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>> welcome back to washington journal. i'm joined now by arthur evans, he's the ceo of the american psychological association and we're going to be talking this hour on the impact to children's mental health from mass shootings. and we will be taking your calls for our guests. our phone lines are going to be split up this way, parents and students can call us on (202)-748-80020, agitators (202)-748-8001 and all others (202)-748-8002. doctor, evans welcome to the program. >> thank, you glad to be here. >> tell us a little bit about, overall, the impact. obviously, it's going to be very difficult, it's a difficult subject especially for kids, the subject of mass shootings. give us an idea of the impact

that has on their mental well-being. >> i think that we need to put it in context. before the pandemic, we had a rising need for children's mental health services. the pandemic has exacerbated that, to the point where the surgeon general of the united states has said that we have a national emergency regarding children's mental health. we've seen a 30% increase, for example, a parents taking their children to emergency departments who are experiencing mental health crises. we're seeing a doubling of a number of children who are reporting symptoms of depression and anxiety. we're seeing practitioners saying that they're waiting lists are larger than they've ever been before. i was talking to someone earlier, just yesterday, he was saying it was going to take him ten months for his child to be seen by a practitioner.

so, we had a crisis and a growing crisis that was exacerbated by the pandemic. i think these recent shootings have only exacerbated that. we know that studies show that, in neighborhoods where there is gun violence, that in the fort to five block area around those incidents you will see a spike in pediatric related e.d. visits related to children having mental health crises. about two weeks afterwards. so, we know that, even if children are not directly involved in these situations, that they can experience them and be affected by them. both from a physiological and a psychological standpoint. even if they're not directly involved. and so, i think we have to have some concern about just the level of violence that we're seeing and the impact that that is having on our children's mental health.

the president spoke on thursday about gun violence and he mentioned the impact on youth mental health. here is a portion. >> even before the pandemic and people were already hurting. there was a serious youth mental health crisis in this country. we have to do something about it, that is why mental health is the heart of my unity agenda that i laid out in the state of the union address this year. we must provide more school counselors, more school nurses, more mental health services for students and teachers. more people volunteering as mentors to help young people succeed. more privacy protection, resources to keep kids safe from the harm of social media. this unity agenda will not fully heal the wounded souls, but it will help, it matters. >> that was president biden from thursday night, what needs to be done? >> i agree with pretty much

everything the president said. we have to invest in children's mental health, we have to make sure that we have a workforce. one of the challenges we have right now for children's mental health is that we do not have enough practitioners. enough people who are trained to work with children, in particular around the mental health issues. i also think we have to really change the paradigm. one of the problems we have is that our approach to mental health is pretty much reactive. we have to wait until children have a diagnosis, and often are in crisis before we intervene. we can do much better than that. we can do what we do for our physical health. for our physical health we put a lot of emphasis on prevention, on early intervention. for example, we talk about putting chlorine in the water. why do we do that? because it is a lot more effective than treating waterborne illnesses. we can take those same concepts

and use them within our approach to mental health. if we do not do that we are never going to get a handle on it and get ahead of this issue. we have to be screening and identifying children earlier. one of the things that is very problematic is that most children who are accessing mental health services are often doing that once they are in a crisis. we know children who are at greater risk of having mental health challenges. we can do a lot better at identifying and intervening before they are in that crisis. finally, i think we need to have much more emphasis on prevention. building resilience. one of the things you heard the president say, there. we talk about strategies that are not about treating the illness. they are about helping children to have the ability to bounce back when they have adversity.

that is something parents agree on. if we can help children develop his life skills, the skills that they need to be able to bounce back, that is much better than treating illnesses once children are exposed to trauma and other kinds of stressors. >> let's talk a little more about that developing resiliency. what are your ideas for parents for how to do that? and for teachers as well? >> one of the things we have to do for our society's have greater mental health literacy. we actually know the things that are related to mental health, i think as parents and educators, and as caregivers all of us need to have a baseline understanding of that. the same way we have for our physical health, we know that children get enough sleep, and have a good diet there are more likely to stay healthy. one of the things that we know about psychological health?

