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The Movement for Children's Mental Health
Dr. Francesca Varrallo Sims shares how to start conversations & break stigmas around children's mental health.
Featuring:
Learn more about Francesca Varallo Sims, PsyD
Francesca Varallo Sims, PsyD
Francesca Varallo Sims, Psy.D. graduated from Medaille College in Buffalo, N.Y. with her doctoral degree in Clinical Psychology. Dr. Varallo Sims has trained in acute and outpatient neurorehabilitation settings that specialized in the provision of neuropsychological assessment.Learn more about Francesca Varallo Sims, PsyD
Transcription:
Alyne Ellis (Host): During the COVID-19 pandemic, Wolfson Children's Hospital has seen a 300% increase in pediatric behavioral health cases. Kids don't always wear their thoughts on their sleeves, so it can be difficult to tell when a child is struggling. Now there's a national movement called On Our Sleeves to promote children's mental wellness and prevent crises.
I'm Alyne Ellis and here to tell us more about this important topic is Dr. Varallo Sims. Welcome Doctor. This is just such a disturbing and important topic. I know the pandemic has just ravaged all of us in some ways as we wait for it to get over. So, why don't we begin with how hard it really is on children and sometimes that's so hard to tell.
Francesca Varallo Sims, PsyD (Guest): It is. Yeah. And so what we know is that, children do not express their emotions the way you and I do as adults. And so it's important for us to find different tools and techniques to explore what they are experiencing emotionally.
Host: So let's talk about some of the warning signs that might tip you off that a child is struggling mentally.
Dr. Varallo Sims: Yeah, absolutely. There's various things that we look for, but the most basic things that a parent or educator could really try to observe is drastic changes to the child's day-to-day functioning. So, what does that look like? Well, that could mean they have difficulty sleeping through the night. They seem more tired, their eating habits change, they might even complain of somatic or physical complaints like headaches, nausea, dizziness. You might notice they are not themselves in terms of their personality. There might be a personality change or fluctuations in mood. Their grades could decline. And of course the most obvious would be, you know, tearfulness or having tantrums and things like that.
Host: So if a parent is noticing this in their child, what should they do?
Dr. Varallo Sims: Yeah, so right away, you're going to want to try to start that conversation. Open up the dialogue about emotional health and, you know, by initiating those conversations, you're demonstrating, you know, I value your emotions and I'm here to support you. And so what I would say, to parents and educators, is to check in, listen, non-judgmentally, you know, make good eye contact, let them know you're really there for them. And then you're validating and supporting what they're talking about. It's already hard enough for them to talk about their emotions. So, making sure they feel safe and accepted is really, really important.
A large focus of the On Our Sleeves campaign here at Wolfson Children's Hospital is giving parents and educators, even clinicians, tools to start these conversations and really, some of these resources that we have available on the website, they encourage that open communication and a lot of them are, initiating conversations with open-ended questions. Right. So, instead of asking a yes or no question to the child, like, did you have a good day? You might say, what was the best part of your day? You know, what didn't go so well. Or when you feel down, what is something that you might do to feel better? These types of conversation starters are going to open up that dialogue and allow the adult to see what might be going on under the surface.
Host: So, certainly talking to kids is really important, but that conversation changes depending on the age of the child, I'm sure. So, let's begin with the youngest children, let's say up to say age six or seven, how would you start that conversation with a kid that age?
Dr. Varallo Sims: Yeah. So, there are various tools that On Our Sleeves have for different ages. And of course, like you're noting. it's saying you have to meet them at their developmental level so we would keep it very concrete, and basic for the younger folks. So for six or seven year old, you would say, you know, The best part of your day. You could ask them that, I think that they are, you know, first or second grader, they're able to answer that. You might say, you know, you look like you might be feeling down, you know, what's on your mind. What are you, thinking about? You know, and then as you get older, you can make it a little bit more complex by bringing in some of those observations that you have of their behavior. And kind of noting why you think something might be, you know, distressing them.
Host: I know this is perhaps an obvious question, but explain to me what is an acute crisis? When do you really react? And I'm not just talking about calling 911, but even before that.
