done in gymnasiums, huge gatherings, a lot of noise and you know, parents got to send hi.

I'm Jennifer Blomquist.

Thanks so much for tuning in tonight to our HealthLine program.

I get the honor of hosting this evening so I want to make sure you realize that we are live in the studio and we will take any questions you may have tonight.

We're going to be talking about mental health awareness and concerns for children and teenagers.

A great topic.

We haven't done something like this in quite a while, not since we were doing all those covid specials a couple of years ago.

We really haven't touched on this topic and it's definitely a very prevalent issue not only here but all over the country.

So take advantage of getting some free advice tonight we have a child psychiatrist psychologist excuse me who's been kind enough to give her time to us tonight there is the phone number.

It's (969) 27 two zero.

It is a free call if you're outside of Fort Wayne just put an 866- in front of there and dial that number and then when you call in they're not just going to throw you on the air.

You will talk to a call screener and you have two options.

You can ask your question live during the show which is great and very easy to do or if you feel more comfortable you can just tell the screener your question and I will ask the doctor the question for you so let's go ahead and meet our guest tonight.

She's a brand new person.

She's never been on our show before.

So thank you so much for coming.

This is Dr. Rachel Lily.

Hello.

Thank you so much.

You are a child psychologist and I'm thinking that people probably always knew they are there some kids who probably deal with mental health issues?

I think we always knew it was out there but the pandemic just put a huge spotlight on it and then it seems like all these kids because of what a huge change in our lives it was for gosh at least well over a year most parts of the country it just seems like you're hearing about all these kids that are dealing with this.

>> It's really sad.

It really is there I mean the prevalence is has always been a concern and access to care has been a chronic concern for kids.

But the pandemic has just really exacerbated that these kids have experienced a once in a lifetime event often early in their childhoods.

>> Yeah, and it sounds like from some of the information you sent me that it affects young and older children and kids were well into their teens.

>> Yes, I as a psychologist I'm seeing kids as young as two and three who have been affected all the way up until my my other teenagers as well.

>> And sometimes as a parent I don't know if we recognize it.

I mean that's what I've heard from other parents.

You know, we've we've sadly heard some stories of families we know and it becomes a very dire situation.

And the one common thing I hear from the parents is we had no idea we had no idea she was so depressed.

It's just heart wrenching.

So what are the signs different according to age or how do you identify that there's an issue?

>> It's a great question.

First and foremost we're looking for changes in behavior changes mood so kids who maybe were once outgoing active playing sports, things like that, if they're starting to become more withdrawn, they're staying in their room a little bit more.

>> They're they're sleeping in later again beyond the typical teenage of high schoolers like to sleep in.

>> But any big change that you're noticing and in younger kids we often can see it come in more of a behavioral acting out.

So being disruptive, perhaps more defiant we can often see it in externalizing as well as those internalizing classic behaviors.

>> So if and I would imagine now that kids are hopefully pretty much everywhere back in their classrooms and I think here we've been very blessed.

You know, the last school year has been pretty normal for most school districts.

>> I think in the area I would think teachers are probably have their little antennas up, you know, don't get it.

Do you hear a lot from teachers, not just parents about children?

Most definitely.

We're seeing actually quite a bit of school avoidance and school refusal just changes in routine kids have been for the last few years at home it's all different.

>> So when you say refusal or avoidance like kids maybe saying they don't feel good, they don't want the school stuff like that, my stomach hurts and then when we're able to stay home the stomach ache feels better and it's not necessarily a malicious or an intentional thing.

>> Their stomach truly hurt is that I was doing all right and not even recognizing or identifying that that that may be some anxiety.

>> All right.

Yeah, that's what I want to get to.

I know we have some graphics that we were going to talk about anxiety and depression.

I wanted to talk about those coming up but I wonder if we can bring up the graphic with the statistics because I thought that was pretty alarming because I know you said in your notes, you know, the E.R.

visits had gone up dramatically and and I had heard that.