we know, for example, that having social connection is enormously important for all of us. for children as well. one of the things we can do around helping to build resilience is to make sure that our children have the social connections. they have that social support. they know how people look at life is a big predictor of how they have the kind of emotional experiences that they will have. helping children to think about and make decisions in a way that helps to maintain their psychological health is in other strategy. the point is that we have evidence based, science based programs that have established and implemented in schools. we need to look at how we can scale those programs up and do that on a much larger scale. i think there is a lot of agreement from parents that if

we can give kids those skills that those are the kinds of things we would like to see them help with children's mental health. >> here's headline from time magazine. school shootings are raising anxiety and panic in u.s. children. i wonder, doctor evans, how anxiety is manifested in children. one of the cues? what does it look like? e out>> it is going to come out in different ways, for younger children it may come out as irritability, clinging this, if you are observing sudden changes and how your child is behaving, that may be a clue as to how they are reacting. those kinds of behaviors that indicate that your child is distressed. those are the kinds of things you want to be aware of. particularly if you see sudden

changes. those are clues that your child may be experiencing psychological distress. >> let's start talking to some of our mirrors. mary is up first in warsaw, wisconsin, on the parents and students line. >> i have a suggestion, if parents should take the game boys and phones away from their children. they are not communicating verbally with other human beings, and also, they do not have a voice now. they are not using their voice to protect themselves. a computer is never going to be able to protect them. during the pandemic they did not even have a safe place for the people in the city to go to if they were being sexually or physically abused at home. they had to live with it for two years. i called in and i said they should have a safe place to go to to use their voice, to say i

need help and have someone listen to them. otherwise they're just going to shut down because nobody has helped them in the past. why should i speak up now? and also, i think it would be great for a psychiatrist to come into the school at the beginning of every year and say this is what you need to ask the kids. are you being taken care of at home? people should not be afraid to ask a child if they are being abused at home. they need to know that it is not normal. people do not want to talk about it but they need to. that is why we are their voices. we need to protect them. >> okay mary. >> god bless you, we need more psychiatrists in the world as well. there are not enough psychiatrists. >> all right, mary, dr. evans, what do you think? she brought up a couple of points. >> she did, i think they are very good points. one of the things that many of us were concerned about during the lockdown was the isolation and caregivers or people who

are working with children not being able to observe what was going on. i think her point is a good one. one of the ways we identify children who are having problems and maybe abused is by people who are in their lives and schools, and so forth. i think that is very important. she also mentioned social media. i want to talk a little bit about that because i know that there was a lot of interest in that. we actually took a good look at the research in this area and one of the points that they call or made is that social media takes children away from doing other kinds of activities. that is probably one of the biggest impacts here child is looking at a screen all day. they are also not doing other things that might be important. i think the caller is making a good point about that. it is one of the reasons

parents should monitor and understand how much social media their children are using. >> all right, let's talk to anthony next in new york. on the line for all others. hi, anthony. >> hi, i just want to echo what other people are saying. i am a pediatrician in a small town. i have been saying for the last decade or so there is a mental health provider shortage. it is very hard. ten month is about what we are seeing here as well for a wait time to get a child to see a therapist. which is unfortunate. i think asking the schools to do even more when they are already overloaded with things that they have to try to do is not going to work. i think mental health for a child to get when they are young. i think, where i am, a lot of it has to do with the lack of

two parent households that can really destroy a child when parents split up. something else i was thinking about social media and screens. we see kids under a year of age who are sitting here with their parents, they come into the room, the parent is holding a phone or tablet in front of the kids face. they are not interacting with the child, they are not playing with the child, they are not talking to the child. >> so, anthony, i just want to ask you as a pediatrician. what are the trends that you are seeing in the mental health of the patients that you are seeing? >> i agree that depression and anxiety has definitely been steadily increasing in the last ten years. the surgeon general did recently come out with a report of a mental health crisis in children and adolescents within the last three or four months.

