Children and youth bear the burden of Covid-19

This article was written by Canadian health professionals, Brae Anne McArthur, Nicole Racine and Sheri Madigan (The Conversation Credit: Shutterstock). They report on the situation in Canada but there is no doubt that their findings may be shared globally.

The authors find that not only did youth mental health difficulties increase during COVID-19, but they became more prevalent as the pandemic persisted.

For most children and adolescents, the past year has been a shadow of a typical childhood. Instead, there have been strict stay-at-home orders, repeated opening and closures of schools, social distancing from peers and other supports, limited or no access to sport and extracurricular activities, and many missed milestones such as graduation. more

During this time, the family unit has been in crisis as well, with financial instability as well as increased psychological stress for caregivers. Independently and collectively, these events can catalyse mental health difficulties in children and youth.

At the beginning of the pandemic, children and adolescents were the lowest-risk group with regards to medical concerns and complications from COVID-19. Now, over a year into the pandemic, they have emerged as the invisible casualties of this global crisis.

Sounding the alarm to a youth mental health crisis

Many clinicians and child-health practitioners are calling attention to a youth mental health crisis. Recently, national children’s charity Children First Canada declared a #codePINK, a term commonly used in health-care settings to indicate a pediatric emergency.

Many pediatric hospitals have reported a 100-per-cent increase in admissions for mental health problems, upwards of a 200-per-cent increase in admissions for substance use and suicide attempts, and report that 70 percent of children and youth have indicated that the pandemic has affected their mental health.

Our child psychology research team sought to better understand the current state of children’s mental health globally, one year into the pandemic. This research summary, published in JAMA Pediatrics, shows that globally, one in four young people is experiencing clinically elevated depressive symptoms, while one in five is experiencing clinically elevated anxiety symptoms.

These rates are all the more alarming when compared to pre-pandemic estimates, which were closer to one in 10 youth having clinically elevated anxiety and depression. This indicates that youth mental health difficulties have likely doubled during COVID-19.

Child and youth mental health distress may be sustained long term

When we looked deeper into which youth were struggling the most globally, we found that—consistent with pre-pandemic data—females and older youth were at greater risk for both depression and anxiety difficulties.

We also found that mental health difficulties were more prevalent as the pandemic persisted. This suggests that as the length of the pandemic continued, along with public health safety measures such as school closures and social distancing, clinically significant anxiety and depression symptoms also increased. This indicates that children and youth globally are struggling with mental health difficulties, and their symptoms are worsening as the pandemic continues.

What can be done to help children and youth?

As researchers and psychologists, we are left wondering whether mental health difficulties in youth will continue to persist for years to come. Will their mental health deterioration be one of the most profound impacts of the COVID-19 pandemic? We think so.

Children and adolescents who endured the various disruptions and emotional and physical consequences of the pandemic are the future of our society. To help foster their well-being and our prosperity as a society, now is the time to act to protect the next generation. We have identified three primary objectives for pandemic recovery efforts aimed at improving child and youth mental health.

Take action now

We can’t wait to make services available to children who are suffering emotionally. We must act now to address a near doubling in mental health difficulties for children and youth during the pandemic. There is a need for government to develop urgent and strategic plans to address the mental health of youth and ensure the provision of accessible and equitable resources to support this initiative.

Return to routine

Decades of research on child development has shown that children thrive in the context of clear and consistent routines and structure. Many of the strategies used to reduce the spread of COVID-19 have forced children and adolescents to stay indoors, resulting in disrupted routines, increased sedentary time (for example, more screen time, less physical activity) and a reduction in structured activities such as sports, camps and extracurriculars.

Keeping schools open and maintaining family routines during the pandemic can protect children’s mental health. It will also be critical to support families by ensuring they have the material and psychological resources needed to help their children.

Mental health supports for children

To address this ongoing crisis, there is a need for equitable mental health services that are accessible to all children and youth. Investing in new models of care that can be adapted to increase scalability should be prioritized. This includes group and individual telemental health services (mental health services delivered by phone, texting or videoconference) and brief intervention approaches. Emerging research awaiting peer review suggests that single-session interventions for adolescent depression during COVID-19 can effectively reduce feelings of depression and hopelessness among youth. Increased access to, and availability of, mental health resources are critical.

