Covid-specific issues & screening

The COVID-19 pandemic is a traumatic event for everyone. All of us are experiencing chronic stress and trauma in response to the pandemic, with biological and psychological impacts. Quarantine, social distancing, and financial strain also have significant effects on humans. Humans feel less safe when we lack social and physical contact with others; on a physiological level, the isolation required by quarantine is experienced as a threat. The impacts of this chronic stress, and chronic activation of our fight-or-flight systems, will last for years. The literature is limited, but what we do know is that mental health diagnoses typically increase following pandemics and quarantines. It is important to assess child and parent well-being during this time.

General screening procedures

1. For All Visits: Discuss with children and parents that COVID-19, and resulting social isolation, is a potentially traumatic event. Ask how patients and families are coping with the stress (see below for specific question recommendations). Provide anticipatory guidance to all families. Open, honest, developmentally appropriate communication about COVID-19 is an important step in preventing symptoms of PTSD. Lancet article: 'Protecting the psychological health of children through effective communication about COVID-19.'

See Zero to Thrive for guidance to explain COVID-19 to young children and the CDC website for guidance in talking to older children about the virus.
See age-related suggested questions for children and adolescents

2. Well-Child Visits: Continue with well-child screening questionnaires utilized in your office and consider age-related questions for children and adolescents.

3. Sick Visits: Use the COVID-specific “Psychiatric Impact of COVID-Child and Adolescent Outpatient Screener” and follow-up with further screening, as appropriate by age (children and adolescents).

4. The MC3 program is available to provide consultations to help your clinic implement mental health screening processes that fit the specific needs of your clinic model.