 So, thank you so much for joining us. My name is Nicole Velulia-Fenton. I have the good fortune of working in UVM's Continuing and Distance Education Department. I am supported by an incredible team, Foster Nye and Eric Melton and Kelly Baldwin as well who are helping out to bring this webinar live to you today. I would like to introduce our incredible panelists who are taking time out of what we all know is an incredibly busy and challenging time. So, I have Tom Delaney who is with us today. Tom is an assistant professor in our department of pediatrics and also an instructor in our fully online Master of Public Health program. Tom, thank you so much for joining us today. And also, we have Annie Valentine. Annie joins us from UVM's Health and Center for Health and Well-Being on UVM campus. She's incredibly busy at this time trying to support undergrad and graduate students. She's an education and training manager in the Center for Health and Well-Being. Annie, thank you so much for being with us. And also joining us today is Dr. Andy Rosenfeld, a child psychiatrist at the Vermont Center for Children and Youth and Families and also an assistant professor. Dr. Rosenfeld, thank you for being with us today. Thanks, and bye to me, Nicole. And also, Dr. David Tamasi joins us, a clinical psychologist and psychotherapist at the University of Vermont Medical Center, a lecturer in many different programs here at the University of Vermont. And one in particular that we work on at the Continuing and Distance Education is the Integrated Health Program. So very happy to have you with us as well, Dr. Tamasi. So as I mentioned a little bit earlier, we have a lot to talk about today. This is an incredibly personal and thought-provoking topic for parents as we all are trying to understand how we can support our children with their own mental health, in addition to our mental health during the coronavirus pandemic and the challenges that we all have been facing. So we're going to hear from Tom Delaney about children's mental health pre-COVID-19. What was the landscape of children's mental health before the coronavirus pandemic? And then he'll talk about possible impacts of disease and disaster on mental health. And then we'll hear from Dr. Tamasi, looking at the mind-body problem during COVID-19. What is the neuroscience happening in our children, in their brains, in their bodies as well? And then we'll move over into discussion about pandemic parenting. That's really what we're trying to do right now. And Dr. Rosenfeld will walk us through some strategies and coping methods for parents of children and young adults. And also making space for loss and the stages of grief, which we are going through, and our children are as well. And then how can we make space for some health maintenance also? And then Annie Valentine will walk us through undergrad and graduate student resources and who they are, what are they dealing with, what can we do to help, what do they need as well. And as I mentioned earlier, we have several slides that are numerous resources for our parents and for our students that many of our panelists have pulled together. And we're happy to share those with you today. And we also have a really interesting and exciting opportunity for folks who are participating in the webinar today is a digital badge. You can earn a digital badge for your participation, and I'll explain a little bit more about that in the opportunity to claim that badge for your participation in this learning experience today. So I'd like to, just a housekeeping note as well, I've mentioned, but for folks that maybe have just joined us, I'm going to keep my eye on that chat box to the best of my ability. And I also have our panelists who are willing to jump in and answer questions. So if you do have questions, please put them in the chat box. I will do my best to keep an eye on them. And if by chance we don't get to your question, we'll put up email address and we'll try to follow up with, you can follow up with those questions afterwards. So I'd like to toss over to Tom Delaney with our master public health program. Thank you so much, Tom. Can you walk us through some of the information and give us a little background, maybe the landscape of where mental health that before the coronavirus with our young, our children and our young adults. I'm just going to take a few minutes to over some recent trends in young people's mental health. And, you know, we could talk for hours about that about what the different trends are and I'm really going to focus on to the ones that people tend to have more questions about which are depression, and suicidal. And suicidality includes suicidal thinking so suicidal acts, and less frequently actually suicide. And first, we're going to go through a couple of graphs stick with it, even though there are graphs and hopefully you don't have graph PTSD from earlier presentations like this. In terms of background on depression anxiety and suicide. I just wanted to make sure we're, we're generally having a common understanding. Most people with depression and anxiety, even serious and depression anxiety will not go on to die by suicide. And that's a misconception that some, some people have some times, and suicide deaths are actually relatively rare and young people so in Vermont, and in mostly US, the age groups that tend to die by suicide more often are actually middle aged and older and they tend to be male. However, suicide attempts, attempts are high in younger people and suicide related thinking and self harming whether it's with suicidal intent or not suicidal intent are actually pretty common in people. And I'll defer to my clinical colleagues for how best to address issues like this as they come up but I do want to drive home the fact that you know any expression of suicidal thinking and self harming behavior should be taken really seriously. That seems really important. The data that I'm going to show you are really from two sources here in Vermont and nationally. The first is a youth risk behavior survey, which is done every other year and most Vermont middle schools and high schools are going to state that. And then for a little bit older young people so ages 18 to 24, we use data from the behavioral risk factor surveillance system or BRSS. These are both self report, but over time we found them to be pretty reliable, and really our best available way of gauging trends in mental health. We can go to the next slide. Okay, so this is the first of two graphs. This is from the youth risk behavior survey. And if you look at the yellow line at the bottom. These are all percentages they're percent of all people. High school age young people who completed the wire BS survey over four administrations of the survey going back to 2013. The yellow line, that's probably our most concerning line and that's at young people who actually report having made a suicide attempt in the past 12 months. And you can see that numbers, relatively, though, in one sense it's really high, but compared to the other lines it's relatively though. There is a bit of a concerning upset from 2017 to 2019 where the number of young people who self report a suicide attempt seems to have increased. The