Dr. Varallo Sims: Right. Yes. So an acute crisis is where the child is expressing a rapid shift in mood. They might be, physically aggressive or appear to be a threat to themselves or others. And they may even express some type of, you know, paranoid thinking. They really just are not themselves. They're inconsolable. And so when it's reaching that level, some of you know, these resources are probably not going to meet that immediate need. So, you do want to reach out for a mental health provider or emergency services.
Host: Do you see a lot of kids in that much distress or in general, are we talking more about the parent and the teachers need to kind of intervene and just talk about feelings?
Dr. Varallo Sims: So, this campaign is an early prevention campaign. And so like with any other medical campaign that you might've seen about, you know, increasing awareness and getting at disease and illness before it reaches that severe level, that's what the On Our Sleeves campaign is for mental illness. So, this is about prevention. It's about awareness. and it's about stigma reduction. And so we want to provide these tools and resources to parents and educators so that children are not reaching that level.
Host: I'm sure there are other things we can do besides talking to our children about what's happening. And one of them I'm sure would be to perhaps turn off the news when the child is around or reassure them that we're okay. We're all just going to wear this mask and go outside and, and have fun.
Dr. Varallo Sims: Yeah. So, you do want to, you know, depending on their age, shield them from things that are not going to increase their emotional wellness, you know? And so really scary news and things like that, you do want to limit that, but really what we are promoting with this campaign is to normalize that people go through hard things, you know, and it doesn't matter how old you are or where you come from, mental illness affects everyone. And so by doing that, we can normalize that we all go through things and it helps break down the, stigma.
Host: And there really is a stigma around children's mental health, isn't there.
Dr. Varallo Sims: There is. Yeah. And you know, it's hard. Parents have a lot of pressure, educators too, you know. We want children to do well and you know, feel confident and navigate their day-to-day lives just with ease. But we all know that some children do not have that same experience. And so for those that are struggling, we really do need to open up this conversation so that they can get the support that they need from multiple levels in their environment.
Host: And finally, what kind of things can we do as a society to help break down these stigmas around children's mental health?
Dr. Varallo Sims: Yeah. Well, you know, what you and I are doing right now, for sure. We need to talk about it. We need to make this mainstream, and that with making it mainstream, we can also say the, having a mental illness or struggling emotionally does not equate to weakness. We really need to liken mental health concerns to any other biological illness that somebody experiences. You know, for instance, we routinely discuss like I noted, cancer, right disease, flus, and we have these well visits for children at the pediatrician, once a year to ensure they're growing appropriately. Well, now this piece is aspirational, right, but what about having one day, annual mental wellness checkups? You know, we need to work to integrate behavioral health into our primary care settings to make it normal and de-stigmatized, you know. Imagine what type of, that type of initiative could do for stigma reduction and early intervention. How might those regular check-ins about mental health impact the trajectory, of lifetime mental illness, or at minimum, it could impact the level of functioning, you know, that child has. Increase their functioning if they do have a mental health disorder. You know, but for us right now, the most important thing that we can do as community is promote these messages, increase the awareness and really promoting that the community join our On Our Sleeves movement, so that we can share these educational resources and prevent crises from occurring.
Host: Well, thank you very much for talking to us today about this. It's a long haul with the pandemic and in a way it's really brought this to the forefront and I, I really appreciate it.
Dr. Varallo Sims: Yeah, absolutely. Well, we're here to help. And we hope that, you know through this campaign, children can learn and parents too, you know. Parents need support too. And this campaign gives them resources as well, but to let them know if you're struggling, you don't have to navigate it alone.
Host: Thank you very much, Dr. Sims, it's really a complex topic. And I really look forward to all the lessons on the website that we can utilize.
Dr. Varallo Sims: Thank you so much.
