Our team at B-Vitals had an opportunity to speak with Dr. Bertin, a developmental pediatrician based in Pleasantville, NY, about how the COVID-19 pandemic has impacted children’s mental health and how his practice has adapted to a virtual environment.
Note: Content has been edited for brevity and clarity with the permission of Dr. Bertin.
[Jungduk] Let’s start back in March, when everyone was starting to understand the real scope and gravity of the COVID pandemic. When did your practice first realize that you were going to need to adapt?
[Dr. Bertin] We’re still adapting— everyone is experiencing an epic amount of uncertainty and change. In the initial moments, it was a lot of rallying and scrambling, and it’s slightly more settled now, but still overwhelming for families because the situation is constantly changing. A solution that might have worked one week might not work a few weeks later.
Everyone’s experience is also so varied, so it’s hard to talk about change in general terms. For example, you have some families that are really struggling – they might have children with medical or developmental conditions that are dealing with disruptions to therapy, and then parents may or may not be working full-time. On the other hand, some families are actually enjoying the family time as well as the lack of scheduling and running all over the place.
What changes have you observed in terms of the types of mental health concerns expressed by your patients and their parents?
My practice is certainly very different than before the pandemic. For one, much of our practice was based on school referrals.
In addition to the ongoing issues around the pandemic – the stresses of making sure kids are continuing to learn from home, getting school work done, and keeping up with interventions – we now layer on the fact that the overall tension across the country has gone up epically. People are even more unsettled from this ongoing, slow, steady build of tension. This has a direct emotional impact on parents and families in terms of anxiety and fear, which is worsened with prolonged social isolation.
Aside from the technical and logistical hurdles of adapting your practice to a virtual setting, what has been the most frustrating or challenging thing you’ve faced as a clinician?
Even as a clinician, there is some small upside to being able to see kids in their home environment. I can certainly see the benefit of continuing to do that going forward. But if I had a choice, I’d always want to be with the kids, on the floor with them playing with toys. Behavioral medicine is all about relationships and play, so I’m looking forward to doing that again sometime relatively soon.
What techniques or tools are you using now that you might not have under ordinary circumstances?
If someone is old enough to interact over Zoom, it’s been valuable to have kids talk me through their play space at home. We have also shifted our interactions with parents, because they have to be my surrogate to help me understand how the kids are playing. Parents are playing with kids, and we’re all talking together. It’s definitely taken some adapting to observe kids in this way.
Beyond that, we have some evaluation and screening tools that patients who are old enough can complete online, so we’re using those types of tools even more than in the past.
Have you seen any shift in terms of the role that general pediatricians are playing in addressing behavioral health?
Everything so far has been so focused on triage. As intense and long-standing as this pandemic feels, it’s only been a few months and those first few months have been focused on triage, so it seems many people haven’t gotten around to addressing mental health yet. Pediatric offices have been closed and families are just doing their best to survive day-to-day, so we may not yet have seen the uptick in mental health care that will eventually be required.
Looking ahead, in 6 months or a year from now, to what extent do you think current practices and dynamics will persist vs. return to the status quo pre-COVID?
In behavioral and mental health, people are finding telehealth extremely useful. Certainly, depending on a child’s age or the issue, this won’t work for everyone long-term. But for many kids, it’d be a logistical win to deliver therapy via telemedicine. Connecting patients with behavioral and mental health services regularly has always been a big challenge and this might be a way to finally take down that roadblock.
Dr. Mark Bertin’s practice specializes in developmental pediatrics, a sub-specialty of pediatrics focusing on the promotion of child development, and developmental disorders such as ADHD, autism, and learning disabilities. As a developmental pediatrician, Dr. Bertin evaluates children’s overall development, provides behavioral evaluation and support, and recommends specific educational and treatment plans, while also offering ongoing support to children and their families.
B-Vitals is a digital health assessment and intervention tool used to empower pediatricians to detect behavioral and mental health problems as part of the standard annual check-up.
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