But I don't know if we want to make a reference to some of these statistics.

Certainly so the American Academy of Pediatrics in October of last year, October of twenty twenty one declared a national emergency of childhood and adolescent mental health .

I have never heard of that before.

I remember hearing that come out but I thought I've never heard them declare an emergency about right.

>> So so yeah we have seen an increase in suicidal ideation behaviors as well as just in general mental health services.

The need for mental health services across the the childhood age spectrum.

>> Well how how do you even start to tackle the problem?

I mean if it's a younger child I'm thinking somebody I don't know if I don't even if I would know how to talk I mean I have six children but I don't know if I if I would know how to approach that versus maybe with my older kids.

Yeah.

Talking maybe I can relate more to what and maybe they can communicate with me better.

So let's start with little children.

You're saying you're seeing children as young as two so a lot of behavioral concerns again some of those acting out when we talk about the like the term but the terrible twos.

>> Right.

So again but we're talking above and beyond this so kids who are or are refusing to go out to the store.

Right.

If there's a big temper tantrum for the store, maybe there's some anxiety there and oftentimes we treat kids as little adults and so we try to talk with them and reason with them and for especially those itty bitty kids that's how kids necessarily think and process information.

So it's more of a behavioral we're going to try these things anyway.

We're going to try to go places and it also can really help to talk to your pediatrician, talk to your family doctor.

>> Yeah, that's always a good starting point.

Is this within the realm of typical development or is this something we need to be concerned about?

>> I mean do kids that age can they do counseling?

Would that be effective for them?

>> Certainly so a lot of times we'll see more for kind of helping parents help their kids.

There are options for play therapy for young children and things along those lines.

So yeah, they're definitely talking to the pediatrician would be a great starting point to decide where do we go from here.

>> Well, and I mean in this area I don't really I almost never see anybody that age wearing a mask anymore and I know that was one thing that it wasn't even so much mental health but just developmental issues and speech delays because they were you know, I've heard a lot of doctors say kids learn so much by watching people's facial expressions and they lost that.

So I don't know.

Do you think that does that have anything to do with their mental health though the masking that the younger kids had aware possibly and as well it's just the change in social exposure.

So kids used to go to the library for reading time or the playground or they saw kids at the store moms and we didn't see that for a couple of years or at least not to the same extent.

And so we're seeing a lot of we're actually seeing a lot more concern for some possible autism or some possible just in general developmental concerns.

And it's sometimes difficult right now to tease part is this because they just haven't been exposed to the social interactions that we typically or have in years past have to?

>> Yeah.

Now that is that is challenging with that age too with all the things that they've gone on I always think up to age five there's just such an explosion of learning and exploring and changes that go on so well.

How about for the maybe more like the elementary school age kids basically five to eleven and they may be able to express I'm thinking maybe at that age they can maybe express a little more or maybe they could give you an answer as to why they're upset or not feeling well certainly and especially I think there's a lot of great social emotional curriculum in schools where there's a lot of the feelings.

>> So feelings ID starting to understand oh my tummy hurts that might mean I'm feeling sick to my stomach because I eat something bad or that might mean I'm feeling nervous about something so really helping give that information to kids both in the educational setting but also at home.

Yeah and modeling is really helpful for parents so as a parent to say oh mommy dropped the ball, I spilled the milk mommy's really angry right now.

How do you see Mommy showing emotion exactly.

All right.

And you think about that we have so much more we can talk about but I do want to remind people that our phone lines are open and we love to hear from you if you want to get some free advice tonight from Dr. Lily, the number is (969) 27 two zero and we keep that phone number up at the bottom of the screen for you throughout the show.

And again, I want to reiterate if you're shy or uneasy about asking the question live, although everyone here is really nice, I can assure you.

But if you prefer to do it that way, you have that as an option and then we can ask Dr. Lily the question for you once you're getting into you know, I have always thought that mental health was probably most prevalent for the middle school years and the high school years.