Host: Dr. Varallo Sims is the Director of Education and Training for Behavioral Health at Baptist Health and Wolfson Children's Hospital. I'm Alybe Ellis. To learn more about the movement for children's mental health at Wolfson Children's Hospital, visit Wolfsonchildren's.com/onoursleeves. You can also text sleeves to 33777 to sign up for their monthly newsletter. This is Baptist Health Radio. As the most preferred healthcare provider in Northeast Florida, we're here to help you stay informed with the latest news, views and resources for your health and wellbeing. Stay well.
Alyne Ellis (Host): During the COVID-19 pandemic, Wolfson Children's Hospital has seen a 300% increase in pediatric behavioral health cases. Kids don't always wear their thoughts on their sleeves, so it can be difficult to tell when a child is struggling. Now there's a national movement called On Our Sleeves to promote children's mental wellness and prevent crises.
I'm Alyne Ellis and here to tell us more about this important topic is Dr. Varallo Sims. Welcome Doctor. This is just such a disturbing and important topic. I know the pandemic has just ravaged all of us in some ways as we wait for it to get over. So, why don't we begin with how hard it really is on children and sometimes that's so hard to tell.
Francesca Varallo Sims, PsyD (Guest): It is. Yeah. And so what we know is that, children do not express their emotions the way you and I do as adults. And so it's important for us to find different tools and techniques to explore what they are experiencing emotionally.
Host: So let's talk about some of the warning signs that might tip you off that a child is struggling mentally.
Dr. Varallo Sims: Yeah, absolutely. There's various things that we look for, but the most basic things that a parent or educator could really try to observe is drastic changes to the child's day-to-day functioning. So, what does that look like? Well, that could mean they have difficulty sleeping through the night. They seem more tired, their eating habits change, they might even complain of somatic or physical complaints like headaches, nausea, dizziness. You might notice they are not themselves in terms of their personality. There might be a personality change or fluctuations in mood. Their grades could decline. And of course the most obvious would be, you know, tearfulness or having tantrums and things like that.
Host: So if a parent is noticing this in their child, what should they do?
Dr. Varallo Sims: Yeah, so right away, you're going to want to try to start that conversation. Open up the dialogue about emotional health and, you know, by initiating those conversations, you're demonstrating, you know, I value your emotions and I'm here to support you. And so what I would say, to parents and educators, is to check in, listen, non-judgmentally, you know, make good eye contact, let them know you're really there for them. And then you're validating and supporting what they're talking about. It's already hard enough for them to talk about their emotions. So, making sure they feel safe and accepted is really, really important.
A large focus of the On Our Sleeves campaign here at Wolfson Children's Hospital is giving parents and educators, even clinicians, tools to start these conversations and really, some of these resources that we have available on the website, they encourage that open communication and a lot of them are, initiating conversations with open-ended questions. Right. So, instead of asking a yes or no question to the child, like, did you have a good day? You might say, what was the best part of your day? You know, what didn't go so well. Or when you feel down, what is something that you might do to feel better? These types of conversation starters are going to open up that dialogue and allow the adult to see what might be going on under the surface.
Host: So, certainly talking to kids is really important, but that conversation changes depending on the age of the child, I'm sure. So, let's begin with the youngest children, let's say up to say age six or seven, how would you start that conversation with a kid that age?
Dr. Varallo Sims: Yeah. So, there are various tools that On Our Sleeves have for different ages. And of course, like you're noting. it's saying you have to meet them at their developmental level so we would keep it very concrete, and basic for the younger folks. So for six or seven year old, you would say, you know, The best part of your day. You could ask them that, I think that they are, you know, first or second grader, they're able to answer that. You might say, you know, you look like you might be feeling down, you know, what's on your mind. What are you, thinking about? You know, and then as you get older, you can make it a little bit more complex by bringing in some of those observations that you have of their behavior. And kind of noting why you think something might be, you know, distressing them.
Host: I know this is perhaps an obvious question, but explain to me what is an acute crisis? When do you really react? And I'm not just talking about calling 911, but even before that.
Dr. Varallo Sims: Right. Yes. So an acute crisis is where the child is expressing a rapid shift in mood. They might be, physically aggressive or appear to be a threat to themselves or others. And they may even express some type of, you know, paranoid thinking. They really just are not themselves. They're inconsolable. And so when it's reaching that level, some of you know, these resources are probably not going to meet that immediate need. So, you do want to reach out for a mental health provider or emergency services.
