The strict lockdowns that have been implemented during the worst global pandemic in more than 100 years affect 99 per cent of the world’s children.
While the movement restrictions are necessary to prevent the spread of COVID-19, quarantine can have deleterious effects on psychological health and wellbeing and many countries have reported a deterioration in the mental health of their populations. Children and adolescents whose needs are frequently overlooked during times of crisis may be particularly vulnerable to the psychological consequences of the shutdown.
Children and adolescents are mostly spared from severe medical complications associated with COVID-19 infection but disruptions to school and social routines coupled with rapid brain development mean they are at increased risk of developing mental health problems.
Early life is a period of high mental health vulnerability: half of all psychiatric disorders are established by age 14 and three quarters by age 24. Roughly 50 per cent of American teens aged 13 to 18 meet the criteria for at least one mental health disorder and almost one-third of them meet criteria for a “severe disorder.”
Mental health problems have serious consequences for school attainment and can disrupt healthy transitions to adulthood. They cost the Canadian economy more than $50 billion a year – with costs to the global economy expected to top $16 trillion by 2030 – making early detection and prevention critical.
Factors that normally protect child and adolescent mental health such as school routines and social networks have largely fallen away during this outbreak.
Polls show that children are worried. They report feeling anxious about family members becoming ill, missing out on school activities and falling behind in class. It is no surprise then that rates of depression and anxiety have increased significantly during the home confinement period.
Though many teens and pre-teens are able to connect with their peers virtually, the effects on their moods could make them less inclined to do so. Impacts of social isolation during childhood and adolescence can lead to negative changes in brain structure that persist into adulthood.
Particularly worrying is the worldwide surge in reported domestic violence cases. Children and adolescents living with domestic violence are more likely to experience emotional, physical and sexual abuse, to report low self-esteem, emotional and behavioural difficulties, substance use and mental health problems. Trends in gender-based violence indicate that girls are particularly at risk.
At the same time, more than 90 per cent of students worldwide have been affected by school closures, according to UNESCO, disrupting academic attainment. This matters because, in addition to affecting education and employment outcomes, educational attainment has life-long physical and mental health consequences.
Children from lower socioeconomic backgrounds are likely to be the worst affected by the school closures. Studies show that the academic attainment gap widens during U.S. vacation periods, amounting to an estimated one month of lost education for children from low-income backgrounds while no such loss is observed for children from higher income households.
School closures will also disrupt other vital services for children. Schools are an important source of nutrition for low-income students, even in Europe and North America, and pressure on foodbanks has increased sharply in Canada, the U.S. and United Kingdom since the coronavirus outbreak began.
Schools also provide counselling and mental health services. Closures will therefore lead to some children failing to receive care in systems that in many countries are already overstretched.
Mental health professionals advise clear and effective communication with children and adolescents. Without this information, children may try to fill in the blanks themselves, which may lead to misinformation and feelings of confusion, apprehension and guilt. Children as young as 2 are aware of changes around them and it is important to provide information at a level they can understand.
On a day-to-day basis, child and adolescent wellbeing is likely to benefit from regular routines that include consistent bedtimes, limitations on screen time, physical activity and a healthy diet. For younger children, offering a small number of healthy choices can enhance pro-social behaviour such as sharing and thus increase harmony within the household. Tips to help children cope and build resilience should also be considered.
The coronavirus outbreak has once again thrown a harsh light on health inequalities including mental health. The young may be especially vulnerable to the mental health impacts of the COVID-19 pandemic – but they also represent a wealth of energy and creativity and should be engaged and empowered as part of the solution.
As the world adapts to a new reality that may continue for months, or even years to come, now is the time for coordinated and decisive action to tackle this preventable mental health crisis among our youth.
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