Melanie Cole, MS (Host): Welcome to Long Live Childhood, a pediatric health and wellness podcast presented by Children's Health of Orange County. Together, we can keep kids happy and healthy. I'm Melanie Cole. And today, we have Dr. Sheila Modir. She's a pediatric psychologist at Children's Health of Orange County, and she's here to discuss with us the media's portrayal of mental health. What a great topic. Dr. Modir, it's such a pleasure to have you with us today. I'd like you to just start by telling us a little bit about yourself and your expertise on this topic.

Dr Sheila Modir: Thank you so much for having me here today. I am a board-certified psychologist at CHOC, and I also consult on film and television productions. So, this includes Disney and Freeform. And the goal of that is to ensure that mental health is portrayed responsibly. I'm also a judge for the Annual Sentinel Awards through Hollywood Health and Society, which provides the entertainment industry with accurate and up-to-date information for storylines.

Melanie Cole, MS: What a cool job. So, also as a psychologist, have you seen an increase in anxiety, anxiety-related disorders over the course of the last few years with COVID with the way our kids had to deal with that, with things we're seeing in the news, media, school shootings, all these things. Have you seen an increase in these types of disorders?

Dr Sheila Modir: Of course. Right now, currently, our children and teens are in a mental health crisis, and that's across the nation. We're seeing that in the number of referrals therapists are getting and the increase of visits to therapists right now. So right now, we know that anxiety disorders, depression, trauma symptoms have overall increased for children.

Melanie Cole, MS: Well, they have, I've seen that myself. And, you know, it's scary as a parent these days to see our children struggling and trying to go to school every day, focus on their homework, do their social activities, get back to that semblance of normal. But then, we've got the internet. We've got movies and media.

Can you tell us a little bit in your experience how movies, shows, and I'm including social media in this? It was going to be a separate question, but I'm thinking we can tie it all together. How does this impact our children's mental health? It could be so confusing. How do kids process what they're seeing on their phones, on TV, at the movie theater?

Dr Sheila Modir: Yeah. I think it's a little tough, because I do think social media has separate messages than what the film and television industry offer, because there's a whole social media world that includes Instagram and TikTok, and they're like small little messages that children are hearing. But in terms of like longer episodes that are 30 minutes long or an hour-long movie. We can agree that it has been influential to a child's mental health. And it actually really depends on what the child is watching and how parents and caregivers are helping them understand what they watch. If we look at young children at this developmental age, they are having a hard time differentiating between themselves and the character that they're seeing on screen. And they're also not really sure of what's real and what's make believe. And we can attribute that actually to their prefrontal cortex in their brain, which is a part of the brain that helps with regulating and decision-making. We know it's not fully formed. So, they are looking to others and possibly to the television to help teach them regulation strategies or stress management techniques. They're taking in subtle messages the shows are delivering. I have parents that come in and talk about, you know, "Yeah, my child watched a scary movie or a violent show." And then, they started acting out aggressively, or they started hitting their sibling. And it's because the child is modeling and copying what they see, because that's a big part of that developmental stage where the child is trying to figure out themselves and they don't have that cognitive ability to fully discern if what is being modeled is good or bad. And that's the parent's job to really step in and to help them understand what they're seeing.

Melanie Cole, MS: Well, it can be confusing with reality shows. Some things like Planet Earth can help to enlighten children, make them more worldly and global and understanding and tolerant. And other shows can, as you say, make them act out or see themselves or think this is a role model. Tell us how the media handles mental health when they're writing scripts, because I think that's what parents want to know. And we go to things like Common Sense Media to hopefully help us make some of those decisions for our little kiddos, but tell us what the script writers are thinking.

Dr Sheila Modir: Yeah. I can tell you a little bit about how they utilize psychology too, because I think that's important. So, how it all works is that I'm sent the script and the writers have a specific question related to the script, related to the topic of mental health. For example, most recently, I reviewed a script for Disney that asked if the writers did an accurate job of how the character responds to, thinks about, or talks about the death of her mother. I read the script, I wrote down notes, and I really paid attention to that particular scene. And then, I sent them my feedback. For one script in particular, the show Cruel Summer, which was on Hulu and Freeform, I was sent the script and then later they actually sent me the actual episode and asked for feedback on how the script and footage were played out and portrayed. And we know right now mental health has become such a popular topic in film and television.

A really popular show that people know about is called Ted Lasso and it portrays multi-layered mental health issues. And they were just recently honored at the White House for their work on reducing mental health stigma. And writers know that this current generation and audience is looking for TV shows or movies that are relatable. Just like you mentioned, we are in this post or kind of current pandemic era, where mental health is a crisis and people are looking for shows that validate and honor their feelings. And the film industry wants to tap into that and make sure they're doing exactly that. They're honoring those feelings. So, I am seeing a lot of care put into scripts. I can't speak to all scripts, and there's shows that I really love and respect where I question the way psychology is portrayed. Even in this season of Ted Lasso, I'm not going to do any spoilers, but there were some questionable things that they are showing related to mental health. But I think, overall, we are headed toward a more positive trend regarding the way media is handling mental health, because it seems like they want to do it right by the audience.

