COVID-19 has disrupted the lives of individuals and families across the globe. For many, the impacts of this global pandemic have been insurmountable and have resulted in significant stressors. Although medical advances have allowed individuals to slowly begin to restore their sense of normalcy, COVID-19 has resulted in unprecedented mental health impacts for many, especially children and adolescents. The present study examines whether stressors related to COVID-19 and whether subsequent quarantine/isolation were possible contributors to psychiatric crises that led to adolescent psychiatric inpatient admissions. Electronic medical records of those admitted to Strong Memorial Hospital’s Child and Adolescent Inpatient Unit between March 13, 2020 and January 1, 2021 were reviewed. Admission and discharge notes were analyzed to determine the presence and context of keywords related to COVID-19. Approximately, 53% of all adolescent psychiatric crises that led to inpatient admission were related to COVID-19 stressors. Results of this study will be used to help understand the extraordinary mental health impacts of a global pandemic and will assist mental health service leaders to better plan for patient flow should there be another wave of quarantine/isolation. Additionally, these results can help inform and develop pandemic-related strategies and interventions that can reduce overall distress in children and adolescents.

Objectives: The COVID-19 pandemic required intensive interdisciplinary pain treatment (IIPT) programs to shift to virtual models of care. This study used a multimethod approach to examine outcomes of a pediatric hybrid IIPT program (50% in-person treatment and 50% synchronous video-based telehealth) and assessed staff experiences while treating within this model.Materials and Methods: Patients (M = 14.73, SD = 2.04; 79% female) reported pain intensity, functional disability, and psychological factors (anxiety, depressive symptoms, fear of pain, pain catastrophizing, social functioning) at admission, discharge, and short-term follow-up. Differences in treatment outcomes at discharge and short-term follow-up between patients who participated in the hybrid IIPT model (n = 42) during the pandemic and those who participated in the traditional inperson model before the pandemic (n = 42) were examined. Quantitative assessments of staff burnout and perceived effort and qualitative assessments exploring staff perspectives about the challenges and advantages of the hybrid IIPT model were gathered.Results: Youth in both groups made significant improvements across the majority of treatment outcomes; however, the hybrid group reported higher levels of pain at discharge and anxiety at follow-up. The majority of IIPT staff reported moderate to high levels of overall burnout, and almost half reported high levels of emotional exhaustion. Staff highlighted various challenges and benefits associated with treating within the hybrid model.Discussion: When considering telehealth as a treatment tool for youth with complex chronic pain, it is crucial to leverage its benefits while addressing its challenges for patients and providers.

Lyme and other tick-borne diseases can cause complex, multisystemic symptoms that pose diagnostic and treatment challenges. This article presents essential information about these infectious diseases and associated medical and neuropsychiatric symptoms. Knowledge of the full range of infection-driven symptoms with these diseases will enable mental health practitioners to (a) avoid misdiagnosis of their patients with a primary psychiatric disorder, (b) facilitate referrals for appropriate medical evaluation and treatment, and (c) help alleviate the suffering caused by these diseases. Clinical Impact StatementLyme disease and other tick-borne diseases can have profound effects on mental health, quality of life, and the general functioning of individuals and family members. This article provides guidance for behavioral health clinicians on treating patients who are suffering from these diseases. It addresses essential issues related to diagnosis, treatment, and the collateral support needs of this complex population.