>> Is that still true or do you feel like it's it's kind of across the board so it kind of is across the board but it's more in kind of the traditional mental health sense that we think of when we think of adults as kids become more do pardon me as they become more articulate and aware of their feelings and emotions and certainly we see kind of more of your traditional mental health concerns start to come out in ways that we may expect in an adult population.

I have to say my husband and I are really strict with our kids.

I mean they don't get a cell phone until they absolutely need like senior like sophomore year when the baseball coach says we don't we communicate with the kids and at the parents.

>> But I have to think that the social media which I personally am not a big fan of that and I've heard their counselors say they attribute a lot of these issues to the social media.

If you have a child who's experiences mental health issues, I mean is it better to just cut that off altogether or is that just going to be too devastating for some of the kids who really like it?

>> Well, I think you know your child the best and I'm a big fan of everything in moderation and everything with appropriate levels of monitoring and supervision.

So there are a lot of apps are a lot of programs available for parents to be able to monitor their child.

>> You can see the text and things like that.

>> OK, but certainly an unlimited reign of technology.

Twenty four seven that yeah.

It doesn't give kids brains time to turn off and be a little bored or be a little bit creative and explore on their own.

>> So again I'm a fan of everything in moderation.

>> I always tell my kids hey we didn't have I didn't have a cell phone.

I was in my mid forties and I lived a pretty OK life so you can survive with this.

We did have someone who called and wanted me to ask the question for them.

So it was a woman named Jane.

She got to know let's see what point at what point should medication be considered for younger children under the age of ten those where they want to ask you because some doctors may be quick to want to write prescription others maybe not so much where should the parent or grandparent with their advocacy be do you think?

>> There's a great question.

So I do want to clarify I'm a psychologist, not a psychiatrist so I don't make medical recommendations correct.

I would not be the one prescribing but usually consultation with a pediatrician would be a great place to start and it depends also on the presenting concern.

So there are a lot of ADHD type medications that they do usually start with some younger children and those those are effective if given at the right dose and when we're looking at more of those anxiety and the depression medications.

Exactly those usually not always but usually we're at least looking to start with medication and therapy but usually we're just starting therapy first depending on the level should be more of a last resort, more of a down the road, maybe not even last resort but down the road especially for I think the question was for younger children.

So certainly we would want to try some therapy first usually .

>> But again that would be a question usually for your your pediatrician.

Sure.

Yeah.

Yeah.

Starting with your family doctors pretty much everything is a good Yes.

>> Good base and they always have connections or good point in the right direction.

Thank you so much Jane for that question.

It was a great question and I want to remind everyone else you can ask your question just like Jane did when she called in and we reiterated the question for her or you can ask it live during the show we still have plenty of time to take your questions.

So there again is a phone number at the bottom of the screen.

It's (969) 27 two zero.

>> You know, you don't you can be very discreet about your question.

Keep it generic.

You know, if you don't want divulge too much information but at least get pointed in the right direction because sometimes it's hard just to start navigating the issue.

>> So I wanted to get back to the medication part because as a parent I think well, you know, if you do get to the point where you're starting to discuss the possibility of using medication, my concern would be is is my going to be in that his whole life or are there long term do these some of these medications have long term side effects?

>> So that would be my I guess question and those are valid concerns I hear a lot.

>> So again in terms of side effects, I'm not really that's not really my level of expertize to speak on those but in no they do not necessarily have to be on them for a lifetime.

It could be a short term fix.

Exactly.

Sometimes it can kind of give them the boost for therapy to be even more effective.

And again working with your doctor and expressing those concerns of I don't want Johnny to be on medication for the rest of his life if he doesn't need it.

Yeah.

So no it does not necessarily mean that it's a one and done for the rest of life.

>> Well, you know I think the other thing is we have this whole opioid crisis and drug dependency and that's just getting horribly out of control and I I can see that too.

