COVID-19 and children’s mental healthApril 27, 2023
Schwartz C, Barican J, Yung D, & Waddell C. (2023). COVID-19 and children’s mental health: Implications for pandemic recovery. Vancouver, BC: Children’s Health Policy Centre, Faculty of Health Sciences, Simon Fraser University.
The global COVID-19 pandemic and its associated public health restrictions caused profound losses for children. Among these losses, declines in mental health have emerged as a central concern. We therefore conducted a systematic review of the best available studies examining COVID-19’s impact on children’s mental health. Our overarching aim was to assist policy-makers in supporting all children as society moves toward recovery.
Eight studies met our inclusion criteria. Although none were from Canada, all were conducted in high- income jurisdictions, including the United Kingdom, the Netherlands, Israel, Iceland, Norway and the United States. Seven of eight studies found that children’s mental health suffered during the pandemic.
Three studies assessed clinically meaningful concerns. These studies found that significantly more children likely met criteria for a mental disorder or experienced clinically significant anxiety or serious emotional difficulties during the pandemic compared to before. Across these three studies, increases were substantial — ranging from 48.1% to 94.2%.
Children’s mental health symptoms also changed during the pandemic, albeit with different patterns for different conditions. Multiple studies found that anxiety and depressive symptoms increased. Increases in emotional problems, mental distress and anger, and decreases in mental well-being were each reported in one study. Nevertheless, for most children these changes were not at a level that caused clinically significant distress. In contrast, behaviour problems improved according to one study but were unchanged according to another. Substance-related outcomes varied as well, with nicotine and cannabis use and alcohol intoxication showing significant declines in some studies but no change in others. Child well-being measures varied even more, with inconsistent outcomes for measures of life satisfaction and interpersonal relationships.
Beyond increased mental health concerns, some children experienced additional challenges during the pandemic. Those from families facing socio-economic disadvantage tended to have poorer mental health outcomes. As well, children had more mental health difficulties when they knew someone who had experienced COVID-19 and when they had fewer supports and less consistent daily routines.
Our systematic review suggests that many more children have needed treatment for mental health conditions — particularly anxiety and depression — during the pandemic. This situation arose against a backdrop of stark pre-existing service shortfalls, with recent international estimates (including data from Ontario, Canada) suggesting that only 44.2% of children with mental disorders were receiving any services for these concerns before COVID-19. Given the considerable challenges children faced during the pandemic — and continue to face — it is imperative to adequately address the needs now. BC should therefore make additional investments in children’s mental health, to offset future health care and related social costs and to meet children’s needs. Collectively, our current and future well-being depends on recognizing and addressing children’s rights to social and emotional well-being.
Read the full report here.