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As U.S. deaths from COVID-19 surpassed 1 million this month, more than 200,000 minors across the United States have lost their parents and other primary caregivers to the virus. Even before the pandemic hit, the numbers of children and teens diagnosed with depression, anxiety, substance abuse disorder, and other mental health conditions were rising, say health experts, who warn that COVID has exacerbated the mental health needs of youth and their families nationwide. Citing an international research study that found that for every four COVID deaths, one U.S. child loses a parent or caregiver, the Centers for Disease Control and Prevention says online, “Identifying and caring for these children throughout their development is a necessary and urgent part of the pandemic response—both for as long as the pandemic continues, as well as in the post-pandemic era.”
It's uncertain the exact number of Missouri children who lost parents and caregivers to COVID. However, with health data showing that more than 20,000 Missourians died from COVID since 2020, the number of Missouri children could exceed 5,000 when applying the ratio of for every four deaths, one American child loses a parent or caregiver. A national COVID database operated by the New York Times showed Missouri COVID deaths on May 8 reached 20,555 statewide, and 3,342 COVID deaths in St. Louis County. A total of 937 COVID deaths were reported in St. Charles County, and 779 in St. Louis City.
Crystal, a St. Louis mother who lost her husband and a grandmother who raised her to COVID, says she has seen the depths grief can reach in her children, including a third-grade son. “One day, his teacher called and said my son told her he had a plan to be with his dad,” Crystal recalls. The teacher and school counselors, says Crystal, have helped her son, as has the St. Louis–based Annie’s Hope—Center for Grieving Kids, which works with children and their families, as well as schools and mental health providers across the greater St. Louis region.
Connie, also of St. Louis, says “never in a thousand years did I think my mom, who battled lupus for 40 years, would die from COVID.” Her mother’s death, Connie says, prompted her to seek counseling through her workplace’s Employee Assistance Program and enroll her elementary-age son in an Annie’s Hope summer camp. Annie’s Hope, she says, helped her son realize he wasn’t alone in experiencing grief and to process the emotions he was feeling after the death of his beloved “Granny.”
Mental health needs of youth nationwide were rising before the pandemic, and continue to increase, according to the heads of children’s hospitals in St. Louis and Kansas City: Trish Lollo, president of Children’s Hospital in St. Louis; Paul Kempinski, president and CEO of Children’s Mercy Hospital in Kansas City; Steven Burghart, president of SSM Health Cardinal Glennon; and Joseph Kahn, M.D., president of Mercy Children’s Hospital in St. Louis. They sounded a public alarm in July 2021, with a commentary published by the Missouri Independent, a nonpartisan, nonprofit news organization covering state government, politics, and policy.
The four wrote, in part: “For the last 15 months, kids’ well-documented social isolation and increased family stress has only intensified the troubling pre-pandemic trends in severe mental health conditions such as suicide ideation, self-injury and substance abuse disorders. … Children’s hospital emergency rooms nationwide have become overwhelmed with families in need of immediate help. On average, some of Missouri’s most reputable pediatric health care providers — a group including St. Louis Children’s Hospital, Children’s Mercy Kansas City, SSM Health Cardinal Glennon Children’s Hospital and Mercy Children’s Hospital St. Louis — saw significant increases of patients presenting to our emergency departments with behavioral health needs vs. the same period in 2019.”
There is no one “right” way to grieve, and emotions will vary in children and adults, according to T. Eric Spiegel, M.D., medical director of inpatient psychiatry services at Children’s Hospital in St. Louis, and associate professor of psychiatry in the Washington University School of Medicine. Children may not always appear sad, Spiegel says, adding, “Even if you don’t think your kids are struggling, check in with them. Ask them if they’re doing OK.” Pediatricians can assist in screening mental health concerns, Spiegel says, noting that the American Academy of Pediatrics recommends screening for adolescent depression when a child turns 12.
Becky Byrne, founder and executive director of Annie’s Hope, says the center is seeing children and families whose loved ones have died from COVID. Grief, Byrne says, is “an ever-evolving, life-long process of change and adjustment” that includes expressing the pain one is feeling, adjusting to a new environment without the deceased, commemorating the deceased, and “moving forward with life.”
Connie and Crystal say Annie’s Hope helped them meet other adults experiencing grief and gain insights into their and their children’s feelings, just as the center helped their children meet other kids while learning ways to work through grief. Connie’s 18-year-old son said of Annie’s Hope: “I like how I’m learning that everyone can be affected differently, and that I’m not weird for feeling the way I do. I like, too, that we can talk about how we feel without being judged.”
Moving forward takes time and patience, and is important for parents and their children, Connie says. While feeling pleased about the inroads the United States has made in preventing, diagnosing, and treating COVID, Connie says: “The COVID pandemic will never be over for me. When my mom died, I lost my best friend.”
