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Back to School Mental Health: Blue Shield of California's Dr. Nicole Stelter answers your questions

With kids going back to school soon, parents, educators, and communities are all concerned about some of the mental health challenges our young people face today. This was a crisis before the pandemic that has only been magnified with the stress of not just COVID-19, remote learning, and mask protocols, but the intensity of current events, social media, and the polarized political climate. We sat down with Nicole Stelter, PhD, LMFT, and Director of Behavioral Health for Blue Shield of California, to get some answers to commonly asked questions about youth mental health.

Stelter Profile Pic
Dr. Nicole Stelter

Q: Transitions are always tough, including going back to school after the summer. What advice would you give to parents and caregivers to help reduce feelings of stress and anxiety – both for their children and for themselves?

A: The first day of school should not be “Day 1” for restarting back-to-school routines. Restart a week ahead so there’s more time to adjust and work out any issues. More importantly: Talk! Ask your kids questions about how they are feeling, what they’re looking forward to, and what they might be dreading. Empathize, don’t minimize. What may seem like a small worry to a parent might be a big deal to them. Finally, seek out resources from the school/district/Parent Teacher Association (PTA) so that you and your children are informed about current back-to-school information, policies, and protocols.

Q: According to the National Education Association, COVID-19 did not create the mental health crisis for youth, but it has exacerbated the problem for both students and educators. In addition, school gun violence has re-emerged as an issue that cannot be ignored. As students return to in-person classes for a second straight year, what kind of youth mental health issues to do think we all need to be mindful of?

A: Don’t assume that if your child isn’t talking about mental health challenges, that he or she is not affected, particularly with the negative impacts of the news and social media. Depression, anxiety, social withdrawal, and perfectionism can live under the surface. Some kids don’t want to worry their parents when there is already stress in the home; some may not know the right words to express themselves; and some simply might not feel comfortable raising it but might welcome the opportunity to open up if someone asked.

Q: California achieved a first in the nation this month: implementing a statewide law setting limits on the earliest school start times for adolescents. How important is good sleep for youth mental health?  What are tips for parents and caregivers to encourage good sleep habits?

A: Sleep is important in providing rest and regeneration both physically and mentally. Our kids need more sleep because they’re busy growing; physically, intellectually, and emotionally. Sleep deprivation makes youth – and all people – less able to deal with stress and puts them at greater risk for depression and anxiety. To encourage good sleep habits, it’s important to have a shut-down routine or bedtime ritual. Electronics and screens can throw off your body’s biological clock, making falling and staying asleep more difficult so try to get off screens early enough in your bedtime ritual. Another good reason to disconnect from electronics is that certain content on social media and in the news can be activating in a way that makes it hard to sleep. It’s also important to get regular exercise, limit caffeinated beverages, and avoid smoking/vaping, as nicotine can be a stimulant.

Q: The CDC recently released the results of a survey that found high school students faced greater threats to their mental health during the COVID-19 pandemic, including job loss among parents, increased experiences of racism, and increased rates of abuse at home. What resources can parents, educators and students turn to in order to support youth mental health? 

A: Our youth mental health initiative known as BlueSky has many impactful resources. I would also suggest the following organizations, all supported by BlueSky:

Q: Rising trends in adverse mental health among children have also posed major challenges for parents. How can communities, employers, and the health system better support parents? 

A: For Communities: Support your kids’ schools, teachers, and staff. Many make efforts to provide services and support, but they are often not fully funded or prioritized. Attend school board meetings and make your voice heard that youth mental health and teacher/staff support is a priority for you, your children, and your community!

For Employers: Prioritize creating psychologically healthy workplaces that emphasize work/life balance and self-care. Review mental health, substance abuse, and Employee Assistance Program (EAP) benefits. Communicate regularly with employees so they know how their benefits work, including where to call to access care, what costs they can expect (e.g., co pays), and that using these benefits is confidential.

For Health Systems: Support your mental health/substance abuse professionals, pay them competitively, and support their training to help chip away at the scarcity of clinicians available to provide care to our youth and families. Communicate frequently with members/patients about the mental health/substance abuse services available to them.

At Blue Shield of California, we are working to review and improve our "end to end" provider experience to build out provider network and partnerships that will help us serve more Californians with their mental health/substance abuse needs. We also offer our members an array of services through our Wellvolution platform, including Ginger and Headspace – two digital health apps that provide tools to help users manage anxiety, depression, sleep problems, and other mental health challenges.

Q: Have there been any positive developments that make you optimistic about the future of mental health among young people?

A: Yes! Since the pandemic, there has been significant work to reduce the stigma of mental health and substance abuse challenges – particularly for young people. There have been courageous examples from celebrities like pop singer Shawn Mendes, Olympic gymnast Simone Biles, and many others who have stepped forward. By sharing their experiences, they show our young people that it is not only OK to have these feelings, but they can talk about them and get the help and support they need to feel better.