Impact of Covid- 19 on mental health of children and adolescents
Mental health is as important as physical health in achieving one’s developmental milestones. Children with sound and stable mental health seem to function and excel at their homes, school and in their communities.
Covid-19 has brought about disproportionate changes in the lives of children and adolescents, pushing them far away from the ‘normal’ growing curve. Obesogenic behaviors in children such as weight gain, lack of routine during the day, increase screen time, disruptive sleep cycle, parents stocking up on calorie dense food stuffs and decrease in participation in physical activities due to social distancing are observed as the core issues due to the pandemic. This complex array of challenges has led to grief, fear, anxiety, depression and parental fatigue, in turn, negatively affecting the mental health of children and adolescents.
Due to the pandemic, school closures for extended periods of time has led to changes in routine, loss of crucial supports such as mid-day meals for the lower economic group children, no interaction with peers, decrease in physical activity and inability to access digital learning. The lower income group cannot afford the technology associated with digital learning, showcasing poverty and deprivation. This inequality has surfaced in the minds of young children, having an adverse effect on their mental health. Also, an additional demand on the parents has been placed as all parents aren’t equally qualified to participate in their children’s educational needs due to lack of technological awareness and education. Work from home parents don’t have sufficient time to involve themselves in their children’s educational needs which has a direct impact on the child’s academic performance. This can have a detrimental effect on the children leading to anxiety or depression. Along with this another impending health concern related to malnourishment among children can arise. In India, the Mid-Day Meal (MDM) scheme serves approximately 9.17 crore children across the country. Closure of schools has severely affected MDM scheme which can lead to deaths among children due to hunger.
Many families and children have suffered extended periods of separation from loved ones as well as deaths of parents/siblings due to the pandemic. Especially during times when parents contracting covid-19 has led to isolation from their children for long periods of time. Grave psychological impact in terms of uncertainty of parent’s health condition, lack of information and understanding and loss of physical interaction is noted.
Social isolation has paved ways for increased time utilization in passive leisure activities such as watching television and online gaming. User engagement in online gaming has increased to an alarming amount especially during the lockdown period. Friendships and family support are the strong stabilizing forces in a child’s life which have been completely disrupted due to the ongoing pandemic. Parental fatigue is another growing concern wherein adults are finding it difficult to strike a balance between personal care, work, household responsibilities and spending quality time with children. According to UNICEF, more than 330 million youngsters have stayed indoors for more than nine months causing debilitating effects on the mental health of children and adolescents worldwide. Disruption of the daily routines, social isolation and uncertainty about the future has led to severe stress among adolescents which has made them prone towards consuming addictive substances, thus leading to a rise in substance abuse.
Mental health related affairs in India are extremely overwhelming. The lack of awareness, associated social stigma, unavailability of appropriate mental health services with severe lack of mental health professionals is already a burden on the existing underdeveloped mental health services in India. On an average, over 70,000 calls concerned to mental health concerns were received by the state helplines set up especially during the pandemic.
In the face of this adversity, we need to adapt a proactive approach by employing certain strategies at various levels to curb the overgrowing mental health issues. At the parental and school level, awareness and education related to the mental health concerns of children and adolescents during Covid-19 is essential. Parents must be encouraged to provide adequate and appropriate Covid-19 related information to their children in order to reduce anxiety and increase better understanding about quarantine measures, lessen negativity associated with the pandemic. Regular family time can be adopted by the parents to reduce anxiety and help the children overcome their fears. Obesogenic behaviors can be managed by the parents by establishing a structured routine, including play time and exercise time, regularizing sleep patterns, monitoring screen time and having tele consultations for weight management.
Schools and colleges should aid in early identification of mental health issues; encourage meaningful participation in activities and promote occupational balance among children and adolescents. Recruitment of mental health occupational therapists/counsellors should be encouraged by school authorities.
Government authorities must focus on developing comprehensive school mental health systems (CSMHSs) in order to deliver adequate assistance to students. This will help in reducing the mental health burden on the existing pitiable system during the ongoing pandemic.
In these times of pandemic and social distancing, tele- medicine seems to be the best option. Internet can be of great help where an individual can contact professionals and make use of self-help platforms to address their mental health concerns. People can also reach out for mental health campaigns and follow mental health bloggers.
The total impact of Covid-19 pandemic is much more than the acute respiratory syndrome and is largely unknown. Protecting and maintaining the mental health of our future generations is our responsibility and it is a possibility only when the government in collaboration with local authorities, school system and parents, collaborate and work towards it.
(The article has been authored by Kritika Amin, Kanishka Sharma, therapist of Plexus Neuro and Stem Cell Research Centre. Parth Sharma, research fellow, Lancet Citizen’s Commission on Reimagining India’s Health System.)