line above that is young people who made a suicide plan which also shows a slight increase in the past two years. The line above that red line is purposely hurt itself without wanting to die so that's non suicidal self injury. That also shows an increase from 2017 to 2019. The largest increase is the top line blue line, which is young people who report feeling sad or hopeless for two or more weeks in the past 12 months and that's, that's a marker and a symptom for major depressive disorder. So these are, these are all concerning trends. I don't have the, the suicidal intention trend data from the BRF SS, but this is depression trend data from the BRF SS from 2013 through 2018. The top blue line is 18 to 24 year olds in Vermont. So if you look at 2017 and 2018, there's about 30% of the young, young adult age 18 to 24 met criteria for major depressive disorder. And then the red line under that is the remainder of Vermont adults so 25 and older. And then below that is the US rates. One thing to note is that it's actually really common in a lot of states we see this pattern where the depression rates in the 18 to 24 year olds are actually substantially higher than they are for the remainder of the adult population. And again, we have this disturbing trend though right so starting in about 2016 we see that the young adults are showing higher rates of depression relative to the other age ranges and relative to the US. So I'm going to head to the next slide. So, we don't have a great research base for talking about what are the impacts of events like the COVID-19 pandemic so I was only able to find one paper in the past 100 years of science that examine the impacts of the influenza, influenza epidemic 1918 to 20 on mental health and that was really focused on adult mental health, not so much young people. But there's literature that's coming from events like the cover from hurricanes, there's literature from the 20 2009 2010 economic downturn various other types of disasters and what you see is that there are, there are immediate impacts and then there are longer and medium and longer term impacts that are seen in terms of populations mental health. And a really interesting and concerning thing is that there can often be a lag time. So, something that's been in the media in the last couple weeks is that there can be a rally around the flag effect we're initially in the immediate weeks following the start of a disaster or in our case of pandemic, people might really pull together and be very supportive of each other and, and there might actually be some protective factors associated with that. However, what you see is over time, there might be sort of a rebound effect where people actually are showing more symptoms and they may have prior to the event. And there's, there are hints that there are increasing concerning behaviors in the US in recent weeks so a report just came out showing that calls to crisis lines for suicide domestic violence things like that have increased in recent weeks. And there are, there's other anecdotal evidence for increases in domestic violence. There, I just saw this morning I saw a report survey showing that there appears to be greater alcohol consumption in recent weeks and there's an older literature showing that in the wake of disasters like 911. A lot of people do turn to alcohol use including excessive alcohol use as a coping mechanism. And then, interestingly, highly increased firearm sales in the US and that's a concern to us who are engaged with suicide prevention because we know that having a firearm in the home is actually significantly increases your risk of someone in your, your family, or in your home dying of suicide. And we can go to the next slide. So, what are we thinking in terms of things to look out for and the negative impacts, well, we believe that there's general increases in social isolation and loneliness. And we're also concerned that people may not be able to access their normal supports. And that could be as simple as, you know, going for a walk with friends maybe you're not doing that anymore. You're not living with all the people that you used to live with, because they are they're now living with someone else. It could be parents split parenting situations where a child is not seeing the other parent regularly anymore. People not having access live access to their faith supports a meetings and a meetings and a lot of these things have done virtual that people may not be able to access them the same way. Another interesting I think that we've seen in the media is separation from other people who are hospitalized, even to the point when they're dying. So not be not being able to say goodbye in ways that we typically would want to be able to say goodbye. So this loss of normal routines normal rituals, and then we saw this, especially going back in the past two weeks, three weeks we saw that people are beginning to lose their jobs and larger numbers, and the literature supports that families and individuals including young people can be really impacted by financial stresses, such as mass loss of jobs. And I just want to point out before we transition is that we should really be thinking too about people who have existing vulnerabilities so young people who may already be struggling with depression anxiety. Young people who have a history of self harming or suicidality. It's really important probably to be checking in with them and helping them connect to services. And I just wanted to end with that that plug. Thank you so much Tom for sharing that background and look at where there are challenges for our young people as well and we're going to hear a lot more about solutions and possible resources and tips to help because I know as a parent, we're always looking for something that we can do to hopefully help with that situation with our children. So I'd like to toss over to Dr. David Tamasi to walk us through what's happening in the bodies of our adolescents that may also be contributing to some of these stresses and anxieties that our children may be feeling about. Dr. Tamasi. Yep, now we can hear you. There we are. Thank you. So in these few slides, I would like to tackle two main areas. One has to do with basic neurology and neuroscience and the other one more with theory and philosophy. Now doing this within a few minutes, it's really a difficult task, but I want to make sure to focus on the aspect that are more relevant to families struggling during this pandemic. And in this context, I also want to spend just a few seconds on expressing the level of gratitude that I have for all the families and I'm a father myself and so I would not even be able to be here or enough for my wife who is actually taking care of the children. And I think just to start in general is to for all of us doing the situation on finding a place in which we can express gratitude to our loved ones. We're all in this together. I would like to move on to the first slide. Thank you. The first thing I would like to mention is attempting to normalize the process we are faced with as a parent, we want to make sure to do our best for our children. Again, we want to make sure to provide a proper support in a time in which we are facing things that