Clinic Spotlight: J. Nathan Copeland, MD

J. Nathan Copeland, MD, Helps Children and Families Struggling with the ‘Next Wave’ of the Pandemic

Between 2016 and 2020, the number of children ages three to 17 years diagnosed with anxiety grew by 29 percent, and those with depression by 27 percent, according to a US Department of Health and Human Services study published in the Journal of the American Medical Association Pediatrics. Even before the pandemic, research had shown that nearly half of autistic individuals also have anxiety, and many are diagnosed with another mental health issue. The findings suggest concerning changes in child and family well-being after the onset of the COVID-19 pandemic.

“The pandemic has been hard on our children, but for autistic kids, it has been particularly difficult — with the constant changes in routines, structures, and resources,” says Nathan Copeland, MD, MPH, assistant professor of psychiatry and behavioral sciences and a Duke Autism Clinic psychiatrist. In the second year of the global pandemic, Copeland and the clinic’s team of providers, including psychologists, psychiatrists, social workers, and nurses, navigated the exponential surge in need for mental health care services and supports by adapting behavioral health care therapy and evaluations to the Duke telehealth platform.

“COVID, ironically, has made us leave our walls. When patients could no longer come to us, we had to figure out how to go to them. The more we can tear down the walls, the more people and the community can be let in,” said Copeland. “Our ability to pivot to telehealth has made it easier for some kids to receive care. Telehealth has broken down some barriers — like the barrier of distance and the barrier of disrupting a child’s day — and it has been critical in our ability to provide care to kids who might struggle mightily with changes in daily routine.”

Although telehealth allowed clinic providers to pivot and meet families’ needs, two years later, as Copeland explains, “Things are still not back to the way we were before, and for many stressed families, they just do not feel there is an end in sight.”

In a Duke Health Media Briefing, covered in multiple national news outlets, Copeland and Gary Maslow, MD, MPH, associate professor of psychiatry and pediatrics and co-director of the Division of Child and Family Mental Health & Community Psychiatry, explained the current crisis, calling it the “next wave of the pandemic.”

“The amount of resources we put into fighting COVID, a fraction of that would make a huge difference in making treatment available for those who need it, and for supporting parents and families so they can care for their children,” Maslow said. “There is beginning to be momentum at the federal and state level to do that, and hopefully at the local and community level we can sustain that and really have a robust response to say every child who has a mental health condition needs support.”