The COVID Generation: A Mental Pandemic in the Making

Abstract

INTRODUCTION: ‘Mental health is a state of wellbeing in which an individual realises his or her own abilities, can cope with the normal stresses of life, can work productively, and is able to make a contribution to his or her community.’ World Health Organisation. World Health Organization. Promoting mental health: concepts, emerging evidence, practice (Summary Report) Geneva: World Health Organization; 2004. In 2019, Howells, Lehane and Lawson questioned children about what wellbeing means to them and also, what is the opposite of wellbeing? (Howells K, Lehane M and Lawson F, 92020, ‘Big Questions Can Science and Technology Make Us Fitter?’ presented at the ‘Wellbeing Conference’ at Canterbury Christ Church University, Faculty of Education and Faculty of Health and Wellbeing, February 2020). The mixed gender focus group of children aged 13 was able to explain that wellbeing, and having wellbeing, was about ‘being happy, being healthy and being well’. They were perplexed by the idea of what might be the opposite of wellbeing and that they had not considered this in detail. The children were able to offer concepts as to what the opposite of wellbeing was to them: ‘Not enough sleep; not enough healthy food and drink; not being able to relax or switch off; not being able to connect with friends and family; not exercising every day and not being, or feeling, valued.’ Mental illness is common even in the youngest members of society. Among children of primary school age (5 to 10 year olds), 14.4% had a probable mental disorder in 2020, an increase from 9.4% in 2017. (page 14: https://files.digital.nhs.uk/AF/AECD6B/mhcyp_2020_rep_v2.pdf) So in 2020, one in seven, up from about one in ten in 2017. Seventy-five percent of mental illness begins before the age of eighteen (Kim Cohen, J., Caspi, A., Moffitt, T. E., Harrington, H., Milne, B. J., & Poulton, R. (2003). Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Archives of General Psychiatry, 60(7), 709–717. https://doi.org/10.1001/archpsyc.60.7.709). COVID-19 is not the first pandemic to devastate nations and disrupt established complacencies. But it is the first to receive a ‘modern world’ scrutiny. Parliamentary debates and press conferences led by the Prime Minister, Cabinet Ministers and Government Scientific Advisors are streamed into our homes and evolving strategies reported minute by minute. As weeks and months tread pathways to years, national media outlets have carried ever more severe warnings about the adverse effect of COVID-19 on the mental health and wellbeing of children and young people. COVID-19 has placed immense pressures on us all, but as an increasing body of research is beginning to show, the long-term effects on mental health will be profound with many variants; all of them immune to a vaccine. The Royal College of Paediatrics and Child Health has warned that the greatest challenge facing children in 20 years’ time will be mental health problems: - https://paediatrics2040.rcpch.ac.uk/summary-of-our-work/#page-section-1 ‘For adolescents and young children, we forecast significant future increases in poor mental health, substance use and the consequences of prematurity. This was set to happen even before the impact of COVID-19, based on previous trends …. paediatricians will likely need to spend a greater proportion of their time looking after children with more complex healthcare needs and working across physical and mental health.’ The COVID-19 pandemic has had a stark impact on children and young people’s mental health. In the main, children are relatively spared severe physical symptoms in response to infection with the SARS-COV-2 virus, although a small but significant number have had serious Kawasaki-type sequalae. However pandemic containment measures have had substantial impact on children and young people’s daily lives, significantly interrupting the normal activities essential for healthy development. There is increasing concern about the impact of the COVID-19 pandemic on children and young people’s mental health. Data now conclusively indicates a substantial overall worsening of mental health in children and young people during the pandemic compared to previous years. This has not impacted all groups equally. Those whose mental health has been worse affected by the pandemic include those from precarious families and those with parental mental illness. Conversely, there have been notable exceptions, with a group of children and young people showing improved mental health at certain points in the pandemic. These are mostly those for whom normal life includes stressors detrimental to their mental health, for whom their removal has been beneficial. Important lessons need to be learnt about how to maintain these improvements, and how to extrapolate to apply their benefit to other children and young people. Prior to the outbreak of COVID-19, concern was voiced about vulnerable children and young people. Dunn J, 2019, ‘At Risk Children’, File on 4: ‘A big thing is lack of trust. They’ve been let down by adults. They’ve been let down by adults that they trust, that they care about, that they loved’: http://downloads.bbc.co.uk/rmhttp/fileon4/12._residential.pdf This Report is a voice for them.