we might not be able to understand ourselves, not so much from the biological standpoint but in terms of our emotional response to stress and anxiety. And so I would like to very briefly discuss what the most important things are in child and adolescents brain in this context and I would like to focus on five main areas that are listed in this slide. So the campus, the AIC and the ACC as well as prefrontal courts. Without spending too much time on each of these areas, perhaps we could discuss what are the most relevant situations that we can find from the perspective of psychology. Now this, in this slide, you can see some basic psychological interventions that we use for children with a lesser population, with a lower population. I only said five, cognitive hero therapy, teleactivity therapy, psychodynamic therapy, humanism for psychology, and then I would almost say everything else including spiritual, religion and tradition. Now, if you don't mind, yes, I would like to focus on the slide on the neuro functional discussion. So one of the things to keep in mind is that we are faced with a twilight zone in the complex of the lessons behavior. We are faced with a lot of change that could have very rapid pace and some theories believe that adolescents move at the last stage in childhood development. Some believe that this is the very first stage of a pre-adult situation. One of the things to keep in mind as a parent is that we should do our best to match our expectations from a cognitive standpoint and an emotional standpoint to the level of skills that adolescents can achieve. So for instance, what would be the best strategy not to lose our patience when we are faced with difficulty? Well, one of the things is to understand that the level of interpretation that an adolescent brain has might not really match an adult once. And this can turn into excessive or inappropriate display of strong emotions, inability to focus, inability to follow rules, as well as some challenges. This is especially true for the previous stage of development, difficulties in assessing what we could quantify as moral or ethical judgment. As a classical example, in the previous stage of development, we cannot really make the claim that a child who is four years old, for instance, is purposely lying to us in the sense that the cognitive capacity may distinguish between a false statement and a lie to not fully bear quite yet. Now granted, when we are faced with a lot of stress, it is hard to remind ourselves that our emotions should match the context and we always start from a place of nurturing sense of self. But it's very good to understand that certain things are neurologically limited in the context of an adolescent's brain. So to start with this great overview, what can we do to at least understand what's going on in the adolescent brain so that we'll be better equipped to match our response? Well, the first area that we see is the slice of the campus, which is an area of the brain that is related to prior things that I would like to focus on, emotional component as well as memory. And for instance, in the context of understanding the bigger picture, it is very challenging to envision a possible future in a situation in which we are forced to stay at home and self-isolate. Now this recommendation, which is a very appropriate recommendation from the epidemiological standpoint to public health, will be considered a very inappropriate recommendation in the context of mental health in general. There's something that we always advise individuals not to use to self-isolate whatever the problem might be. So this situation we find ourselves in is by definition an unfortunate series of events that do not foster an appropriate mind-body connection. So inside the hippocampus and the growing hippocampus placed in memory of production and retrieval, the other areas are pretty much related to applied response, stress response, talking about the underlying special areas that have to do with both cognition and emotion. And it is special for the anterior singular cortex as well as for the anterior isler cortex. And then for the prefrontal cortex, which is what we should be focusing on, an area that is not really fully developed until the very last stage or the last sense, and granted it developed a little earlier for biological female subjects than male subjects. Now that part of the brain is responsible for a cascade of responses, especially cognitive and even more ethical judgment to be able to understand a situation and act appropriately. So in a situation like the one that I'm lessons is faced with, there might be a disconnect, neuro-cognitive disconnect as well as a cognitive disconnect between our ability to jump ahead and seek adventure and react in a very fast rate, but at the same time having enough cognitive knowledge to have a certain level of power, not to overemphasize from asthma, and this applies to our concept of self, the lessons sent to me. I would say self-focused, I would not say self-centered necessarily, but I think we need to have, there's been a lot of time being worried about their physical appearance, the way they interact with the earth. And so what appears sometimes to us as either a reckless behavior, or in a proper display of emotion, or simply unpreparedness to face life circumstances, it also has to do with the neurologic situation of finding themselves in. And this is based on a variety of events, the two which I'd like to focus mostly are related to myelination and pruning, which are both connected to our ability at the brain level to recreate same types of data that are focused on new experiences, which in turn means that the more we can help our children navigate their emotions, either with words or with their body, in the context of deep reading exercises, for instance, spending time together addressing issues that might linger just below the surface over a meal, for instance, to be navigated with experiences with them, we've actually demonstrated them the appropriate response, what you think, how you think about things, and also relate to the body. And this is really what I'd like to focus on the very last slide, which we call the broader perspective, and it's really impossible to discuss the mind-body problem in a few minutes, but for the purpose of this pandemic, I understand there are certain things that we can teach and we can guide our children that should be based on thoughts and words, so the way we express them will be label an issue for them. A lot of the difficulties that are left since we've faced with our particular inability to actually understand from a thought standpoint what is going on, so labeling the issue helps them navigate what appears to be an unknown response. In the previous stage of development, we could develop a temper tantrum, for instance, where a child feels almost cognitively possessed by the situation, not really understanding what is going on at the level of a so much forming situation, their body and definitely not thinking clearly, in the case of the adolescent, we might have votes on one side addressing that by talking on and nurturing way toward children, on the other side also using their bodies as a way to foster emotional