Guest Blog: COVID Pandemic Families: Major Challenges and Resources

*This piece is edited from an original article published in the Spring 2021 PaPS Transactions publication.

In an effort to support mental health and initiatives led by the psychiatric community, PRMS is pleased to feature the following edited piece by Niharika Padala, MS4 at Cooper Medical School of Rowan University, and Rama Rao Gogineni, MD, Child and Adolescent Psychiatrist and Professor of Psychiatry at Cooper Medical School of Rowan University. Ms. Padala and Dr. Gogineni discuss the effects of the pandemic on families and offer recommendations and resources on how to better care for your patients.

For over a year, a microbe has changed the shape of civilization from the way we greet one another to shaking the financial horns of the bull market. According to Johns Hopkins’ COVID map as of April 2021, the U.S. accounts for over 31 million cases and is in the lead on a global scale. During an age when mental health awareness is on the rise, the pandemic unmasked and further brewed psychiatric illnesses in the U.S. population. COVID-19 not only affected mental health on a molecular level but on a socioecological level as well. Inequities in the healthcare system and the degree of damage it can cause to whole communities became apparent. We write today to shed light on the ways COVID-19 has affected family units and ways mental health providers may help them.

Pandemic Effects on Families:

• Increased time together as families became a double-edged sword. Families now have more access and time to discover new hobbies, talents, likes, and dislikes of each other. Opportunities for personal development and self-care grew. While it was expected that divorce rates may go up, polling described by Stanley and Markman (2020) showed that the majority of couples reported no change in the level of relationship satisfaction (Lebow).
• On the other end, NORC surveys reported that intimate partner violence has risen while reporting it to authorities has decreased. Compared to previous years, there is increased depression, anxiety, irritability, loss of temper, and loss of companionship, all of which stress interpersonal relationships (Lebow). Increased exposure to perpetrators and reduced opportunities for escape have become problematic for victims of domestic violence—partners and children alike (Fegert).
• Restricted social support and leisure outlets to send children to due to social distance protocols placed a high burden of childcare and maintenance on full-time working parents. Factors such as fear of death, grief from the loss of family members due to COVID, financial disturbances, job insecurities, added childcare and education responsibilities, lack of coping skills, lack of time and access for their mental illness or substance use needs, along with lack of privacy have all increased pressure on parents. All these stressors have been significant contributors to the rising incidence of child abuse. In addition, child protective services and similar organizations have been disrupted and limited, placing families—particularly those with vulnerable children—at higher risk for harm (Fegert).
• A rise in xenophobia, intolerance, and systemic racism was seen not just on a local level but on a political level (Lebow), leading to increased hate crimes, murders, and civil unrest, which all naturally lead to a rise in mental health crisis stemming from fear and anxiety.
• Families of color are particularly at a higher risk for severe illness from COVID-19 because of comorbidities, including diabetes, hypertension, obesity, lack of insurance, and treatment/testing access. Lack of access is limited to COVID-19 related measures as well as general healthcare for their underlying medical needs, mental health needs, and substance-use treatment (SAMHSA).

Recommendations and Resources:

• Advocate for increased number of mental healthcare providers and services.
• Understand that spirituality and ethical beliefs can be powerful sources of coping strategies and resilience building. Become comfortable addressing them and utilizing them where appropriate.
• Use key community members and local faith-based leaders as first line communicators to bring awareness about resources, vaccinations, and COVID-19 spread prevention hygiene.
• Increase cultural competency in the context of treating patients during the pandemic through workshops such as: https://pttcnetwork.org/centers/networkcoordinating-office/sdh-and-covid-discussion-series where recorded presentations specific to different communities can be found.
• Watch the Association of Family Psychiatrists “Family Therapy and Family Support in a Transformed World” virtual conference recording: https://www.familypsychiatrists.org/
• See the American Academy of Child and Adolescent Psychiatry’s comprehensive list of resources for families and clinicians: https://www.aacap.org/coronavirus#telepsych

Please visit the PaPS website here to read the piece and to review the full publication.

REFERENCES

“COVID-19 Map.” Johns Hopkins Coronavirus Resource Center, Johns Hopkins University & Medicine, 16 Apr. 2021, coronavirus.jhu.edu/ map.html.

Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child Adolesc Psychiatry Ment Health. 2020 May 12;14:20. doi: 10.1186/ s13034-020-00329-3. PMID: 32419840; PMCID: PMC7216870.

Lebow J. L. (2020). COVID-19, Families, and Family Therapy: Shining Light into the Darkness. Family process, 59(3), 825–831. https://doi.org/10.1111/famp.12590

OBHE. “Double Jeopardy: COVID-19 and Behavioral Health Disparities for Black and Latino Communities in the U.S.” SAMHSA, 5 Jan. 2021.

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