PPA Mental health tips

April 2021

Dear PPA families,

We are honored and privileged to provide medical care and support for your children. The global pandemic has forced change upon all of us and we want to express our appreciation for your willingness to adapt to the changes we have instituted within our office.

During the last year, many of you have shared stories with us about the unexpected positive impact the pandemic has had upon your families. You have cited decreased commute time, more home-cooked meals, and more family time, as positive outgrowths of the pandemic. In contrast to this, we have seen an unsettling rise in consultations for mental health concerns as both parents and children have been impacted by anxiety, depression, and other mental health issues. In February 2021, a study published in the JAMA Psychiatry confirmed our observations. The study found that, across 190 million ER visits between March and December 2020, there was a significant visit increase in consultations for mental health conditions, suicide attempts, and drug overdoses. As your child s medical home, we at PPA would like to combat these trends with you since we believe that your awareness and vigilance are irreplaceable safeguards for the mental health of your children.

Most families have been spending more time together as parents work and children study at home. However, electronic devices have distracted and disturbed meaningful conversations within the family. Therefore, although family members are physically close, family communication is often inadequate and fragmented.

In our busy lives, creating space for connection requires awareness and planning. In the remainder of this email, we will discuss a simple daily ritual that can serve to nurture this connection and ultimately prove to strengthen the health of your child and family. We are starting with a simple suggestion. As Paul Coelho wrote in The Alchemist, The simple things are the most extraordinary things, and only the wise can see them. 2

A tradition that spans all cultures and generations is a sit-down meal with family and friends. For a moment, picture what your family mealtimes look like right now. Remember that no family is perfect and that small changes in daily life can reap large rewards for both you and your children.

Numerous studies cited in the Archives of Pediatrics & Adolescent Medicine,3 Journal of Pediatrics and Child Health,4 and Journal of Nutrition Education and Behavior,5,6 have demonstrated that having a family meal more than three times per week will make a statistical difference in the psychological, physical, and emotional health of your child. The family meal can take place at any time but it needs to be regular and predictable. Please consider taking on the challenge of instituting a regular family meal at least three times a week in the months to come.

Set aside at least thirty minutes for your shared mealtime and treat it as a priority. Turn off all cell phones, computers and televisions so that you can focus on each other. Start your meal by giving thanks or sharing something you are thankful for. Remember that the daily practice of gratitude can produce positive physical and psychological effects. Studies conducted by Robert A. Emmons, professor of psychology at UC Davis and a leading scientific expert on the science of gratitude have concluded that daily gratitude can lower blood pressure and reduce lifetime risk for anxiety, depression and substance abuse. It can also facilitate sleep and improve immune function.7

Family meals also provide an opportunity to teach and encourage good nutrition. Each meal should include lean proteins, fresh vegetables, and fresh fruits. Meal planning and preparation should be done as a family and will teach your child discipline and the benefits of teamwork. Encourage each family member to participate in age-appropriate roles such as table setting, food preparation, cooking, and clean up.

The conversation should be intentional. This can be hard since we often use meal times to go through our To-Do List or to discuss conflicts. Save negative or difficult conversations for another time and let your meal times become a safe, combat-free zone. If it feels difficult to get the conversation going, place a list of conversation-starting questions in a basket at the center of your dining table. These questions can be about current events or celebrities or they can be personal questions like:

  • What was the best part of your day?
  • What was the worst part of your day?
  • What’s something funny that happened to you today?
  • What’s something that you daydreamed about today?
  • If you could be any animal, what would you be and why?
  • If you were in a spaceship what would you do for the first day? Where would you go?

Remember that we rewire our brains through repetition. Doing something over and over, no matter how small, has a huge power to create change in our thinking. With daily repetition, you will soon establish the habit of family mealtime.

As your medical home, we believe that you are your child’s greatest advocate. Check-in with your child each day and know that we are standing beside you to offer support and appropriate referrals if concerns should arise.

Please take a moment to comment on our Instagram (@ppa7001) or Facebook (@PediatricProfessionalAssociates) pages with your ideas for family meal time.

Best wishes,

Your Pediatric Professional Associates Medical Team



  1. Holland KM, Jones C, Vivolo-Kantor AM, et al. Trends in US Emergency Department Visits for Mental Health, Overdose, and Violence Outcomes Before and During the COVID-19 Pandemic. JAMA Psychiatry. 2021. doi:10.1001/jamapsychiatry.2020.4402
  2. Coelho P. The Alchemist. Harpercollins Publishers; 2018.
  3. Eisenberg ME, Olson RE, Neumark-Sztainer D, Story M, Bearinger LH. Correlations Between Family Meals and Psychosocial Well-being Among Adolescents. Archives of Pediatrics & Adolescent Medicine. 2004;158(8):792. doi:10.1001/archpedi.158.8.792
  4. Utter J, Denny S, Robinson E, Fleming T, Ameratunga S, Grant S. Family meals and the well-being of adolescents. Journal of Paediatrics and Child Health. 2013;49(11):906-911. doi:10.1111/jpc.12428
  5. Neumark-Sztainer D, Story M, Ackard D, Moe J, Perry C. The Family Meal : Views of Adolescents. Journal of Nutrition Education and Behavior. 2000;32(6):329-334. doi:10.1016/s0022-3182(00)70592-9
  6. Robson SM, McCullough MB, Rex S, Munaf MR, Taylor G. Family Meal Frequency, Diet, and Family Functioning: A Systematic Review With Meta-analyses. Journal of Nutrition Education and Behavior. 2020;52(5):553-564. doi:10.1016/j.jneb.2019.12.012
  7. Emmons RA, McCullough ME. Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology. 2003;84(2):377-389. doi:10.1037/0022-3514.84.2.377