intelligence and body awareness. So the model I suggest here, it's not something that I came up with, it's part of the longest tradition within philosophy, critical neuroscience. I was just wanting to focus on this critical asthma model, which I call self-soul spirit, just for clarity. Now, whenever we talk about things that are at the core between solid evidence-based science and more theoretical speculation, the individual should relate change and adapt those firms to their own experience. But one of the things that I noticed, at least in my conversations with my patients, is a sense of unexpected, gloomy, dark future that we're faced with. So there is a normalization of the process and this overall tension that has to do with not quite knowing the ending if you want to over-simplify it too. But nonetheless, by definition, by the logical and by definition, it's more prone to new things in black and white and possibly engaged in what we call cognitive distortions and psychology, not in better guided, but we are actually able to utilize some of those words to shed some light on the experience. So in this sense, I attempted to reframe the stress response, the anxiety we faced, the fear, uncertainty, even existential experience. And I suggested this with the individual experience, which is subjectively understood, the transcendental experience, which can be internally felt, and metaphysical experience, which can be finally inspired. Now without sounding too geologically focused here, the idea that it had, it is in a term of uncertainty, focusing on fostering multiple levels of understanding what parents should at least think about. So bringing sense of community and closeness to their children and value their own individual response to the theater and anxiety. In that sense, it's subjectively understood, each experience is unique to match their emotion by allowing their body to react appropriately, so not attempting not to express the way they feel, whether they express their emotion by worship, or raising their voice, or crying, meaning where they add and then bring them to a place of more conscious awareness and relaxed response. And finally, divinely inspired, of course, this one sounds very, very religious, but it stays upon this lack of certainty, which can be associated with the bargaining phase. And so Dr. Rosenthal will have more to say about the grief response, but part of this bargaining phase that we might have to deal with is, in the absence of strong responses, figuring out a way to properly reframe the questions of why this, why me, why now, and even more important, what does this pandemic, this experience mean to me? Thank you, Dr. Jamassi. We really appreciate that as well. And I know Dr. Rosenthal, you're going to talk a little bit too about, you know, maybe thinking of ways to bring gratitude into our lives more often. And you shared with me when we talked a week ago, just the practice that you've been doing on your way home, just thinking of all the things that you've got done and things that might write, versus as parents and working parents, we often think of ways you didn't get done. And so I really appreciate that you're sharing that with me. So Dr. Rosenthal, can you walk us through here, because we are trying to parent amongst a pandemic, and what does that mean? And what resources can you also provide parents to try and help them through this? Yeah, thanks for including me in this conversation. It's really beautiful to hear the epidemiology and the neuroscience behind some of this, and I'm glad to talk for a few minutes about some practical aspects of parenting. I think that there is no playbook for parenting in a pandemic, so the title's a little bit tongue in cheek. And I think that most of what we know has to be adapted for the current situation. So I wanted to start with a familiar attitude of putting your oxygen mask on first before you can help the people around you, and what are the ways that we can do that now? I think it's really called for, because when you and I were talking about this presentation at Coal, we were just kind of marveling at the way all of our lives have been disrupted at every level and every facet. And everything that's sort of held together, our families, our jobs, our knowledge of the world, everything that's scaffolded that has kind of been ripped out from underneath us in many instances in a way that's really unsettling you. And how to cope with that while we're being asked to continue working or looking for work, supporting our families, schooling our kids, managing our households, and all the other things is kind of just overwhelming. And I think that the first point I put under the oxygen mask is awareness, acknowledging that sense of overwhelm, the roller coaster of emotions that go with that in ourselves is probably the first step to then being able to figure out how we can show up for our kids, our families, or our kids who are looking up to us or looking to us for support. And on that note, I also wanted to invite everybody, everybody is breathing now, hopefully, but I wanted to invite everybody to take a breath with awareness together now and this sense that taking the next breath, focusing on the breath and knowing that you're breathing and noticing the difference between the breathing that we do every day, every hour, sleeping, waking, parenting, not parenting, yelling, calm, and what it might feel like to take a breath with awareness. And that's a skill that I think takes a lot of practice and is really worth trying to access now because there's not a simple parenting tip or strategy I can say will work in every situation or for every family or for every kid or even for one family or child all the time. There's a lot of flexibility required and I think the flexibility is born from awareness of what's happening inside of me, what am I feeling right now and what's going on with my family, my kids, the people around me in the situation. And we don't often make space for that. So actually taking time, even if it's one breath for one minute or one walk or one nap or whatever the space is that one can make to build that awareness. It's going to model and it's also going to feedback becoming aware of what your child's experiences or your children. And that I think is probably the key to a lot of pandemic parenting is tuning in to what's going on with your children. So getting myself in a place where I am open to listening and being an active participant in their experience will allow me to see what might be needed in that moment, whether it's a peanut butter and jelly sandwich or a walk outside or some extra screen time with their friends, whatever it might be. In the second underlying principle I would highlight is the individuality of it all. I think Tom and David to some extent both highlighted developmental changes in the sequence and how this isn't going to be the same for a three-year-old or a 13-year-old or a 23-year-old and within that span every 13-year-old is not like every other 13-year-old. So remembering that you're an expert on your kids and your family and taking the millions of websites and recommendations that are being floated around and picking the ones that are useful to you reminds