Two children per classroom will lose a parent or sibling before age 18, experts say

Crisis care is severely lacking in the commonwealth as the state’s children face more risks related to gun violence, overdoses and mental health issues: that was the message child advocates and care providers delivered to the House Children & Youth Committee in Harrisburg Wednesday. 

As the COVID-19 pandemic has persisted for nearly three years, rates of gun violence, drug overdoses and mental health issues have skyrocketed in urban and rural areas alike. Just recently, as many noted during the hearing, gun violence has become the leading cause of death for young people. 

“Firearm-related deaths have now overtaken automobile accidents as the leading cause of death among children in the U.S. and here in Pennsylvania,” state Rep. Sheryl Delozier, chair of the House Children & Youth Committee, said to start the hearing. “More and more of our children are dying from being exposed to violence, suicide and other severely unhealthy behaviors.”

Lawmakers heard from grief, pediatric health and legal experts on a variety of threats children and youth are facing today. The common theme among testifiers was clear that children are experiencing worsening and complicated risks related to physical and mental health while resources for preventative care and support groups are severely lacking. 

Teresa LaVallee, director of Highmark Caring Place, a center for grieving children and families, said family situations have gotten significantly more complex during her more than two decades working with those experiencing grief. 

In recent years, LaVallee said, the center has seen more instances where grandparents are raising their grandchildren after their parents' deaths. 

“(Death) impacts their lives in so many ways. Oftentimes they experience financial struggles if a parent dies and you go from a two-income family to a single-income family,” LaVallee said. “(There are) obvious impacts in living arrangements. Oftentimes they have to move. Sometimes (they) move to a different state so that the family can get help from extended family members, which then also means a change in schools, a change in neighborhoods and a change in friends.”

LaVallee noted that one in 13 children in the U.S. – about 8% – will experience the death of a parent or sibling by the age of 18. In Pennsylvania, that figure is one in 22 children, which equates to more than 122,000 children, or 4.6% of children in the commonwealth. 

“That’s about two children per classroom,” LaVallee said. 

With so many children experiencing traumatic experiences, mental health care has become increasingly necessary for youth. 

“We talk about the physical aspects of gun violence all the time, but what we don't necessarily realize is that there is a huge amount of emotional, mental health and entire ripple effects of violence that we see in our communities,” Dr. Joel Fein, co-director of the Children’s Hospital of Philadelphia’s Center for Violence Prevention, said. 

Fein noted that in Pennsylvania in 2020, more than 1,700 people were killed by a firearm and that 60% of those deaths were by suicide. “That (statistic) has the highest per capita in rural areas of our state. Gun violence is not a problem of just cities in Philadelphia and Pittsburgh … it’s a problem across the entire state of Pennsylvania,” he said. 

These troubling statistics have coincided with calls from advocates and experts to policymakers to collaborate across sectors to provide better preventative programs. 

Jennifer Dee, vice chair for administration at CHOP’s Department of Child and Adolescent Psychiatry and Behavioral Sciences, said it’s “imperative” that legislators, clinicians, and community-based organizations work together to find solutions for these vulnerable communities. 

Dee noted that after firearms, suicide is the second-leading cause of death among those 10 to 24 years old. 

“In the first half of 2021 alone, children's hospitals recorded cases of self-injury and suicide in children ages 5 to 17 at 45% higher rate than during the same timeframe in 2019,” Dee said. “And for children under 13, the suicide rate is twice that for Black children than for white children.”

While implementing programs to prevent these instances of violence and drug overdose is necessary, Dee said, the strains that gun violence has on the health systems and the community members affected by it can also be seen in the behavioral health space, where care is also lacking. 

Dee noted that Pennsylvania has just eight child and adolescent psychiatrists for every 100,000 children in the commonwealth. In closing, the testifiers implored lawmakers to do more on both ends of this issue, where preventative measures are taken to prevent tragedies and extra support is given to those working with individuals dealing with one of the worst days of their life. 

“You hear about violence prevention, and it’s a wide spectrum,” Fein said. “We provide food, provide housing support, provide mental health care. We do all of that because we know people who are affected by (violence) cannot possibly rise up from it without basic, foundational help in their lives.”