By Prof Cathy Creswell, University of Oxford
Prof Eamon McCrory, University College London
Prof Essi Viding, University College London
Prof Ian Goodyer, University of Cambridge.
8 July 2020
Between 50% and 75% of all mental health problems seen over the life-course have their origins in the first two decades of life. Prior to the COVID-19 pandemic, the prevalence of mental health problems in childhood and adolescence was already high, with marked increases recently observed in emotional problems, particularly among female adolescents.1
While viral risk to child and adolescent wellbeing during the COVID-19 pandemic has been markedly low, with 1 death per 5.3 million children, the impact on mental health on young people is likely to be substantial. Several factors relevant for mental health are important to consider including:
- Isolation and loneliness increase risk of depression and anxiety in children and young people, with impacts evident up to nine years later.2
- Disruption to routine contributes to less organised and unpredictable environments, sleep disturbance, and reduced physical activity all of which can have an impact on mental health.
- Family stress is already known to be elevated at the current time, with parents particularly likely to have experienced high anxiety and a range of stressors during lockdown.3,4,5 This in turn affects the ability to support and meet the needs of children and young people, especially those with higher levels of prior need.
- Domestic violence and maltreatment are at the extreme end of parental dysfunction and have increased during the pandemic. 6,7
- Bereavement will be more likely for many. For some this will have been traumatic, increasing risk of prolonged or complicated grief, with a significant and enduring impact on everyday functioning.
- Reduction in support networks, including school and community networks and access to services that support mental health and provide safeguarding.
The overall effect of these stressors and reduction in supports is likely to be particularly pertinent for children and adolescents who are at critical stages of developing the social and cognitive competencies that provide the foundation for current and later mental health. Indeed, there are already early indications of negative mental health impacts of COVID-19 and distancing measures on children and young people.8,9,10,11 Those with prior vulnerabilities (e.g. mental health problems, prior trauma) and particular vulnerabilities in the COVID-context (e.g. BAME, looked after, and shielding children and young people) are likely to be most affected, yet may face particular challenges in accessing and engaging with support during the pandemic.
Immediate action is needed to:
- Support all children and young people in returning to school as soon as possible, recognising the broader functions of schools beyond provision of educational content (e.g. social, emotional, creative, safeguarding etc).
- Deploy a preventative approach to mental health by increasing wellbeing through a programme of summer activities that will enable young people to connect with peers, re-establish routines, and be actively engaged beyond the home.
- Ensure safeguarding, bereavement, and mental health needs are promptly identified and evidence-based provision is made available to those who need it.