me of with my wife and I raising our own kids and there's so many parenting manuals and guides and we decided we're just going to pick one. It may not be the best one, but there's a good enough one for us and we're going to stick with that so that we feel some comfort and this is our path and we're going to stick with something that's familiar, some guidance. So figuring out what works for your individual family without being overwhelmed always. Am I doing the perfect thing all the time? Good enough is good enough. The last point I try to underscore is recalling our values which probably haven't shifted too much because of the pandemic and values is not just the things that we value but it's also the situations and the people that help us to feel valued. The interactions where we feel as if we matter and some of those will be with our kids, some of those will be with our friends or with our colleagues. The part of that ripping the rug out from under our quote-unquote normal lives is that the places where we usually find a sense of purpose may no longer be there, whether that's employment or whether that's a part of our parenting that we cherish or whether it's a relationship with somebody who we may have lost to death. We may have lost to distance. There have been so many losses during this time and so much uncertainty. So coming back to the situations that bring us a sense of meaning and what matters I think is important no matter what we're doing. On the next slide I've tried to highlight loss itself because it's so ubiquitous right now and there's the maybe more obvious loss of those of us who are grieving or dying or have lost loved ones. And then there's a lot of hidden losses about our routines, not so hidden losses of jobs and financial stability, losses of connections and mental health supports. And I think that the theory of the five stages of grief and grieving or death and dying are different books written about it by Elizabeth Kugler Ross who created and David Kessler who's added a lot. I am reminding myself about these stages because I think they're applicable to a lot of what we're experiencing. I've listed them here, denial, anger, bargaining, depression, acceptance and potentially meaning making. And I put wash, rinse, repeat because this is not a linear process. David Kessler, one of the authors on this topic describes it as a description of the stages, not a prescription. This isn't a surefire pathway to get through the pandemic or death or loss. But it's a description of common human experiences when faced with tremendous losses and uncertainty. And each of us may be at different stages of this at different times and getting out of sync if somebody is at acceptance and somebody else is at denial. That's a hard fit. We also may cycle through stages of it over the course of a day or a week. I've been thinking in my own family sometimes it's not a question of, you know, is there going to be a meltdown today or this week? It's whose turn is it today to have a meltdown or how many of us? And so recognizing that I think is important because if it goes unnamed then we can't address it and we can't support each other and it just kind of grows in its power to make us feel small or ashamed or unsupported. And I put on here in relation to kids some of the unseen losses that are driving the kids to practice as are some of my best conversations with my kids or teenagers, you know, before and after class talking to their friends and catching up or with a teacher or a coach or an important mentor. So to recognize that all those things can't be replaced or recreated but to acknowledge the loss and think about how those supports might be derived from other sources. I'm probably aware of but maybe haven't had a conversation with our children that recognizing that they're feeling that too. Right. And holding some space for recognizing the stages and then for me it's a lot easier to be like, ah, they're in bargaining. They're trying to think, well, maybe I can go outside and play with my friends if, you know, if we keep three feet apart, that's probably safer. You know, some of that is just dealing with what are the health ramifications of COVID-19. Some of it is, how can I get back to some sense of normalcy or reclaiming things that I might have lost. This next idea about negativity bias is also to recognize that we have this built in mechanism for seeing the negative for being critical if not hyper critical for seeing the flaws. It comes from a good place that this is a survival mechanism. This is how we kept the tribe alive, kept ourselves alive by being on alert for dangers, for threats, for negative things in the environment for things that wouldn't work. So because it's built in, it's helpful to not beat yourself up about having a negativity bias when the world has become appreciably more dangerous. Now we're getting messages from reliable sources that say, try not to go outside. Try not to be close to people. And those are sometimes unfounded fears, and right now they're more founded than usual. And so having that negative part of our brains, the worry part, and the parts of the brain that David mentioned in terms of our sort of reptilian or more ancient brain survival modes and hyperdrive right now is just a normal response to times with very abnormal circumstances and the emotions listed here, scared, angry, sad, confused, overwhelmed, those are normal responses. So the first thing about what can I do is don't just do something, stand there. Kind of turning the familiar phrase on its head to circle back to awareness and bring your awareness to what is this experience? How is it affecting us? How is it affecting our children, our parenting, and our connection? And that there isn't always something to do. Some of the losses we've had can't be reclaimed or reinvented, and we may have to find new ways to connect or new ways out of this or new ways to tolerate these unusual levels of distress. Next it requires a lot of flexibility and recognizing that it's not about getting through stage one of denial and then I'm done with it. It's going to cycle back, the emotions are going to be up and down, and that's why awareness is needed almost all the time because there's not one recipe, it's not a linear course, and neither will it be for our kids who are going to shuffle through their understanding based on their developmental stage, their cognitive capacity to make sense of it, so bring some awareness to listening what's going on in ourselves and others. And finally, if all else fails you can just focus on the negative. So this technique comes out of stoic philosophy that I find helpful to share is called negative visualization, and it's essentially a gratitude practice flipped upside down where instead of saying for what am I grateful, I take a little time to imagine some of the important things as if they were losses. What if I didn't have this forum to speak to my colleagues? What if I didn't have Zoom so I could keep seeing the patients and families that I work with? What if I didn't have my wife at home taking care of the kids so I could be doing this job? What if I didn't have this job? So on and so forth. Not dwelling on the loss itself but allowing some