As children returned to school on 8 March, parental relief that home-schooling was over in England has been replaced by a new fear: of an increase in mental health problems among young people. The headline is that the pandemic is causing anxiety and grief in children and teenagers. But the situation is more complicated and, in some cases, more positive.
Research about young people’s well-being is minimal. As a Lancet Psychiatry article acknowledged in April 2020, “few studies around the world cover children”; most evidence about the effect of Covid on mental health concerns adults.
The findings of what studies there are regarding children’s mental health are mixed. One study of 168 children, with an average age of ten, in the east of England recorded an increase in depressive symptoms in July last year. Research by Russell Viner at University College London published in February this year, which analysed data from around the world, also concluded that children were showing higher levels of anxiety and depression when schools were closed.
But another study by the School for Public Health Research of around 1,000 children aged between 13 and 14 in south-west England found little overall change in anxiety, depression or well-being. In this second study, the mental health of those who were struggling in October 2019 had actually improved in the spring of 2020.
[See also: Mourning and melancholia: the psychological shadow-pandemic]
Many of the problems affecting young people’s mental health also pre-date Covid. According to Jamie Arkell, a consultant psychiatrist at the Nightingale Hospital in London, “the deteriorating mental health of young people has been going on for at least a decade”. Arkell points to data from the US, which shows the decline in young people’s mental health has been a trend since the appearance of social media in the mid-2000s.
In the UK, a report on self-harm published in February this year found the number of children aged nine to 12 admitted to hospital having hurt themselves intentionally increased from 221 in 2013-14 to 508 in 2019-20. In other words, adverse trends in children’s mental well-being have been evident since 2013.
One thing mental health professionals know for certain is that the psychological response of young people to the pandemic depends greatly on their socio-economic background. As Arkell says: “Covid is disproportionately affecting the bottom end of the social scale. In Queen’s Park, west London, for example, there has been what we might call a ‘Covid gift’ for some young people. Families live in nice houses. Children have gardens and new puppies. In some ways, the mental health impact of the pandemic has even been positive.”
That combination of hardship and home comfort has created a situation in which such privileged children may develop personal resilience: the pandemic has pushed them, but not to breaking point.
Living through a period of global upheaval might actually be the making of more fortunate children. They are learning to deal with feeling anxious, bored and lonely. They may not all be suffering from mental health conditions, so much as learning to deal with the realities of life. Covid could be the event from which they emerge as the most psychologically resilient of their generation.
[See also: Emily Oster on why reopening schools is the safest option]
The same cannot be said for other young people with fewer advantages. They are more likely to remain Covid Kids rather than become Generation Grit. Arkell returns to the example of life in west London. “Those who live nearby in Willesden Lane, for example, are facing a different world, of knife crime and hunger, issues made even more serious because of the pandemic. Naturally, their mental health is more at risk.”
Children from less affluent communities have been particularly vulnerable to the effects of school closures. According to Carla Croft, a consultant clinical psychologist at Barts Health, “some of our most at-risk children get some of their mentoring and protective adult attachments at school, so the situation is especially worrying for them”.
Headlines that portray all children as a “lost generation” because of the pandemic, and their poor mental health, risk exacerbating the problems they draw attention to. This is especially true in the case of reporting on suicide. A Lancet Psychiatry article in November 2020 warned that news reporting on suicidal behaviour can have a considerable influence on suicide and self-harm among young people, who are “more likely to be influenced by what they see and hear in the media, and are disproportionately featured in news coverage of suicide”. Young people are also at “increased risk of imitative suicidal behaviour”.
A more precise understanding of how lockdown has impacted children is needed if medical professionals are going to support those adolescents likely to emerge from the pandemic with mental health problems. As Croft said: “We are expecting 20-30 per cent of at least these more vulnerable people to have some form of diagnosable problem. It will be very important for us to truly give what some young people will need in what psychologists call the ‘recovery’ and ‘restoration’ phases after trauma. They need opportunities to make sense of what has happened to them and then time to reconnect with their peer group and the systems outside their homes.”
[See also: School closures further isolate a lonely generation – and the effect on children could be disastrous]
Arkell agreed that the most important aspect of helping vulnerable children is connecting them with the right networks of supportive mental health professionals, as well as sporting, cultural, religious and musical programmes, which research suggests protect young people’s well-being. “Adversity only becomes trauma when experienced alone, or without any support,” he said.
It may be a less dramatic message than those given by the headlines that currently dominate our coverage of adolescent mental health, but it is one we all need to hear.
Rachel Kelly is a mental health advocate and author of “Singing in the Rain: An Inspirational Workbook” (Short Books)
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This article appears in the 10 Mar 2021 issue of the New Statesman, Grief nation