Children and youth represent our largest investment in the future. The mental health implications of COVID-19 have been particularly dire. Although there have been some COVID-19 recovery initiatives targeted at this group, we need clear and actionable items to move forward with a mental health recovery plan that will address the increased severity of mental illness in children and adolescents and the rising need for services.

Ultimately, the policy choices we make now will have long-lasting effects on the prosperity of the next generation of youth. There is an urgent and rising demand for child and youth mental health services in Canada. Parents, practitioners, allies and policy-makers need to come together to develop methods of mental health service delivery with widespread impact to meet this demand.

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Martin Doherty, writing for The Conversation, says that at the age of about four, children reach important milestones in brain development.

One of these is a huge improvement in understanding others’ thoughts and feelings. This is the start of empathy. Another is in spatial thinking—understanding how objects are positioned and related. This is the beginning of the ability to read maps.

Martin and his colleague, Catherine Sayer, conducted a study with 175 two to five-year-olds to explore how children are able to use scale models to figure out where something is in the real world. At about four, children are able to use a scale model of a room to work out where something is. We thought that this might result from children’s understanding of how one thing can represent something else. But we actually found that four-year-olds’ ability to use scale models came from their spatial abilities.

At the same age, children start to understand that someone’s behaviour is due to what that person believes, not necessarily what is really the case. This has interesting consequences.

If you’ve played hide-and-seek with young children, you may have noticed that they aren’t always very good at it. They love the ritual of looking in all the wrong places first, but beforehand they may tell you where they are going to hide, hide in the same place every time, or not be especially hidden.

After their fourth birthday, they get much better at hide and seek. They understand that the seeker looks in the wrong places because they don’t know where the hider is.

At about three to four children also start to tell lies. They realize they can make someone believe something that isn’t true.

Understanding symbols

Martin’s earlier research with fellow psychologist Josef Perner suggests that four-year-olds don’t just start to understand how others’ minds work. Figuring this out is part of the development of an understanding of “representation”—that symbols, like thoughts, words, or pictures, can be used to stand for something else.

Children start to think about how words relate to objects. This means, for instance, knowing that “animal” can refer to something you already have a name for, such as “rabbit”. This might help children learn the new word.

Their ability to use a understand the components of pictures also improves around this age. Very young children use a lot of trial and error to complete a jigsaw, picking up random pieces to see if they fit. By the time they are about four years old, they start to use the picture as a guide, trying to connect lines and match bits of colour, while checking the guide picture on the box lid.

Developmental experiments

Another ability children develop at around four is using scale models. A classic set of developmental experiments involved a model of a regular household room. The real room had typical furniture—sofa, table, cupboard and so on—and the model had miniature versions laid out in the same way.

Children were shown where something was hidden in the model and told to find an object hidden in “the same place” in the room. Children of around four can find the object using the identical layouts. If shown a sticker under a particular chair in the model room, for example, they can go straight to the “same” chair in the other room. This is the fundamental understanding required to read maps.

Adults see scale models and maps as representations. Maps represent a town or a country. A scale model of, say, the Eiffel Tower represents the real thing. At first, Martin suspected children’s ability to use scale models is more evidence of understanding representation at this age.

He was wrong. Instead, the researchers found that this ability is based on a development in children’s spatial abilities that also occurs at about four. This is the ability to think about spaces and where objects are within them. Spatial abilities help with maths skills, and good spatial ability is linked to an interest in science, technology, engineering and mathematics.

Their experiment was simple. They compared the model room task with a test of understanding how representation works. The two abilities develop around the same age, but they found they were not related. Children who could do one task couldn’t necessarily do the other.

They also had a test of purely spatial ability. Children who passed the model room task also passed the spatial task. So it looks like the model room task relied on children‘s spatial thinking.

They don’t yet know why two important but apparently unrelated abilities arise at the same time. Perhaps it’s related to changes in the growing brain at this interesting age.

Provided by The Conversation.

Image supplied by Freepik.