feeling of appreciation that when I go home and see my wife and kids, thank goodness that they're still there, that I have them when I have the opportunity to speak with you all and hear and learn with you that I'm very grateful for that experience. So negative visualization can be a nice counterpart to a gratitude practice of focusing on the positive things. And finally and fundamentally, all promotion or health maintenance, the basics that without these it's hard for any human to function while getting a good night's sleep, having a consistent sleep routine, not buying into the myth that we can catch up on sleep, certainly not after a marathon pandemic like this. Is there going to be a chance to catch up on sleep for a few months or a few years, making sure to fuel the body? I like to think about putting into our bodies what we want our bodies to be made out of. So there's no particular pandemic diet but just thinking about how what we eat and drink is affecting our well-being and our balance. Moving just turns out to be important for brain health and balance and social connections. So whatever way that is that maybe gardening, maybe cooking, stirring the pot together, maybe going for a walk, but all of those things count and connecting. Again circling back to the people where we get a sense of value, being valued, mattering, we matter to us, we matter to them, the people that believe in us. And then the bonuses here which I would include finding a space for stillness or what some call mindfulness doesn't have to be a formal meditation practice, but finding some kind of peace of mind however one does that. Reading is a great sort of retreat and practice and coming back to your own classics. What are the books from different stages of your life that have seen you through? Some ups and downs and introduce you to ideas or characters that are helpful. And then lastly music. This is kind of movement for the mind, whether it's dancing or singing or playing music. Those are all ways that we connect to ourselves and connect to one another and allow us to also be centered in that awareness that I was mentioning from the beginning. I think finding options amongst these and trying to tend to the basics even in time of crisis is quite important for ourselves and helping our kids with these routines. And thank you for giving us that visual representation in the beginning when we were talking about the oxygen mass. Because if we as parents can't find at least an opportunity to do some of these things that you list here, then we're going to be in more jeopardy to be able to support children as well. Speaking of children, we've been talking about kind of a wide range of the ages of our children. There's no doubt that we need to be considering what's happening with our undergrad population and our graduate students here at UVM as they are scattered all over the United States back at their homes as well. So Annie Valentine joins us as well just to give us a glimpse of the kinds of conversations that you're having with our undergrad and graduate students and the particular challenges that they're facing and some opportunities to support them as well. Thank you. I hope I'm loud enough and I'll see my best to be clear and succinct and just want to thank the presenters that came before me and capturing some of the things that I am gathering from our students. In the past few weeks, not trying to make assumptions as an educator around what our students need but really listening to them and not getting a better understanding of what they are experiencing. But I wanted to go over just a few of the vulnerable audiences that we know are experiencing this pandemic in some different ways and that we're paying attention to. So our BIPOC students, so Black, Indigenous, people of color, are international students who make up a small portion of students who are still on campus and might be experiencing some targeted responses due to people's perspective on this pandemic. Our seniors, so students who are getting ready to graduate and as we talk about grief and loss that we're experiencing that on many levels, but that, you know, working really hard to get new degree and then not having that community experience. It's really challenging. I'm sorry, I put that twice for the BIPOC, but also our LGBTQA population. I've been following the chat here and thinking about students returning home to spaces that might not feel safe, where they feel supported or where they have maybe come out or to their families or are in the midst of going through transitioning and so what does that feel like and what does that mean for them? Students with learning disabilities and trying to maintain their academic performance and struggling with different platforms as we all are in different ways. Students with ongoing mental health challenges, as Tom mentioned, and I have a weirdly colored purple shirt on today, but I am wearing this intentionally as today is the first National Accredit Recovery Day. We are really trying to support our students who are in recovery from substance use disorders. During this time, as Tom mentioned, increase in substances might happen for those who don't necessarily have a substance use disorder, but then those that might be working their recovery and having this be a really challenging time to find connection and to maintain that. And so I just really want to give a shout out and acknowledge the journey that those students might be on. And so again, this is not exhaustive, but these are some of the students that we are considering. And then what are the experiences that are happening? And again, the presenters before me have highlighted some of these. But these are some of the things that I've been hearing directly from students, as well as other colleges in terms of their company centers and sitting in webinars to kind of get a collective understanding. You know, feeling disconnected, feeling isolated, but grief and loss for many different reasons. The overarching anxiety and fear and worry about when will this end, what will be the follow up, and then the financial burdens that come along, potentially after it, whether it's because of our family members and their job loss or financial aid and how they're so much unknown. So we're looking at that conflict at home. So maybe you have gone to college, leaving conflict that had already been there. But then there's also the conflict that might be arriving because of this new living experience. So either way, there might be some tension and thinking about what your privacy is and how do I find my independence in some of this new living when I have left home and been living on my own. And the choices and decisions for myself and now that is shifting. Again, not what next he's relationship problems. Right. So I am in a relationship with someone I don't see or can't touch. I don't have that, that, that connection in the way that I once did. Again, thinking about issues of bias and racism, microaggressions that might happen through technology. We are always sharing a slide moments around the different programming opportunities that we are providing that also we open to lots of different ways that people can come into technology behind a screen