Host: Do you see a lot of kids in that much distress or in general, are we talking more about the parent and the teachers need to kind of intervene and just talk about feelings?
Dr. Varallo Sims: So, this campaign is an early prevention campaign. And so like with any other medical campaign that you might've seen about, you know, increasing awareness and getting at disease and illness before it reaches that severe level, that's what the On Our Sleeves campaign is for mental illness. So, this is about prevention. It's about awareness. and it's about stigma reduction. And so we want to provide these tools and resources to parents and educators so that children are not reaching that level.
Host: I'm sure there are other things we can do besides talking to our children about what's happening. And one of them I'm sure would be to perhaps turn off the news when the child is around or reassure them that we're okay. We're all just going to wear this mask and go outside and, and have fun.
Dr. Varallo Sims: Yeah. So, you do want to, you know, depending on their age, shield them from things that are not going to increase their emotional wellness, you know? And so really scary news and things like that, you do want to limit that, but really what we are promoting with this campaign is to normalize that people go through hard things, you know, and it doesn't matter how old you are or where you come from, mental illness affects everyone. And so by doing that, we can normalize that we all go through things and it helps break down the, stigma.
Host: And there really is a stigma around children's mental health, isn't there.
Dr. Varallo Sims: There is. Yeah. And you know, it's hard. Parents have a lot of pressure, educators too, you know. We want children to do well and you know, feel confident and navigate their day-to-day lives just with ease. But we all know that some children do not have that same experience. And so for those that are struggling, we really do need to open up this conversation so that they can get the support that they need from multiple levels in their environment.
Host: And finally, what kind of things can we do as a society to help break down these stigmas around children's mental health?
Dr. Varallo Sims: Yeah. Well, you know, what you and I are doing right now, for sure. We need to talk about it. We need to make this mainstream, and that with making it mainstream, we can also say the, having a mental illness or struggling emotionally does not equate to weakness. We really need to liken mental health concerns to any other biological illness that somebody experiences. You know, for instance, we routinely discuss like I noted, cancer, right disease, flus, and we have these well visits for children at the pediatrician, once a year to ensure they're growing appropriately. Well, now this piece is aspirational, right, but what about having one day, annual mental wellness checkups? You know, we need to work to integrate behavioral health into our primary care settings to make it normal and de-stigmatized, you know. Imagine what type of, that type of initiative could do for stigma reduction and early intervention. How might those regular check-ins about mental health impact the trajectory, of lifetime mental illness, or at minimum, it could impact the level of functioning, you know, that child has. Increase their functioning if they do have a mental health disorder. You know, but for us right now, the most important thing that we can do as community is promote these messages, increase the awareness and really promoting that the community join our On Our Sleeves movement, so that we can share these educational resources and prevent crises from occurring.
Host: Well, thank you very much for talking to us today about this. It's a long haul with the pandemic and in a way it's really brought this to the forefront and I, I really appreciate it.
Dr. Varallo Sims: Yeah, absolutely. Well, we're here to help. And we hope that, you know through this campaign, children can learn and parents too, you know. Parents need support too. And this campaign gives them resources as well, but to let them know if you're struggling, you don't have to navigate it alone.
Host: Thank you very much, Dr. Sims, it's really a complex topic. And I really look forward to all the lessons on the website that we can utilize.
Dr. Varallo Sims: Thank you so much.
Host: Dr. Varallo Sims is the Director of Education and Training for Behavioral Health at Baptist Health and Wolfson Children's Hospital. I'm Alybe Ellis. To learn more about the movement for children's mental health at Wolfson Children's Hospital, visit Wolfsonchildren's.com/onoursleeves. You can also text sleeves to 33777 to sign up for their monthly newsletter. This is Baptist Health Radio. As the most preferred healthcare provider in Northeast Florida, we're here to help you stay informed with the latest news, views and resources for your health and wellbeing. Stay well.