The Covid-19 lockdown has affected the mental health of some 40% of teenagers, stressed by being cut off from friends and schools, fears of falling ill and a future that is out of their control.
That’s one of the key findings of a recent survey by UNICEF and the International Federation of Medical Students Associations (IFMSA), presented at a panel discussion Tuesday on the impacts of the pandemic on adolescent mental health. The discussion was hosted by the Geneva-based International Pediatric Association, together with UNICEF and the World Health Organization (WHO).
Why is this important? Adolescence is the period of life when youngsters become empowered, forge their identity and build plans for the future. Even without a pandemic, however, around 20% of adolescents will experience some mental health problems. With Covid-19, the developmental process is even more threatened by lockdown and its consequences.
While few formal studies have been done, data available from sources such as the recent UNICEF-IFSMA survey is worrisome enough.
Some 70% of young people have developed negative feelings about the future as a result of the Covid-19 pandemic;
79% are more worried about infectious people in their midst;
44% say they do not know enough about the virus; and 38% believe the worst is yet to come in terms of both numbers of cases and economic decline.
Pierre-André Michaud, honorary professor at University of Lausanne and previous head of the Adolescent Health Unit at the Centre Hospitalier Universitaire Vaud:
"There is a wealth of clinical and physiological studies on Covid, but the impact on mental health has not yet been quantified. Undoubtedly its impact on mental health will be significant.”
Uptick in child psychiatric consultations: Despite a lack of formal statistics, clinical psychiatrists also reported an uptick in consultations during the months of April, May and June. Michaud predicted a worsening of depression and pandemic-related anxiety disorders, even among those with good mental health over the coming months.
Major impacts. The impact is accentuated by social inequalities. While adolescentes may be less susceptible to severe Covid-19 disease, as such, they suffer the practical consequences of physical isolation, which can lead to:
Loss of contact with their peers as well as opportunities to keep physically fit, due to a lack of recreational outlets;
More severe family crises, including risks of domestic violence, and stress from the hospitalization or death of loved ones;
A loss of access to mental health services along with fears of being stigmatized or discriminated against if symptoms occur;
Progressively greater feelings of worthlessness and anxiety. Michaud:
"This widespread feeling of anxiety that is out of control is generating concerns for adolescents who are already fragile.”
In more extreme cases, Michaud says, this can lead to higher rates of: school dropouts; teenage drug and alcohol abuse; eating disorders; unplanned teen pregnancies; and severe depression or psychosis, which often emerges first in adolescence.
Responses. Parents and other adults who work with teens need to focus in identifying youths who are in difficulty. Demonstrative and even violent behaviour may be covert manifestations of distress. Michaud:
"Parents, teachers and social/community workers must invite them to express their emotions and worries so that they can build up an exchange despite the context.”
Ensuring widespread youth access to basic mental health services, such as psychotherapy and psychiatry, is critical. Hotlines can often be a first link for those in crisis.
Other important steps may include: strengthening distance education; fostering youth social interactions, even at distance, and better systems of mental health monitoring.
Bottom line: Youths need frameworks that foster connection, verbal exchange, meaning and contact with adults other than their family. Michaud:
"We don't know what the future is made of, so it's complicated. What enables young people to master anxieties and worries are verbal exchanges and talking about what they are experiencing.”
UNICEF and IFMSA have developed sevral youth ‘“listening” platforms, including U-Report, which seen some 6.5 million interactions since February among its 10 million users in 63 countries.
An opportunity Like any crisis, it also brings opportunities and "the chance to rebuild better". Fabio Friscia, in charge of the development and participation of teenagers at UNICEF :
"Covid-19 teaches us to build resilience and problem-solving skills in adolescents; give them tools to manage stress situations and emotions; strengthen social bonds and improve interpersonal skills. Young people also have a responsibility for their physical and mental health.”
Youths who are given opportunities to help others during the pandemic, as part of activities such as delivering meals to older people in their community, also develop their own mental capacities for resilience. Michaud:
"When young people are given the opportunity, they build something that makes sense of what is happening. Some are creative and develop responses to the current situation. In several instances, teenagers even rebuilt relationships with their parents thanks to the lockdown. They started playing together, sharing, doing things they had stopped doing. There are always two sides to situations like these.”