Creating healthier futures for ill children

Guidelines for families - How to take care of your mental health during stressful situations

The main psychological impact to date is elevated rates of stress or anxiety (WHO, 2020). As a result of unforeseen measures, such as quarantine, and its effects on many people’s usual activities levels of loneliness, depression, harmful alcohol and drug use are also expected to rise. At the same time, access to care is disrupted, especially in heavily affected areas, leaving people with existing mental health conditions more vulnerable than before. Families, too, are experiencing heightened pressure and stress, which may affect the mental health of parents and children. Here we give an overview of common guidelines on how to manage stress during stressful situations, such as the COVID-19 pandemic, advocated by the leading health organisations.

The World Health Organisation and other institutions such as Centers for Disease Control and Prevention (CDC) have put together useful resources to support population mental health.

The most important message is to take care of yourself at this time. Everyone reacts differently, and your own feelings will change over time. Notice and accept how you feel. Taking care of your emotional health during a challenging period will help you think clearly and will help your long-term health.

Try and use helpful coping strategies such as ensuring sufficient rest and breaks during work or between shifts, eat sufficient and healthy food, engage in physical activity, and stay in contact with family and friends. Make time to unwind and engage in healthy activities that you enjoy and find relaxing. Avoid using unhelpful coping strategies such as use of tobacco, alcohol or other drugs. It's also helpful to minimize watching, reading or listening to news about COVID-19 as it causes you to feel anxious or distressed.

Stay connected and maintain your social networks. If health authorities have recommended limiting your physical social contact to contain the outbreak, you can stay connected via telephone, e-mail, social media or video conference.

How can families cope?

The coronavirus situation has also placed heigtened pressure on families. Parents may experience feelings of stress, exhaustion and burn-out due to increased responsibilities, such as home-schooling. For children, too, the everyday routine has changed completely and the pandemic may cause fear, anxiety and confusion.

During times of stress and crisis, it is common for children to seek more attachment and be more demanding on parents. Discuss COVID-19 with your children in an honest and age-appropriate way. If your children have concerns, addressing them together may ease their anxiety. Children will observe adults’ behaviours and emotions for cues on how to manage their own emotions during difficult times. Be a role model. Take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members.

Help children find positive ways to express feelings such as fear and sadness. Every child has his or her own way of expressing emotions. Reassure your child or teen that they are safe. Let them know it is ok if they feel upset. Share with them how you deal with your own stress so that they can learn how to cope from you. Sometimes engaging in a creative activity, such as playing or drawing can facilitate this process. Children feel relieved if they can express and communicate their feelings in a safe and supportive environment.

Maintain familiar routines in daily life as much as possible, or create new routines, especially if children must stay at home. Provide engaging age-appropriate activities for children, including activities for their learning. Where possible, encourage children to continue to play and socialize with others, even if only within the family when advised to restrict social contact.

Limit your family’s exposure to news coverage of the event, including social media. Children may misinterpret what they hear and can be frightened about something they do not understand.

Digital health tools

There’re a number of digital health and wellbeing tools that you may find helpful for yourself or your children.

Common apps for stress management, relaxation and better sleep are Calm or Headspace. In Headspace you can explore guided exercises, videos, help you get healthier and happier. It also includes sleep exercises and bedtime sounds and physical activity routines. In their blog, you can find numerous free science-based articles on work, health, sport, meditation and more, Similar to this, awarded as Apple BEST OF 2018 winner, Calm has been designed for mental fitness, relaxation and sleep. Both apps are subscription-based but are free to use for the first couple of weeks so you can test them and see if they suit you.

You can find safe and validated apps for yourself or your children from ORCHA’s app library. ORCHA is a world leader in health app reviews and prescription services. They offer a range of evaluated apps for managing health and well-being - you can find the best solutions (i.e. safest and clinically valid) with the highest scores. Topics range from quitting smoking and managing diabetes, stress, sleep or weight. There’s also a variety of solutions specially designed for children, for example, to help relieve anxiety (see the evaluation for Triumf’s game here). ORCHA has also released a COVID-19 specific app library, which can be accessed here. Numerous providers are offering their products for free to help various population groups cope with COVID-19.

A list of digital health solutions that have been made availavle during COVID-19 can also be found from Catalyst 2.0 website. Categories include testing, behavioural/mental health, diagnostics, data visualisation, educational initiatives, and more. You can also find Triumf’s health app there under Behavioural Health.

Triumf Health game has also made publicly available until the end of May in Estonia and UK to provide age-appropriate support to children and help them cope better with the crisis situation. In response to the coronavirus, the game has been extended with a virus-specific pathway that is available to children who are able to read. The game is now among the most popular applications on Google Play in Estonia. Through interactive tasks we deliver trustworthy information related to COVID-19, including how to protect oneself, consequences (i.e. isolation), how to self-manage during the outbreak and explain concerns that may develop due to the novel situation. The aim is to provide a safe environment through which to deliver up-to-date information related to COVID-19 and relieve anxiety amongst children. Find how to become a user here.