We are facing pandemic fatigue.

“The pandemic seemed to catch all of us by surprise and disrupted all of our lives in some way, forcing us to make adjustments. The longer it lasted, the more our collective fatigue and discouragement set in,” said Jennifer Mertz-Turner, a licensed mental health counselor and owner of J M-Turner, Inc. Counseling and Play Therapy in Kendallville.

As a registered play therapist-supervisor, her focus is working with school-aged children, teens, couples and adults with anxiety, depression and relationship stressors.

For children, the pandemic has meant a disruption in what once felt safe and normal, Mertz-Turner said. Going to school, playing with friends, visiting grandparents, going on vacations ... or to a movie ... all have been disrupted.

Some of the children Mertz-Turner sees are attending school online because they had the choice.

And some of the children are “back and forth” between in-person and online learning because of exposure and quarantines.

“The ones online from the beginning are doing OK because there is no disruption and disruptions for those in school can be challenging. There is a lot of stress in that,” she said.

“Nothing about this past year has been what any of us would consider normal,” she said. “Kids thrive with routines, structure, looking forward to things like play dates and vacations and seeing their grandparents. Everything this year has been completely disruptive. Not knowing is hard for the kids and the adults, too. Parents are trying to balance work responsibilities and helping kids with online schooling. There is pandemic fatigue.”

In general, the children she helps are facing anxiety and worry, adjusting to loss in a family, loss related to divorce, challenges with social relationships at school, falling grades, behavior problems, separation anxiety, storms, etc.

In play, themes about death, family members getting sick and obsessive-compulsive disorders may surface. With older kids, there is depression, feeling judged or left out, self-esteem issues, panic attacks, etc. The focus is on helping them to learn coping skills.

“There is such a stigma about asking for help,” Mertz-Turner said. “Part of our role is providing a safe place to talk about all those big feelings. Often kids are acting out through their behavior and when you ask what’s wrong they honestly don’t know.

“We provide a safe place to express those feelings. Play is their first language. We process first with images and then with words. Often we get flooded with emotion and have difficulty talking about it let alone problem solve it.

“For kids it’s harder to understand why do I feel this way. Through play they learn ways to manage and understand those feelings and (this helps) parents understand the world of a child.”

Mertz-Turner lists five ways to help a child.

1. Let the child know how much you care.

2. Help the child regulate his or her feelings, perhaps like taking deep breaths.

3. Listen and help the child name the feelings.

4. Relate with empathy and understanding.

5. Reason when calm with helpful problem solving.

“Try to slow down and be their calm,” Mertz-Turner said. “’I’m here for you and you are safe with me.’ We teach mindfulness.”

Mertz-Turner said that she and many other therapists have had fuller caseloads and waiting lists to meet the demand for services since the pandemic began. Telemental health services have helped to provide connection and consistency as an alternative to in-person sessions.

Bobby, her therapy dog, comes to work with her. “He has been a gift of love for these kids,” she said. “A golden doodle, Bobby was named after her father who passed away.

“He has a gift for connecting with kids and adults,” she said.

On average, patients come for 10-12 sessions during a three to six month period.

“Kids are needing connections and relationships,” she said. “All the divisiveness of the election and the protests — the kids are feeling that as well.

“I asked my teen clients what they would like people to know ... they all said, ‘I just wish they realized how stressed we are.’”

When parents struggle with addiction and stress, it trickles down to the kids, she said. And helping parents is as important as helping the kids learn emotional coping skills and self-care.

“Part of getting through this is self care — rest and play — finding that balance. Otherwise we get overwhelmed and shut down,” Mertz-Turner said.

What we are seeing here in northeast Indiana is similar to the situation nationwide. Between March and October 2020, the number of visits to emergency rooms nationwide by children younger than 18 for mental health reasons increased by 44% over the same period in 2019, according to the Centers for Disease Control.

The number of mental health visits for adolescents ages 12 to 17 was 31% higher; for children ages 5 to 11, it was up 24%, CDC figures show.

From March 2020 to December 2020, Riley Hospital for Children in Indianapolis experienced a 61% jump in emergency room visits related to mental health and suicide compared to the same months in 2019, according to Indianapolis-based Side Effects Public Media.

Hilary Blake, a psychologist at the Indianapolis hospital, said COVID has shone light on an ongoing mental health crisis in Indiana.

“We don’t have enough providers, specifically psychiatrists to help with children with mental health needs,” she said.

She said often children and adolescents feel comfortable confiding in a school counselor or a teacher. “Some school counselors are definitely doing things via Zoom and things like that,” she said. But it takes a toll if you are not there face-to-face with a student, she said.

The theme of the year for Mertz-Turner — and thousands of other professionals involved with mental and physical health — has been adapting to help people as safely as possible.

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