Two Years Into the Pandemic, Teens Logging on for Help
Like many of her teenage patients, Anna Hankins, MD, spends more time on her devices than she used to. A pediatrician with UVM Health Network – Central Vermont Medical Center, she is one of the many physicians using telehealth technologies – video visits or digital messaging – as a means to reach her patients.
"I have gone from seeing telehealth as an emergency measure to use in the middle of a crisis, to being just a normal part of my medical practice," she says. “It’s been fantastic for mental health care. I’m getting a better understanding of my adolescent patients than ever before.”
A National Emergency
“Adolescence is challenging under normal circumstances, but COVID has really exacerbated the mental health challenges faced by young people,” says Michael Hoffnung, DO, Attending Child Psychiatrist at University of Vermont Children’s Hospital, the Vermont Center for Children, Youth and Families and Assistant Professor of Psychiatry at UVM’s Larner College of Medicine.
Low self-esteem, eating disorders, anxiety and depression have become more commonplace, which Dr. Hoffnung attributes to a variety of factors including isolation, breakdowns in daily routines, and more screen time and social media use. These observations have borne out across the United States, with children’s health organizations recently declaring a national emergency in child and adolescent mental health.
Pediatricians are often on the front lines of this challenge, diagnosing and treating mental health issues or serving as the bridge to longer-term psychiatric care. Maintaining regular contact is critical, and telehealth has become an important tool for providers across the UVM Health Network to monitor their patients’ mental health and maintain care through weekly video visits. This sort of consistent care can help keep kids from experiencing symptoms so severe they end up in the emergency room.
“Telehealth visits aren’t for everybody, but they offer a lot of flexibility and can be an excellent alternative to the mental health care patients receive in person,” Dr. Hoffnung says.
A Safe and Comfortable Environment
Dr. Hankins feels that the online format empowers her patients to seek and receive care on their own terms, with fewer disruptions to their daily lives. This is particularly true for teens and their families, whose busy school and work schedules can make in-person visits more stressful.
“Video visits remove that stressor, and they allow patients to talk about intimate and private things in an environment where they feel safe and comfortable – maybe that’s their bedroom, their front porch or during a free moment in between school and sports,” Dr. Hankins says.
In the process, physicians are seeing a new side of their patients – their own environments – which is typically absent from in-person mental health visits. “With in-person visits, my patients have gotten up, dressed and driven into the office. I get a very curated version of them. But with telehealth, I get a flavor for what their daily life is like,” says Dr. Hankins. For example, she says, if a teenager is still in her pajamas in the afternoon and there are several energy drinks on the bedside table, “I've just gotten so much information about that adolescent and about why they might be struggling with sleep, school performance or anxiety.”
One theme transcends technology: relationships. Dr. Hankins says that “the better I get to know my patients – the families that they live with, the worlds that they are navigating – the more effective I can be in evaluating them, treating them, advocating for them and having a genuine relationship with them – which is the coolest part of my job.”