COVID and the cost to children’s mental health
With the coronavirus forcing countries into lockdown and schools to close, children in particular have been impacted as their lives are disrupted
Before the UK went into lockdown in March 2020 to curb the rapid spread of the coronavirus, Ben* was an outgoing 14 year old who did well at school, played sports regularly, had a good social network and supportive parents.
Apart from struggling to cope with losing his two grandparents a couple of years before, Ben had never suffered emotional difficulties to any serious degree. A few months into the pandemic, though, separated from school and his friends, he started to become withdrawn. He stopped taking showers, became more and more reclusive, and his mum Katrina* noticed his mental health was in steep decline.
By September, Katrina suspected Ben had begun to self-harm, after finding broken glass and bloodied clothes in the top of his wardrobe. Things worsened and, despite her best efforts and attempts to get Ben the urgent mental health care he needed, in February the situation reached a crisis point. Ben was experiencing crippling panic attacks that stopped him from being able to do schoolwork. He eventually confided in his mother that he’d had suicidal thoughts, something he had never experienced before. “What could be more terrifying to hear as a mother?” Katrina asks.
Across the world, the coronavirus pandemic has hit mental health hard, the effects of which have been discussed to varying degrees in the global media and by institutions such as the World Health Organization. However, in many of these conversations, the impact on children has been notably absent. In the UK, a report into the impact of the first lockdown from mental health charity Mind found “more than half of adults and over two thirds of young people said their mental health has got worse during the period of lockdown restrictions”.
According to Tom Madders, director of campaigns at YoungMinds, the impact on children has been especially grave over the most recent lockdown period. “In a recent survey we carried out with young people, 75 per cent told us they have found the recent lockdown harder to cope with than the previous ones,” he says. “Many have told us they have struggled with social isolation, a loss of routine and the pressures of home schooling. Some are deeply anxious, have started self-harming again, are having panic attacks or are losing motivation and hope for the future.”
Research published in The Lancet in January corroborates YoungMind’s findings, with data showing an increase in incidence of mental health problems in children under 16, particularly among girls and young women. One of the report’s authors, Dr Tamsin Ford, professor of child psychiatry at the University of Cambridge, says this is especially the case for children in underprivileged environments.
“The risk is hitting those who are already most vulnerable hardest,” she explains. “We’re seeing a divergence between the affluent and less privileged. It’s one thing to sit in your house with a decent wifi connection when everyone has their own laptop, but it’s not the same as living in a small house with no outside space, locked at home every day while your parents have to go to work.”
It’s a trend that has seen referrals to Dandelion Time, a charity specialising in helping children and their families cope with mental health issues, skyrocket since the beginning of lockdown. The charity’s founder and a former GP Dr Caroline Jessel says referrals have doubled since the first lockdown. “In addition to this and perhaps more concerning,” she says, “is that the cases presenting are more serious, meaning our own referrals to safeguarding, when we think there’s a real risk to the child’s safety, have tripled.”
Ford agrees, noting that research shows people are presenting later and with more serious issues owing to the pandemic. According to Jessel, the long-term risks for these children are huge. “We so often see that unless these problems are effectively treated, the children will go on to struggle later in life, perhaps passing their trauma onto their own children,” she says. “It creates a cycle.”
Lockdowns have also interfered with children’s access to care. Dandelion Time’s novel approach aims to break the trauma cycle by reconnecting children with the natural world. Their ability to do this has been compromised during lockdown. “We have been able to continue working, but there have been times when we haven’t been able to see the families,” Jessel explains. “Contact has been more sporadic or been interrupted if staff or children may have to isolate. It’s been extremely difficult.”
The government’s recent announcement of £79 million in funding for the care of children and young people who need mental health support is reassuring. “The NHS has stepped up its support for children throughout the pandemic, including introducing a 24/7 crisis support line, face-to-face, telephone and digital appointments,” says Professor Prathiba Chitsabesan, NHS England associate national clinical director for children and young people’s mental health.
“I would encourage anyone worried about themselves or a young person to talk to their GP, health worker or a teacher at school and if you are facing a mental health crisis, please call your local 24/7 NHS all-age mental health helpline.”
A combination of going back to school and some medical intervention is helping Ben to feel more positive, but Katrina is adamant that none of this would have happened if it weren’t for the pandemic. “If he’d been going to school and maintaining relationships outside the house, I am certain we wouldn’t be in this position,” she says. Katrina believes Ben’s anguish has been compounded by long waiting times for medical care. “Twelve weeks might sound like a short time, but when you’re a child suffering with depression or a parent trying to keep your child alive, it feels like an eternity.”
Ford is quick to reassure that with adequate support, most youngsters will be OK. “We shouldn’t forget how resilient people are,” she says, although she adds that teachers and primary carers will need a lot of support to help them navigate the period of re-establishing routines as the world begins to open up again.
“It’s pushed our family to its limits; we need more support,” says Katrina. “After what we’ve experienced, it makes you wonder how many other children and their parents are in this position.”
*Name has been changed to protect the individual’s identity