There are around 2.2 billion children in the world; which is approximately 28% of the world’s population. COVID-19 has impacted the lives of people around the world including children and adolescents in an unprecedented manner. This pandemic and lockdown has brought a sense of fear and anxiety around the globe. This phenomenon has not only effected short term but long term psychosocial and mental health implications for children and adolescents. The quality and magnitude of impact on minors is determined by many vulnerability factors like developmental age, educational status, pre-existing mental health condition, being economically underprivileged or being quarantined due to infection or fear of infection.
Impact on children
It is observed through international data that the number of children who are symptomatic, tested positive, or die from the virus is very small as compared to older age groups. Since this virus has physically affected children at relatively low rate and it may appear to be small or insignificant, but it has affected their minds a lot. Hence, it is getting difficult to immune from the stress that has occurred because of this pandemic and quarantining.
In one of the preliminary studies during the on-going pandemic, it was found that younger children aged 3 to 6 years old were more likely to manifest symptoms of clinginess and the fear of family members being infected than older children aged 6 to 18 years old. Whereas, the older children were more likely to experience inattention and were persistently inquiring regarding COVID-19. Although, severe psychological conditions of increased irritability, inattention and clinging behavior were revealed by all children irrespective of their age groups, it was also shown that children experienced disturbed sleep, nightmares, poor appetite, agitation, inattention and separation related anxiety.
There is an unavailability of researches on how this pandemic is affecting children’s mental health, mostly because the virus has been so fast-moving. We can not to say that children who have not been officially diagnosed with the virus have not been affected at all. Children other than psychologically affected are also vulnerable and at an increased risk of abuse during school closures.
COVID-19 has also presented some challenges related to food security for some children which increases the chances of issues related to post traumatic distress. It has also been observed that there is a reluctance in seeking medical attention due to fear of contracting COVID-19, which has resulted in decreased admissions but increased the severity level.
According to recent study published in JAMA Pediatrics, researchers in Wuhan city of Hubei province, group of 2,330 schoolchildren were studied for signs of emotional distress. Those children were quarantined for an average of 33.7 days. During this period, 22.6% of them reported depressive symptoms and 18.9% were experiencing anxiety.
A survey questionnaire was administered on 359 children and 3,254 adolescents aged 7 to 18 years. It included an anxiety scale, depression scale and a copying style scale. The results predicted that 22.3% had clinical depressive symptoms, which is actually higher than the 13.2% predictable rate of the depressed youth in China. Anxiety symptoms levels were also higher than the previous reports after the virus.
In Bangladesh, a survey of 384 parents with children aged 5 to15 years was conducted. Severity of subthreshold 43%, mild 30.5%, moderate 19.3%, and severe 7.2% were recorded.
Children’s depression, anxiety, and sleep disorder scores were grouped into severity categories.
On 1,143 parents of children aged 3 to 8 years, the emotional impact of the quarantine was assessed. It was observed that 85.7% parents informed that there was a change in their children’s emotions and behaviors during the whole quarantine. It was also observed that 76.6% had concentration issues, 38.8% nervousness and 31% loneliness. Lastly almost 75% of parents described the feelings of anxiousness and stressed about the whole quarantine situation.
Due to the COVID-19 pandemic many parents have become fearful and worried due to their health and inability to meet the demanding economic needs in the developing countries like Pakistan.
Like many other countries, in Pakistan, all the educational institutions were closed, exams were postponed, shopping malls, restaurants, and all areas of public gathering were under a strict lockdown. Families were isolated at home and under great stress. In these testing times of social isolation, children and adults were becoming exposed to the excessive media coverage of the pandemic. The screen time of children and adolescents has increased manifold as they are confined to their homes.
The pandemic has disrupted the financial and economic activities around the globe creating a sense of uncertainty and insecurities among the masses. Around 50% of the parents have reported that financial troubles due to social isolation are affecting their parenting skills.
Other effects that are caused by the pandemic is social isolation, instability, fear of getting infected, abusive backgrounds, boredom and frustration which are results of social distancing.
Extensive researches have shown that fear can be contagious and children are extremely sensitive to the emotional state of adults around them, who are their essential source of security and emotional well-being. Some children may start showing archetypal reverting behaviors like asking for bottle, thumb sucking, toileting accidents, not wanting to dress or feed themselves, becoming clingier and demanding, wanted to be carried, as well as problem in sleeping. These stress reactions in children may cause parental self-doubt. The sleep pattern changes, awakening in the middle of the night, having nightmares. Parents have reported that these issues have increased yelling, shouting and even slapping their children due to increased frustration caused.
Children were disappointed for missing birthday parties, school functions, going out with their friends, playing in playground with other team members, as well as not being able to visit their friends and other family members. Teen’s feels frustrated, nervous, disconnected, nostalgic, and bored because of social distancing during this pandemic. School closures can have and had significant impact on the lives of children with special needs and their families. Their regular therapy sessions have gotten interrupted and they are more likely to show aggression and irritability.
To conclude we need longitudinal and developmental studies, and implement the plan of actions to cater the mental health needs of the people especially the children during the pandemic as well as the post pandemic. It is also important to inquire and keep a follow up on the parents’ who are seeking clinical help as the parents’ mental health is important as it can affect the children in long term. Research validates that COVID-19 is affecting the mental health of children and that depression and anxiety are predominant. For clinicians who treat children and adolescents, talk with them about the impact of COVID-19, particularly those with social anxiety disorders, remaining at home and doing online schooling may temporarily relieve their anxiety.