale will naturally cause massive disruption.

All of us, adults included, are dealing with a global event, forcing us to concede we lack control over much of what happens to us – a lesson we all have to eventually learn.

But there are ways policymakers, communities, and caregivers can help kids know they have some consistency in their lives in the form of support from people who care for them.

According to a recent surgeon general’s report, disruptions to routine due to income loss from the pandemic, including financial and housing instability in the household, were among several contributors to the rise in child mental health problems. 

Policymakers can relieve stress on families and create more stability in children’s lives by increasing access to healthy foods, safe housing, income support and paid parental leave, according to the American Academy of Pediatrics

Schools have historically provided much of the structure and stability in kids’ lives. But when schools are closed, relationships with other safe, nurturing adults can help.

For guardians, the surgeon general’s report recommends caregivers “provide children and youth with a supportive, stable, and predictable home and neighborhood environment.

“A lot may be outside of your control, and there will be trial and error as you figure out what works best for your child,” the report authors wrote. “That said, try to help children stick to a regular and predictable daily schedule, such as regular dinnertime and bedtime.”

Caregivers can also take care of their own emotional health. To prevent chronic stress in kids, “parents and caregivers — as well as grandparents, extended family, teachers, coaches and neighbors — need to be in ‘relational mode’ and available, engaged and attuned to the child’s emotional needs, according to the American Academy of Pediatrics.

“If the adults in a child’s world are in “survival mode” due to their own adversities or social determinants of health, they are less able to provide the pivotal positive childhood experiences that buffer adversity and encourage both resilience and relational health in the next generation,” the report states.

According to the surgeon general’s report, since the pandemic began, “rates of psychological distress among young people, including symptoms of anxiety, depression, and other mental health disorders, have increased. Recent research covering 80,000 youth globally found that depressive and anxiety symptoms doubled during the pandemic, with 25% of youth experiencing depressive symptoms and 20% experiencing anxiety symptoms.”

When kids are isolated, they’re less likely to interact with people who’d notice mental health problems. But the American Academy of Pediatrics also points out that directives to “social distance” don’t mean people have to alienate each other.

There are other ways to connect when kids aren’t in school. Faith-based and civic organizations can also help. 

“If nothing else, pandemic-mandated stay-at-home orders should increase our collective awareness of the distress associated with being socially isolated or vulnerable,” the American Academy of Pediatrics wrote. “The coronavirus pandemic has highlighted the urgent need to provide all children with the (safe, stable, and nurturing relationships) that buffer unexpected adversities and build the skills necessary to be resilient.”


The American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry (AACAP), and the Children’s Hospital Association (CHA) join together to declare a National State of Emergency in Children’s Mental Health. 

Get help: 

If you’re in crisis, get immediate help: Call the National Suicide Prevention Lifeline at 1-800-273- 8255, chat with trained counselors 24/7, or get help in other ways through the Lifeline.

From HELP4WV: “When it comes to children, it’s easy to see that something is wrong, but scary and difficult to know where to look for help. We are available 24 hours a day and seven days a week to assist in finding the most appropriate and available treatment for an array of youth behavioral health needs. From parenting support to immediate crisis response, contact 1-844-HELP4WV to talk to a trained Helpline Specialist who can help you understand options and link you directly to treatment providers.”

Keep checking the Think Kids blog for more posts about kids’ mental health in West Virginia.

Erin Beck is our Kids’ Health Correspondent. You can follow her on Facebook and Twitter


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