I think people are afraid I don't want my child to be dependent on a medication because that will that lead them to trying other things that make them feel good in the short term.

>> So I don't know if that's something that's being addressed in the field right now or so it is and actually a lot of research and data showing that it's actually kind of the opposite to be true that we sometimes have children's mental and emotional needs are not being met when they're young.

They may turn to self medication when they're older and so if we're able to address it with the guidance of a doctor in the support of a psychologist or a therapist or a provider, then we're more we're less likely to see some of that self medicating helping later happening later.

>> Well, and one thing I liked from your notes because I can totally relate to this you know, the importance of talking and listening and you mentioned you know, you don't have to like sit down and have this formal discussion like you mentioned car rides that if you carpool that's a great time to talk to your kids before they get distracted.

So I don't want to discuss some of the unique ways to just grab information from them.

And car rides are great because it's not quite the same form of like I'm staring you in the right side by side you looking out the window.

>> And just in general, how was your day?

Oh, how was soccer practice so really keeping that line of communication open and then the really big piece of it is to listen.

>> Yeah, that's hard.

That can be very hard for parents to do.

It is because we're advice givers.

We want our children to be happy and successful and sometimes all they need is that listening and validation and that sometimes I encourage parents to say what what can I do?

What you need for me rather than jumping in and giving advice, giving strategies, just being there and listening what this is when I get a lot because I have five boys and one girl my daughter will talk your ear off and the boys are one word answers you know it's like pulling stuff out from them and sometimes am I annoying them because I'll keep asking them questions and then I see you know then it's like sometimes I don't even get a one word answer.

>> So I mean I don't I don't know where how do you find the right you cut off line like OK I've asked this and I'm going to kind of leave them alone and I think it's kind of art.

Yeah, I think there's a direct science to it but I think part of our job as parents is to be a little bit annoying.

>> OK, sometimes I agree but I usually also really like the open ended question so rather than just anything that they can respond with like good or how is your day good.

>> Yeah.

How was what was one thing that went well today for you is look there's more for them to expand on even if it's still going to be a short answer.

>> I like that.

That's great advice because I love it when they get in the car and then I'll say Oh so what did you learn today and the thing yeah I love them.

I'm sure they learned something.

So we had somebody else who wanted to ask you a question as well.

This is from a gentleman named Doug.

So Doug said he has a child who is aid and other behavioral behavioral issues asks constantly for him and his family but went around other family members perfect.

So maybe with mom and dad different behavior than when they're with grandma grandpa definitely.

And that's very common.

We see that a lot and sometimes it's even with one parent over the other.

OK, so and it's not necessarily anything you're doing wrong as a parent or anything like that.

It's where kids are comfortable and where they can express how they're feeling and it's so frustrating.

Right, right.

So there are behavioral strategies and techniques you could work with a behavioral therapist for but it's a very common concern to have different behaviors across different environments.

>> Yeah, no I've seen that I think even at home sometimes and sometimes it's nothing against a mom or a dad but sometimes one or the other just interacts or I don't know they just have a different vibe with different kids in the family and sometimes it just is a better match than with the other parent I would think so we have still we've what do we have six six minutes left so that's plenty of time to get some questions in here again you can ask it like like Doug did which Doug that was a great question.

Thank for sending that in.

You can do that where you just call text the call screener and we can ask the question for you or you are welcome to ask it on line again.

We have five minutes left now so plenty of time to call and there's the number (969) 27 two zero one they wanted to make sure we talked about was just access to care which I always feel I I've been doing this show for like thirteen years and I just feel like there is no excuse for saying there's nobody to help me because there is so much available if you just make some calls or willing to make some calls so you know, suppose you start with your family doctor or a pediatrician can pretty much any kind of mental health issue with children be addressed locally?

I mean is that something that you would maybe go to start with?

>> Therapist Yes.

Usually I would say again you go to your family doctor, you can also call oftentimes there's a number on the back of your insurance card and that yeah, the person there can answer who your credentialled with who would be able to take your insurance.