and commit kind of work and act by racism, microaggression, xenophobia, things that we are trying to manage while trying to provide supportive places for our students. Managing that online learning, I think that's all across the board from faculty, staff, students trying to figure out how to do it how to create a schedule for themselves the technology challenges and then the other light stressors that are just going on that are not related to COVID and in the virus right so that there's other losses there are other things that we are managing and then let's just get compounded. And so these are just a very brief glimpse of what we appear in our students saying they're experiencing and then also having them share with us what what would be helpful and what they're needing. So, I've been reading some of the comments in the chat around what are the ways that we can support our students and. And so, and also knowing that the age of 18 to 24 is that vulnerable time and the onset of mental illness actually kind of is heightened and so how do we pay attention to validate. These feelings to really listen when a person is saying that they are struggling that they are, you know, feeling hopeless and despair we know that those are really strong signs to pay attention to. You're also seeing that students really want an opportunity to connect face to face. And so, we might want to create we being educators of webinar or something that's recorded, but they really want to see our face to see us. So, we're trying to have our homes and have this kind of vulnerability together to share in in this experience together so that's something that we're trying to work with on the university, helping them create a routine. I also recognize that we can try for the best, not perfection. I think perfectionist thinking outside of a time like this is really hard to manage, but then also trying to stay to par and doing all the things perfectly is just a really hard thing to do and so resisting that pressure, helping to validate that this is difficult and to work the best that they can and to reach out and also have people reach out to them. Understanding that self care and the collective care. I think, again, I think Dr. Rubens have talked a little bit about the gratitude and how much that that really help our sense of self and connectedness and so how are we thinking about ourselves about an individuality but that was part of a larger community in the global world right now that it's really going to be time time. When that news exposure and when they ask us to Facebook or Instagram again and think about all the different parenting headlines and styles and things that we think we should be taking care of during this time but we're lowering expectations and doing what really feels good for us in these moments and paying attention to that. And then going to those still safe offerings. So, again, at us at the university what we can be offering for our students virtually that we try to offer to them in their experience on campus, the multitude of offices within my division and also other divisions across campus that are really trying to support the student holistic experience at EEM. No it's not just their academic life, but their full social and spiritual life and environment. So how do we provide some of those offerings. This was a brief survey that we got off of my well-being and I thought it was just a glimpse again of what students are saying that they are meeting and wanting and it looks like that FaceTime and video chat is really important. So seeing people's faces, seeing expressions, seeing a tear in someone's eyes or seeing someone feel some emotion is a really important piece of connectedness during this time. And then these are just some resources that you'll see on the left or right side of each other when you're looking. Some of the UVM resources that we have. So our Center for Health and Well-Being is our main area where we provide counseling and psychiatry services, our student health services, the office that I'm a part of which is Living Well Education and Outreach. And then Athletic Medicine is another arm of that, but really trying to make sure that we are providing telehealth to our students through faith-to-faith opportunities. Having mental health resources available and then doing some of those virtual programming opportunities, trying to set up some spaces where students can talk about the issues that have been brought up throughout this webinar. I wanted to also just, I know Dr. Rosenfeld and you need to get going soon. And so I just wanted to give an opportunity, some of these resources also listed like the Family Dinner Project and Common Sense Media and Smiling Mind were ones that you shared with us as well. Do you want to just touch on these quickly before I know that you have to access them? Sure. I would just add that starting at the top of the NCTS and the National Center for Drama and Stress, it's a network of people who are experts in this area put together a lot of resources. And this one is, that link here is relatively comprehensive. And I know there are some questions on the chat about managing kids who are having difficulty or parents who are having difficulty even before the pandemic crisis and how to address that. So I think that to achieve is helpful, thinking about that globally. The Family Dinner Project is capturing the idea. In some sense, I think what David's getting on the chat box of while there is a possibility for some traumatic stress related to this, there's also equally a possibility for traumatic growth. For many of us, the most meaningful experiences of our lives are also some of the most difficult and they turn us around this corner and see we're coming. So the Family Dinner Project is an idea for using this forced family time to find some joyful family moments to connect over eating and cooking, shopping to the extent that we can do that and time together conversation. I think a lot of parents have struggled with screen time and software management data that that's how kids are connecting. So where do we set all the limits are kind of off the window and common sense media has a ton of useful stuff on education, homeschooling and screen time. I think this link is a particular article addressing the difference between quantity of screen time and quality of screen time and the science that's pointing toward it matters what you're watching and how you're watching and with whom you're watching. Not just how much. Smiling Mind is I think my favorite mindfulness app because it's free. There's not even options as subscribed so it comes out of Australia and it's developmentally sensitive and that there are meditations for different age groups as well as different settings. So if you're three years old or you're an adult, you can find something there for you so you can download that if you're looking to use to find some stillness. And the other ones I don't think are links that I suggested but also have a lot of great resources, some geared toward specific populations and some applicable to everyone. And Dr. Rosenfeld, before you go, I just wanted to recognize something you did mention is the varying age groups in your household and the different