WEST FARGO — Before the coronavirus pandemic, Jocelyn Kendall woke up early, took the bus to school. On Tuesdays, she had piano lessons. Every other day she played her cello during orchestra practice. She danced — ballet, hip-hop and modern — and started rehearsals with the Fargo-Moorhead Community Theatre.

Jocelyn kept herself busy.

A seventh-grader at Cheney Middle School, the 12-year-old became active with the student council, tried to plan a school dance and a snack shack, offering cheap treats for kids, and was slated for summer music camp, but it all came crashing down after North Dakota reported its first case of COVID-19 in March.

“Everything in my life was canceled,” Jocelyn said. “Once school got canceled I realized how serious it was and that it wasn’t something just in China. And then it went downhill from there. Dance was then canceled, so we started doing it on Zoom. Then the theater was canceled.

“I’m not fearful, mostly because I know what COVID is. I know I have to mask up. But it is still that feeling that I could get my family sick from being with someone in the same room. It was just difficult to get through,” Jocelyn said.

Newsletter signup for email alerts

One aspect of the pandemic that ventilators and vaccines can’t fix is the mental health aftershock that will linger for months, or even years, after the last person is inoculated, local psychiatrists said. The impact affects everyone, but they’re most concerned about the mental health of school-aged children.

Social distancing has isolated families. Millions of Americans have lost their jobs and their health care, and with those losses their sense of stability. All of the physical and emotional trauma of the pandemic, with a death toll of over 341,000 in the U.S., is putting mental health workers to the test.

“We are seeing a spike in mental health issues in youth and young adults,” said Bismarck psychologist Tami DeCoteau of Decoteau Trauma Informed Care & Practice. “And we will see the ripple effects of COVID for the next year or two. As a whole, adolescents are suffering the most. That seems to be a group that is particularly hit hard.”

The threat after the pandemic

Mental health issues stemming from the pandemic have not only caught the attention of psychologists. This month, Sen. Amy Klobuchar, D-Minn., and 14 colleagues wrote a letter to the National Institute of Mental Health urging the body to begin prioritizing studies to understand the impact of the pandemic on the mental health of children and young adults.

“One recent study found that nearly one-third of surveyed high school students reported feeling unhappy or depressed in recent months, and more than a quarter of those students felt disconnected from teachers, classmates, or their school community,” Kloubuchar wrote.

The National Alliance on Mental Illness has also heard from many young adults experiencing anxiety and depression, which it attributes in part to social isolation. The warning signs parents and teachers need to look for include severe risk-taking behavior, significant weight loss, excessive use of drugs or alcohol, and drastic mood swings, according to the National Alliance on Mental Illness.

The prolonged physical isolation between children is increasing loneliness during the pandemic and will not end after forced isolation ends, according to the Journal of the American Academy of Child & Adolescent Psychiatry.

And poor families are suffering the most, said Heather Simonich, a childhood trauma expert at PATH of North Dakota, a nonprofit organization that provides behavioral health services.

“Families are disproportionately impacted according to their vulnerabilities. Some families can’t work from home and can’t support kids well through distance learning,” Simonich said.

Melissa Quincer, a faculty member in the University of North Dakota Counseling Psychology and Community Services Department, said she’s seen a 400% increase in calls for help, with up to 40 referrals every month.

“Interestingly, we’re also seeing a decrease in no-shows; we can see you with telehealth,” Quincer said. “Children really like routine and do really well when they know what is happening. And that is all disrupted right now.”

During the pandemic, government guidelines for going to class or participating in activities like sports or drama have changed sometimes at a whiplashing rate. When North Dakota Gov. Doug Burgum issued an executive order limiting winter sporting events, not everyone got behind the move.

In November, The Forum published a letter to the editor from Kevin Dahmen, a doctor who runs the child and adolescent psychiatry unit at CHI St. Alexius hospital in Bismarck, who wrote that halting winter extracurricular activities while keeping shops, gyms, restaurants and bars open will only worsen depression and suicides in adolescents, and exacerbate an “emotional rebellion” against government guidelines.

“It is my professional opinion that completely canceling all extracurricular activities for our youth will result in worsening of the epidemic of depression and anxiety that are already occurring in our communities,” Dahmen wrote. “It is no more dangerous for 12 kids and a coach to be present in a full-court gymnasium than for 150 people to be walking around Target.”

While going back to school or playing sports is crucial for children’s development, public health risks also must be weighed, Simonich said.

“All those things are very important, but it’s weighing the pros and cons of public safety and health with the detrimental effects of pulling kids out of school or activities,” Simonich said.

Can technology fill the social gap?

So far, Jocelyn hasn’t contracted COVID-19, but she has friends who did. They pulled through, she said.

“It is kinda stressful, but at the same time it’s something that if it happens, it happens, but do whatever you need to stop it,” she said.

Describing her family as a musical and artistic one, Jocelyn misses her busy days, but she’s learning to cope with the stress. Zoom classes and Facetime chats while playing Fortnite have helped retain friendships with some classmates, but her classes are smaller now, and some pre-pandemic friendships are becoming blurry over time.

School "was something that I could go to, like every day and have fun with. And I’m really missing that in the pandemic. I only get to see half my friends on the days I go to school, and the others I am losing contact with because of the pandemic,” Jocelyn said.

Adolescents have been forced into a crash course in online social interactions, which help to fill some of the social gaps, psychologists said.

“Human beings yearn for physical connection, and Zoom can overcome a lot of that, but I still think there is something to be said about in-person communication that is critical for children’s development for that social-emotional learning,” Simonich said.

Amy Geinert, an assistant professor in UND's Counseling Psychology & Community Services Department, said that although society today has more ways to connect than a century ago, digital connections can never replace physical contact.

“There’s been a collective trauma experience. It won’t be that we snap our fingers and kids are back in school and everything goes back to normal. There will be long-lasting effects,” Geinert said.

For Jocelyn, online gaming and chatting is one outlet that helps her socially, she said. Her mother, Jessica Kendall, agreed, adding that the technology has given both of her children a way to be together with friends.

One of the best decisions parents can make is to talk about the pandemic with their children. Don’t hide all the news, said Tamba-Kuii Bailey of the counseling psychology department at UND.

“A child can see the landscape, they see people wearing masks or they’re not visiting friends like they used to. It is imperative for parents to reach out and have really appropriate conversations with their children. They can tolerate it more than we realize,” Bailey said.

Gunter, the three-legged cat, hopped onto the couch while Jocelyn and her mother discussed how their family openly talks about the pandemic. Gunter was rescued after Hurricane Harvey, a Category 4 storm that made landfall in Texas and Louisiana in August 2017.

“We talk a lot about what would happen if my dad got COVID-19," Jessica said. "My husband and I are in our 40s. We’re not young by any means, but we’re in the demographic that it could affect."

Jocelyn isn’t fearful to go to school, but also prepares for the risks. She would prefer in-person instruction, she said.

“Right now in school we’re doing hybrid learning, but it’s better when I’m in class because you have the person teaching with no distractions, like a cat or an animal, or my brother distracting. In the times I’m not distracted I get a lot more work done,” Jocelyn said.

When not in class or with friends online, she listens to music, she said.

“This is another hill I have to go over," Jocelyn said of the pandemic. "I really can’t control it. It’s something that has to be done. So everything at the moment is on pause, hopefully it will all come back next year."