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SV Chat: Dr. Nicole Stelter has advice for how to talk to your kids about mental health
San Jose Mercury News - 9/30/2022
As the back-to-school excitement fades, and the homework assignments start piling up, now is the time to check on your kids and their mental health. After two chaotic school years, things are somewhat back to normal this year, but kids are still transitioning, and so are parents.
We spoke with Dr. Nicole Stelter, Director of Behavioral Health at Blue Shield California, about what to keep in mind. She shared some tips for how to talk with kids about mental health, what to look out for, and how to help.
Q: When and how should parents start talking to their kids about mental health?
A: It’s not an easy conversation, but it doesn’t have to be hard either. Sometimes it is just being willing to know that you are not going to get it right the first time. You are not going to be perfect, but you just have to be a good enough parent, you don’t have to be perfect.
A lot of times parents and guardians, grownups in general, worry we could “infect” our children with mental health issues or anxiety because we ask questions or talk to them about it, which is fortunately not true.
Part of stigma reduction is making it about health. When we start telling our kids “don’t ride your skateboard without a helmet, because that’s not safe,” “don’t climb up a bookcase and jump off the top,” when we talk to them about taking care of their bodies, that’s a great time to talk about what it means to take care of your mind and your brain.
What does that look like? Destigmatizing it, normalizing it as part of just what you do to take care of yourself and to take care of each other. Those are conversations a lot of parents are already having in different ways. So this isn’t anything different, per se, it’s just an addition.
Q: This is the second year of kids going back to school since COVID, and we’ve heard a lot of discussions about how COVID has challenged young people’s mental health. What are the specific concerns that have arisen in the past few years?
A: Anything that disrupts the social fabric of what our kids and communities do is potentially a challenge for mental health and emotional well-being. There’s a similar kind of disruption, right, those are the places that we find social support, that we find community. And for kids, they’re working out where they fit in the world, and they’re going to be curious about whether that’s OK, all of those things that are really, really important for development.
There’s just a lot of interruption to that normal social development. Part of the other thing we’re starting to recognize is how much learning was impacted too over the last couple of years.
There’s some catch up or reframing and reinforcing that needs to happen. This is a generation of kids who are going to be experiencing academics and learning in a completely different way than any of the rest of us have had to do. And I think we’re still trying to figure some of that out.
Q: What are the specific mental health concerns that are the most common, and that parents should be looking out for?
A: I think our biggest concerns right now are not necessarily any different than before, or going to be any different going forward.
Parents should be looking out for their kids being anxious. A lot more worry, isolation, withdrawal. Those are all concerns to make us start thinking about anxiety, start thinking about trauma response, depression, concerns about substance abuse.
Substance abuse to some extent is an indicator someone is needing to check out from something that is overwhelming. It can be substance abuse, it can be too much time with video games. When a parent, teacher, community, or guardian sees a kid finding ways to check out, you should be concerned about what overload is happening there.
And the overload can be about pressure to perform, because kids know they’re not the same students they were three years ago, so some are feeling their performance lapsing.
It could also be about social skills. A lot of us are, frankly, are out of practice. And if you’re a kid, you’re new to doing a lot of those things. So that can be pretty stressful. And they might want to withdraw or avoid.
Q: If a parent is noticing a kid isolating more, or they are concerned about substance abuse, what should they do to help their kid or to get them help?
A: Probably the most important thing is to ask them. Parents and guardians will avoid asking directly, because we expect them to blow us off, or we think we might infect them with the idea of something when it’s not really happening and make it worse.
But those are the most important things to address, and not avoid. Don’t wait for it to go away. Find a way to ask questions about how they’re doing.
The kind of questioning I’m talking about is really open ended. Asking a question in a way that says ‘I care about the answer, but it doesn’t have to be a particular answer.’
I would say parents can absolutely reach out via their insurance provider to find out what is available for help. We [Blue Shield] have our BlueSky program, which is focused on teens and kids, but also it can be for parents, teachers, guardians, so that people can find free resources really quickly.
You don’t have to wait for there to be a problem before you start taking care of yourself. It’s like going to the gym. We don’t go because we have a backache, we go to prevent the backache.
Q: How can parents model good mental health habits for their kids?
A: I think we forget that this is part of how we teach our kids.
We can be open about our own health. If you think about your physical health, you would talk about something that’s going on for you, a medical concern, so this is very, very similar.
What gets a little tricky is, there’s a boundary in there as a parent. If I’m stressed out because I’m worried about my kids, what can happen is our kids can take that on. And we don’t want that, they’re working through their own stuff.
You can say “work has been really hard lately,” or “I’ve been having a lot of stress,” and “here’s what I’m doing about it.”
The most important thing you would want your kid to hear is, “and here is how I’m taking care of myself,” and that it is OK to do that. I’m putting myself and my health first, just in the same way I want you to do.
Q: Are there specific habits that parents should either be encouraging or discouraging for their school-age children that make a big difference in their mental health?
A: It’s really the simple things. It’s the basics.
Are they going to bed and getting up relatively at the same time and getting enough sleep? Sleep hygiene is really important. It is just as helpful for older kids as it is for younger kids to have a bedtime routine or a ritual, which includes reducing screen time, giving your brain a chance to quiet down before you need your body to also quiet down and go to sleep.
For older kids, disconnecting from content that is stimulating, things like social media, the news. Make sure that they are getting regular physical exercise, not drinking caffeine too late in the day.
The other parts are really about eating well. I know it sounds oversimplified. Are they drinking enough water? Are they eating as regularly as they need to? Is it balanced?
Those are the things that can set them up to be able to take on what they need to from a mental health perspective. So pretty basic, but it’s a very important foundation to being able to be resilient and take care of themselves.
DR. NICOLE STELTER
Title: Director of Behavioral Health for Blue Shield of California
Residence: South Orange County – just moved from Long Beach where she lived for almost 30 years. “So I still kind of ‘claim’ The LBC.”
Education: La Mirada High School, BA Psychology, MS Marriage and Family Counseling, PhD Industrial/Organizational Psychology
Family: 2 teenage boys, 2 step-sons, fiancé, 2 step-kitties, 1 dog
FIVE THINGS TO KNOW ABOUT DR. STELTER
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