challenges that may present from a mental health and wellness perspective. And I know Dr. Sassi was guiding us through neuroscience and behind what is happening in the brain development of our children. I know you, Dr. Rosenfeld, have varying ages of your children. What's some advice that you might give for parents that are trying to navigate preschoolers all the way to middle school to undergrad populations? How can you best approach that as a parent to help them through this? That's a big question. I think so being developmentally sensitive means paying attention to where your child's mind and body are in the same way that you wouldn't teach a six month old to ride a bicycle. You also have to be aware of things like David was mentioning before, the cognitive level of difficulty, the social skills. And at the youngest in the spectrum for infants and toddlers, you may not need to change too much. They're pretty resilient and adaptable and pretty egocentric in the sense that the natural state of the mind at that age is to kind of see the world as revolving around me. That's how it goes. So they'll notice changes in routine and they'll benefit from routine, but they don't require a lot of explanation of why you can't go to the playground anymore. They may require still some attention, some fun activities. Whereas as kids get older and their minds tend to develop the capacity to think more abstractly and to reason through things, they're going to be overhearing what parents and caregivers are talking about what's there on the news. And so there's some more caution in monitoring their exposure to those things and even to what older siblings are saying. And also some more space for noticing what their questions are. And school age kids might get into fears of, you know, what happens if I get sick and what can I do concretely to help with this and what happens if mom and dad gets sick or grandma and grandpa? Or will I ever see my teachers again? So those would be typical kinds of fears at the sort of monsters under the bad stage of younger kids. As kids get older, more toward like between and middle school years, they start to develop more abstract thinking about what this means for the world, about what this means for climate change, about what this means for their future going into high school or going into college. And so there's an opportunity for maybe more anxiety there, but also more problem solving and it's a really spirited time of life. So that's doubly hard when you're trapped in the house. The kids are finding new ways to connect on, as Annie mentioned, through social media and other fora. And that's a time when kids are meant to be out exploring and taking risks. So being confined to the home is hard. Looking for new ways to help kids explore and take risks to some extent is, I think, a challenge for all of us for the older side of the population. And it just all requires a lot of flexibility. Absolutely. Flexibility and a lot of patience and recognizing as a parent that you can take a break as well. I have found in my house that I've been trying to take walks by myself that need that space, sometimes need that time to be able to recharge, as you mentioned at the beginning. We need the oxygen mask for ourselves as well as parents. Hopefully everybody comes out of this with a fuller appreciation of the full-time work that is parenting or that teachers are doing every day. And that now parents aren't getting any time off. It's kind of a 24-7 job. So, yeah, finding a way to take a break is only route to sanity, I think. Yeah, absolutely. Thank you so much for being with us. And I know you do need to go if you need to sign off with you and we so much appreciate your time today. We are going to wrap up here for everybody. I just wanted to recognize Tom, can you just share with us? There's a lot of resources on this slide. And thank you so much, Tom, also for putting those into the chat boxes today too. But just maybe give us an overview of what we are seeing here and resources for folks here in Vermont and beyond. Yeah, absolutely. So for people experiencing mental health crisis, calling the National Suicide Prevention Lifeline is free, confidential, and they can connect you to services here in Vermont. So that's 800-273-8255, which is 273-TALK. And then the crisis text line is also free, confidential. And, you know, if you don't want to actually talk to people, texting is a great way to go. And that's just text VT to 741-741. And then a lot of the remaining resources are specific to specific populations. But we should probably all know and be sharing the Suicide Prevention Crisis Line, Lifeline, and we should be sharing the crisis text line as well. And I know there's, by different counties and different areas around the state, here are more resources for folks in different parts of Vermont. We will also be sharing all of these and follow-up, you know, with a reporting of this presentation, so to make sure that you have access to those as well. I did also want to share that the University of Vermont has many resources, and I know that Annie has listed many of them for our undergraduate students as well. But if there's questions surrounding on campus various different questions, the University of Vermont has a lot of information on the Office of Emergency Management, the University of Vermont Medical Center also has a COVID-19 page that has a lot of resources. And then if I can hark back to Dr. Dan Carney, always her suggestion to make sure that you're getting information from the most evidence-based sources in terms of the Centers for Disease Control and Prevention, the CDC, the World Health Organization, the Vermont Department of Health. Before we say goodbye and thank you to everybody, I did want to share to folks who are participating today, we have an opportunity for you to earn a digital badge, a learn and earn for your participation today. And we have a link here on the screen to claim the badge and just a quick information, what is that? What do I mean by earning a digital badge for participation? It's a way to demonstrate a learning experience that you have gone through today. It is something that people often put on their LinkedIn, share socially as a credential for your own personal and professional development. So we wanted to share that opportunity for you taking the time, the hour, out to have this important discussion and learn from our panelists to actually have a digital badge and a credential for your time today. Trying to give an opportunity to parents to show how important and how much we value your time as well. Thank you all of you and I know Andy Rosenfeld had to sign off, but thank you so much Dr. Tomasi, Dr. Tom Delaney and Annie Valentine. Thank you so much for your time, for your resources and your wisdom and your patience today. I know everybody has found a lot of value in what you presented and we really appreciate your time. I'm going to sign off with everybody. As we've mentioned, we will share this out. All folks who have joined us in RSVP, we wish you the best in health and patience and find those opportunities to find some gratitude in your day. And we wish you well and we'll hope to see you again soon. Have a great afternoon.