Melanie Cole, MS: Well, I agree with you. I think they want to, and also the way that peers are observing their peers that have mental health issues when we see shows about high school and kids in school and things like that, trying to help us to be more tolerant and understanding of these issues. And they were doing this a little bit with shows like The Good Doctor, where they were showing autism spectrum and things and the way people would approach that. So, you know, I'm glad that they're hitting the mental health topics because boy, as you say, it's such an epidemic. What are some things that parents can do using media to positively impact our child's mental health? We're all looking for some solutions and help here. And so, tell us some of the things that you would suggest we do.

Dr Sheila Modir: I think there's actually a lot of media in general that is done really well, especially for children. I have a child myself now, so I'm paying much more attention to how TV shows for kids are created. And there's this one show, for example, called Daniel Tiger's Neighborhood, and it has episodes related to emotional regulation, coping skills, talking about feelings, problem-solving. And these are all really important skills for a child to learn. I even had a patient's parent tell me that the parents and Daniel Tiger have taught them so many ways of how to talk about feelings with their own child, because the language that they're using is just so well-done or well-written. And some shows utilize song and rhymes to teach coping skills. For example, with this Daniel Tiger show, they say, "When you feel so mad that you want to roar, take a deep breath and count to four." And I think that these are the things that parents can really pull from, right? So when you are watching a show with your child, which I think is really important in order to help positively impact your child's mental health related to media, when you're watching the show, you're not only engaging the child and bonding with them, you're now learning the language that the show is using, especially if it's a show that's using more mental health language to help your child continue to learn the skills, right? So, you could echo what Daniel Tiger says when you're seeing your child is dysregulated and say something like, "When you feel so mad that you want to roar, take a deep breath and count to four." And your child knows what you're talking about based off of that show. And it could be a really great way to help teach deep breathing and introduce those coping skills.

So, I think that making sure that you are involved in watching the show with your child, pointing things out that happen in the show, which is such a huge way of teaching social skills, right? Because at a young age, they don't know maybe things like irony or they don't know sarcasm. And so, things can get a little confusing for them. So, you can help talk about, "Oh, this person is being sarcastic," or "This is a experience of bullying. What would you do differently?" And so, things like that are really great ways to use a show to really elevate your parenting skills.

Melanie Cole, MS: What great advice that is. And the shows, as you say, are getting so creative in helping our children to see those things and learn that. I love that example that you gave. Well then, Dr. Modir, without mentioning any names of shows, I'd like you to speak to parents about what to look for in a show that would signal that maybe that show is not appropriate for our children.

Dr Sheila Modir: So, what we want to make sure that we're looking for is, does this show focus on any sort of violence, aggression, a lot of conflict between characters, the use of any sort of weapons, fighting; anything that you, within your intuition while you're watching the show, you also are like, "This feels a little uncomfortable" Or maybe the jokes are things that are a little bit more advanced for my child to hear or listen to. So, I think that there are shows out there that might tap into that, and it's because they're very entertaining. And they might have a larger audience that is interested in something like that, but you really want to be cautious. Make sure you have guidelines, limits and expectations around what is watched in your home and how much of it is watched. So, I think that those are just small things to look out for.

I think the shows that really promote those socio-emotional skills are really helpful. And I think that sometimes people are like, "Is too much media, is that going to take the place of anything?" And it could, but I think what we want to be careful of is how do you use the media? Are you involved in the media? And what exactly is the content of what is being watched? Because there are, again, some really great things out there that could add to your parenting skills. But again, we also want to be careful for the things that are not. But overall, I do think some of these larger production companies are being more cognizant of what they are showing.

Melanie Cole, MS: I am so glad to hear that. As we wrap up, offer parents your best advice as the media expert you are. And as a psychologist and a pediatric psychologist, help the parents out here with your best advice about what we can do to foster good mental health in our children with this epidemic going on, what you'd like us to know about helping our children to deal and cope with some of the things that they're seeing in the media today.

Dr Sheila Modir: My advice to parents is to make sure that you are involved in what your child's is watching. I also believe that you should make sure that there are certain expectations around what is watched and when it is watched. Oftentimes we know that when it gets close to the evening and they're watching things that are a little bit animated that could impact bedtime. So, just really being cognizant of the timing, of the content and the limits around media, and knowing that media does influence what your child does and their certain behaviors, right? So, we talked about that prefrontal cortex. And we know that they are learning and taking in information constantly through modeling. So, having that lens as you choose the shows that you want your child to watch.

Melanie Cole, MS: Well, thank you so much. What an interesting episode. This was very unique. And thank you, Dr. Modir, for joining us and sharing your incredible expertise in this area. For more pediatric mental health and wellness tips for your children, please visit choc.org/mentalhealth. Thanks for listening to Long Live Childhood, a pediatric health and wellness podcast presented by Children's Health of Orange County. Together, we can keep kids happy and healthy. And parents, please remember to share these shows on your social channels as we're all learning from the experts at CHOC together. I'm Melanie Cole. Thanks so much for joining us today.