So that's often a great yeah that's true resource teachers guidance counselors, school personnel may have a good grasp on a how your child is behaving at school and B who are some really great local therapists and providers as well.

>> So yeah that's typically where I would start and certainly here in Fort Wayne we have a good robust therapy plethora of options.

Yeah.

Every once in a while there may be a specialty concern something that's maybe not seen quite as commonly where they have some specialties in bigger cities.

But that's also the beauty of virtual care.

>> Right, right.

That's true too.

And so that's also an option.

And I just wonder is it hard because I'm hearing that there's a shortage of mental health counselors and things because we've had this explosion not only in kids but of adults.

So is it hard to find somebody I mean if you call and feel like your situation is kind of urgent, can you get in to see somebody usually fairly quickly?

So again, it depends on several factors age insurance, your ability and availability to drive certain places.

It may not be within five minutes of time but yes, we I mean we are seeing a shortage but that doesn't mean that there are not therapists available and if you express to the person taking the call I really need this quickly that can start the ball rolling and again I've said it a million times but pediatricians are a great way and they can sometimes have some ins and some pull with some some local therapists if it isn't urgent or more urgent, I can say they could speak on your behalf and be nice.

So I just want to spend the last couple minutes if you could just talking about the difference between anxiety and depression because I always heard that it can be hard to to separate the two or do they working hand in hand do some kids have both simultaneously.

>> Yes to all of the above OK so they can be different difficult to differentiate and they do often go hand in hand sometimes a child may be particularly anxious and so because of that maybe avoiding going places, staying in or withdrawing more which then may lead to some lower mood.

OK, so there's a lot of different there are some distinctions certainly but there is a lot of overlap that we see as well.

>> And is that something that we can therapy a lot of times treat that those situations can or do you always have to resort to medication?

Certainly I would say especially in kids usually the best recommendation and best practices to start with therapy first and again every case is unique but starting with therapy first and also consulting with your therapist do we do we need to add a medication they can kind of walk with you?

>> Sure.

That process and you know, another thing is we have a lot of great school systems in this area and I'm always impressed by how much they will how much time I mean I know they're all busy the school counselors and everything, but I'm always impressed by like normally they send at least my daughter from her elementary school.

They send regular emails about this is what we're talking about or they'll send a paper home and there are always more than willing to talk to parents.

>> I mean like you mentioned, that's a resource but there's somebody that you don't have to have insurance, you know, to talk to them to that may be a good option as well.

>> What about for the the children though?

How involved should they be?

>> I mean I realize it could be like family therapy but like how much would you tell them about what they're what they have or is that something that you leave up to?

You know, the parents leave that up to the counselor or I would ask for guidance from the counselor and therapist and I'm all for one for openness to the developmentally appropriate level.

Yes.

So we're not going to necessarily give all the nitty gritty details and there may be things we discuss individually with the therapist but certainly I think a self awareness and an understanding of why am I feeling this way can be really cathartic and can be helpful for kids again if it's approached at the right developmental level.

Yeah.

So seeking guidance from your therapist can be really helpful in that piece.

>> OK, you have good communication skills so whether if you if you started off parenthood without good communication skills you will have them by the time your kids are ten because you kind of have to that's for sure.

>> Well, Dr. Lily, this has been such a pleasure.

I appreciate you coming on and I know you helped everybody who watched tonight.

So and you know, like we said, a great starting point is with your family doctor who probably you have a relationship with them more times than not has a great resource and maybe, you know, thoughts about where to go depending on what your issue is.

So we will see you again here next week.

There'll be another next Tuesday evening.

Mark Evans will be hosting that one.

They're going to be talking about blood disorders and again the same format where you can call and ask questions live during that program which again will start at seven thirty.

I'm Jennifer Blomquist.

Thanks so much again for watching tonight.

>> Take care.

Have a good week and we'll see you back here next Tuesday