The advice from the child psychologists varied in detail but had a consistent message: Check in on your kids.

They repeated it over and over Wednesday night, during a forum their employer, Children’s Hospital Colorado, hosted to discuss youth mental health in the state. In May, the hospital system declared the situation an emergency, and its officials have said repeatedly since that they’re seeing unprecedented levels of hospital admissions and emergency room patients in an acute mental health crisis.

The demand and waitlist for Children’s services is “unreal,” said Jenna Glover, a child and adolescent psychologist. Young Coloradans visited Children’s ER more than 6,500 times in 2021 for mental health reasons, the system said. The demand for services at Children’s ERs — for both mental and physical problems — has been so high that the system has occasionally had to open a tent outside to make room.

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The pandemic has leveled a battery of challenges at Colorado’s youth, the experts said: Children and teens have had to deal with changing routines, the illness and death of parents and caregivers, the loss of connection with friends and family, social isolation during school shutdowns and quarantines. Teens, Glover said, have missed rites of passages, such as graduation and sporting events. 

“We have an increase in frequency and intensity of difficult emotions,” she said, without the “positive emotions” that come from milestones and activities. There’s been an increase in internalizing disorders, such as anxiety and depression, and more kids have eating or substance use disorders because they’re looking for a semblance of control or release.

“They’re struggling in a way we haven’t seen before,” Glover said. Before the pandemic, between 10% and 12% of teens experienced anxiety and depression at a clinical level, she continued. Now, that number has risen to roughly 25%, or one in four.

Jessica Hawks, a child and adolescent psychiatrist and a director for the hospital’s mental health institute, said warning signs for children include irritability, acting out more, isolating more, changing their eating and sleeping habits, and a lack of motivation or interest in usual activities.

Children's Hospital Colorado to host youth mental health town hall

The No. 1 thing parents can do is “spend quality time with their children.” She said parents should remove their cellphones and be present and focused and that they should “catch your kids being good,” meaning responding to good behavior and good things, as opposed to only bad. 

At the same time, Hawks continued, parents should keep expectations: With the amount of disruption COVID has brought, some caregivers may want to loosen rules to overcompensate.

Glover echoed the advice that parents check in, on everything from substance use to whether they’re drinking enough water, eating enough food and getting enough sleep. Outside time — even when it’s freezing — is important, too, she said.

Check in with your pediatrician if you’re concerned, the experts said. Lock up firearms and keep toxic or potentially harmful substances away from your kids.

When you check in, she continued, validate the hard things kids are experiencing. Resist the temptation to fix immediately, and instead listen and acknowledge the difficulties. Hawks urged parents to be good role models and normalize that “it’s OK to not always be OK.” 

“Normalize that life can be hard sometimes,” she said. That applies to how adults handle difficult times, too, as it sets an example: “It’s really important that we pay attention to what our kids are watching us do.”