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    How to Help Your Child Resume School After a Mental Health Crisis

    October 17, 2020
    stressed teen in online class

    Imagine your scariest first day of school. Now imagine it’s your first day returning to school after a hospitalization or an extended absence due to a mental health condition.

    Catching up academically is a big concern. Fitting in is another—how do you pick up where you left off with classmates and teachers?

    This harrowing experience may be more common than you think. Among children 3 years and older, 10 percent of hospitalizations are due to a mental health condition, such as depression, bipolar disorder, or psychosis, according to a study in Pediatrics.

    Other reasons for hospitalization include suicidal ideation, self-harm, substance abuse, anxiety, and eating disorders.

    For many reasons, the transition from hospital to home and school is daunting. “Hospital stays are getting shorter while the number of children with mental health issues is growing,” says James R. Batterson, MD, chief of child and adolescent psychiatry at Children’s Mercy Hospital in Kansas City, Missouri. “But sending them home too quickly is like instantly releasing someone from intensive care.”

    Even for children who don’t require hospitalization, mental health conditions can disrupt schooling. For example, kids with attention deficit hyperactivity disorder (ADHD) are more likely than their peers to miss 15 or more days of school each year, according to the Centers for Disease Control and Prevention.

    To help children re-enter school after an extended absence, communication among hospitals, parents, and schools is key, says Paul Hyry-Dermith, EdD, director of Bridge for Resilient Youth in Transition (BRYT). The BRYT program, based in Massachusetts, partners with schools to offer a dedicated classroom, trained staff, and academic and counseling services to students during such transitions.

    If you don’t have such a program near you, there’s still a lot you can do to help your child on the road to recovery. Try these expert strategies.

    Recovery Strategy #1: Maintain Care

    With any type of hospitalization, it’s essential to get timely follow-up care to address underlying issues and minimize the risk of readmission. And with most mental health conditions, you’ll need a long-term treatment plan that may include therapy, medication, or both.

    Reach out to your child’s mental health clinician as soon as possible. If you don’t have one, check with your health insurance, or find resources at samhsa.gov. You can also look for experts through the American Academy of Child and Adolescent Psychiatry.

    Plus, check out our parent’s guide to finding good mental healthcare.

    Recovery Strategy #2: Personalize Your Child’s Medication Plan

    As part of ongoing care, your child may need to start a new mental health medication, change medications, or change the dose of a medication. But not all medications work for all people in the same way.

    A mental health medication may work well for some children—but it may cause side effects for others, and vice versa. One reason for this is that our genes play a big role in determining how our bodies may react to medications.

    If your child’s clinician recommends medication, ask if pharmacogenetic (PGx) testing can help. Genomind® Professional PGx Express™, for example, looks at 24 genes related to mental health treatment. It provides guidance across 10+ mental health conditions and 130+ medications to help clinicians determine:

    • Which medications will likely be the most effective
    • Which medications may have side effects
    • How you metabolize medications for personalized dosing guidance

    The Genomind test requires a prescription. Wondering if it can help your child? Learn more about Genomind here.

    Recovery Strategy #3: Connect, Communicate, and Commit to Paper

    Ideally, a child’s hospital, home, and school will follow the same written plan covering:

    • Expected milestones
    • Academic expectations
    • Follow-up care

    If you can, enlist a school liaison for regular updates through email, phone, text, or meeting. Also, consider a 504 plan to help your child with any necessary academic accommodations, such as reduced homework or adjusted class schedules.

    Recovery Strategy #4: Establish Structure

    Establishing a structured daily routine is an important factor in a child’s adjustment following a hospitalization. BRYT sets a predictable schedule to ensure academic help, quiet times, and regular meetings, Dr. Hyry-Dermith says. Parents can do the same at home.

    “Set a dinner hour, schedule activities and lessons, and have family meetings about reintegration,” Dr. Batterson suggests.

    Recovery Strategy #5: Develop a Script

    After an extended absence, it’s likely that your child may hear classmates and friends ask, “Where were you?” As a parent, you can help your child prepare and practice a response.

    “The child can ask, ‘What did you hear?’ and tailor the answer accordingly,” Dr. Batterson says. After that, a quick, simple statement can be:

    • “I had a tough time and feel better now.”
    • “I took a break to sort out issues.”
    • “I needed to rest and get well.”

    Recovery Strategy #6: Create a Safety Plan

    BRYT’s “retreat” room acts as an in-school space where the child can feel safe, Dr. Hyry-Dermith says. But any school or home can serve as a calming location if a child is feeling distressed. 

    At school, try a counselor’s office, resource room, or nurse’s couch. “Work it out so the child and teachers have a private code that signals the need to go to that spot,” Dr. Batterson says.

    At home, it can be a separate room or even a quiet corner, as long as the space does not allow access to harmful devices, such as knives, sharp tools, or guns.

    Recovery Strategy #7: Watch What You Say

    BRYT staffers know the power of language, Dr. Hyry-Dermith says. They never imply a youngster is “faking” or “seeking attention.”

    Parents and other family members should also avoid charged statements, such as:

    • “I’m disappointed in you.”
    • “You should know better.”
    • “This is an act.”

    Instead, keep conversation positive and self-forgiving. Let your child know that psychological issues are common in both kids and adults—they are not alone.

    Sharing your own stories of resilience can also help. “Remind your child that everyone occasionally falters, but they’re not defined by their worst moments,” Dr. Batterson says.

    Recovery Strategy #8: Stay Tuned for Signs of Trouble

    Even if treatment is going well, it’s possible that your child’s mental health symptoms will fluctuate. BYRT staffers stay vigilant for early warning signs of problems, Dr. Hyry-Dermith says.

    Parents should also watch for:

    • Increased isolation
    • Unusual restlessness
    • Dull or “flattened” emotions
    • Unexplained headaches or stomachaches

    “Don’t be overbearing about it, but do suggest solutions for your child,” Dr. Batterson says. This can include strategies for stress relief, such as controlled breathing and progressive muscle relaxation to coloring books or fidget toys. Ask your child’s clinician which stress solutions might work best for your child.

    Recovery Strategy #9: Care for Yourself

    After a child’s mental health crisis, parents are often wracked with guilt. To provide maximum support for your child, it’s critical to sustain your own physical and mental health.

    “These are usually long-term issues, so parents have to maintain themselves,” Dr. Hyry-Dermith says.

    Many parents benefit from connections with others facing similar situations. Check if your hospital, school, or community offers local support groups. You can also find support groups through the National Alliance on Mental Illness.

    Plus, check out our guide to caregiving for someone with a mental illness.

    Recovery Strategy #10: Keep the Lines of Communication Open

    Even if you do everything right, you or your child may still face some setbacks. But experts say empathy and open conversation can make a big difference.

    “If I could change one thing, it would be for families and kids to really start talking about mental health,” Dr. Batterson says.

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    Topics: ADHD in children, bipolar disorder, Child Mental Health, depression

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