it has been exacerbated by the pandemic. it was sad that the first thing they close were schools, and the last thing they opened were schools. which is not what happened in europe. i believe just a few weeks ago they said they were opening things before schools were open in america. and that did not happen in europe. >> all right, anthony, let's get a response from dr. evans. i do agree that we are seeing these and the gentleman they're seeing them as a pediatrician. i do think that schools can play an important role. when you talk to schools there is a three tier strategy that most schools want to employ. and we believe they should employ. there should be these broad based strategies that affect

school timing. help to build resilience and children and create an environment where children are less likely to be bullied and so forth. that is very important. there is also, at the moment schools can play a role in identifying those children who have the problem. children who are at greater risk, the color before i was talking about that. we believe that that is important, schools can also be an important referral source for those kids who are having real difficulty. making sure that there are adequate connections between schools. and that there are resources within the schools when those kids have problems is very important. >> franklin is up next in goals burrow north carolina, on the line for others. hi, franklin. >> good morning. >> good morning. >> i want to make a comment

that one of the main problems i see in today's schools and to do with children is a fact that they school system and the government took got out of the schools. as long as god was in the schools we had as a morning prayer and everything. we could see all of these problems that we see now in schools. there was no school shootings, there might be a fight between the students every now and again. but, since the government has intervened and taken christiane a day totally out of the schools, all of a sudden all of these problems enter into the schools. because there is a vacuum there. trying to deal with this problem in a natural way. >> okay, franklin, let's get a

response. any response there, dr. evans? >> sure, i think a lot of things are causing what we are seeing in terms of the stressors that children and youth are experiencing. society has changed a lot from the time that i was in school. our children today are dealing with all kinds of things i did not have to deal with and people of my generation did not have to deal with. 20 or 30 years ago. i think that there are a lot of social pressures. the thing that i agree with the caller about is that we know that spirituality is actually a very important protector. something that protects our mental health and physical health, for that matter. that is an individual choice. people have to decide, parents have to decide where they come out on that but the collars notion that spirituality is a supported by the mental research. >> all right

>> all right, daniel is a student in san bernardino, california. good morning daniel. daniel, are you there? go ahead, daniel. >> okay, so, i thank you miss heard, me my name is dennis. but i have been through, i wasn't in the classroom but my elementary school, in six, great went through a shooting. ever since flynn, they've done things like when you try to get into the front office there is a color camera and stuff like that. you have to wait for the door to open and it's locked. one entry and multiple exits will be good. i used to live in a reality, not a reality, but a mindset where i thought that lightning could never strike twice. because once you've been in a shooting i felt like it could never happen again. but we're starting to go into an era where you can go through multiple shootings in your

lifetime, and it can happen. >> daniel, how old are you? >> 16. >> so, you're in high school now? >> yeah. >> what was that shooting in your elementary school? what was that incident about? >> it was basically about, it was a domestic violence case and it was the lady who worked at the school, he was going through a lot of domestic violence from her husband and stuff like that. he ended up going into the school, he wanted to that special needs classroom and opened fire on the lady. one kid ended up dying, one kid ended up being injured. the lady, the woman ended up dying and the man also took his life. but i feel like each side only tries to focus on one thing, rather than all coming together and focusing on multiple things to fix the issue.

>> all right. >> i've seen them blame it a lot on video games, even weed, and it's never been because of violent video games or violent movies. i've -- and i've never thought of killing people or injured people are opening fire. the number of other reasons why stuff like this is happening. >> all right, let's get a response. go ahead, doctor evans. >> first of all, i'm sorry that you experienced that. i think it was dennis, made a lot of good points. one of the things that struck me about his initial comments is that sometimes our fixes to problems can actually exacerbate them. going through that kind of traumatic event, schools can also over engineer or over

respond to and create other problems. if children are reminded constantly that they are potentially at risk, we have to count the cost of those kinds of interventions. but the other point that i think is important, in terms of what he's breaking up, is that we know that when children are exposed to these kinds of traumatic events that there is often a long tale, in terms of the length of time that children, youth, others are going to be affected. we know, for example, from research into what happened to people after 9/11 war after katrina. that was almost a decade where people, a decade later, we're still experiencing post-traumatic stress. so, i think it's really important, i think his story really emphasizes the importance of us not only making important investments

now but sustaining those overtime. because the youths who have been involved in these kinds of incidents are going to need support long term. >> doctor evans, there is a headline here from the pew research center. it says this, a majority of u.s. teens fear a shooting could happen at their school and most parents share their concern. i wonder why you say to students, to parents who are saying, you know what, i'm too afraid to go to school now. >> i think parents have to talk to their children. one of the things that parents can do is to reassure, but i think that reassurance has to be based on some facts. so, if you're a parent, you ought to know what steps your school is taking to protect your children. what procedures do they have in place? what kinds of processes and