Children’s mental health problems during the initial emergence of COVID-19.

Abstract

On March 11, 2020, the World Health Organization (WHO) declared COVID-19 a global health pandemic. The impact of COVID-19 on mental health has received widespread attention, but almost no longitudinal studies exist that examine changes in children's mental health during its initial emergence. Using a regression discontinuity natural experiment via a longitudinal cohort design, the present study examines trajectories of children's mental health from December 2019 to March 2020. Participants were 231 children (female n = 106 [45.8%]; average age = 5.69, SD = 2.09) in 22 early childhood education classrooms across Toronto, Canada. Children's mental health was assessed via educator reports on the Strengths and Difficulties Questionnaire in gender-adjusted percentiles, with the Impairment Rating Scale serving as a secondary measure. Data were analyzed with 3-level (classroom, individual, and time) Markov Chain Monte Carlo estimation (MCMC) growth curve models. Of the three assessments conducted per child, many of the final assessments occurred formally after the pandemic announcement and prior to the closing of childcare centres. Results suggest that male children enrolled in early childhood education showed a modest decline in mental health problems prior to the pandemic announcement by the WHO. However, following the WHO announcement, male children's mental health problems worsened significantly. No post-pandemic differences over time were observed for females. This study provides the first longitudinal evidence in Canada of heightened risk to children's mental health during the early emergence of the COVID-19 pandemic. Findings support initiatives aimed at increasing access to mental health care for children during and after the pandemic, in addition to incorporating mental health in home and school based educational services. Public Significance StatementThis study suggests that Canadian children's mental health problems, as reported by early childhood educators and leading up unto the childcare shutdown, increased during the early emergence of COVID-19, specifically for boys. Findings highlight the need for school-based mental health services, including support for teachers and early childhood educators, during the pandemic. Mental health services for children who have returned to school during COVID-19 remain a major priority, in addition to telehealth, home-based education, and parental supports for families who are keeping children at home.

Keeping the Faith: Religion, Positive Coping, and Mental Health of Caregivers During COVID-19

“…These major stressors have resulted in widespread emotional distress and increased prevalence of mental illness ( Cooke et al, 2020 ). Indeed, stressors emerging from the COVID-19 pandemic are associated with increased psychological distress, anxiety, and depression for young people ( Li and Leung, 2020 ; Singh et al, 2020 ; Browne et al, 2021b ), parents and other caregivers of children ( Wade et al, 2021 ), and the general population ( Xiong et al, 2020 ). Disasters can deprive and drain one’s personal and mental resources, and the imposition of public health precautions can result in a dwindling of one’s network of support ( Aten et al, 2015 ).…”

The Impact of the COVID-19 Pandemic and Societal Infection Control Measures on Children and Adolescents' Mental Health: A Scoping Review

“…Similarly, a study from China reported significant changes in anxiety among adolescents but not children, and no change was identified for depression (67). In a Canadian study, significant impact on emotional and behavioural problems was detected for male children enrolled in early childhood education, but not females (59). A study from Australia reported no differences in adolescents' reports on negative affect, nor positive affect, during the pandemic as compared to a baseline period (57).…”

“…The scoping review discovered 15 longitudinal studies (Table 3), which involved repeated measures over time and provide stronger evidence to address the question of impact on mental health. Five longitudinal studies involved children (51,55,56,58,59), nine involved adolescents (53,54,57,(60)(61)(62)(63)(64)(65) and one involved children and adolescents (52). Most of the studies indicated negative impact of the pandemic on mental health, including increased symptoms of depression (60,63,64,66), anxiety (60,63,64,67), loneliness (63), psychological distress (51,53,65), hyperactivity and impulsivity (55), and emotional and behavioural problems (59), as well as reductions in emotional regulation (55), happiness and positive emotions China, Asia "To assess the prevalence of two specific mental symptoms, anxiety, and depression, and their socio-demographic correlates among adolescents in the Chinese population during the COVID-19 outbreak.…”

“…The two Canadian cross-sectional studies reported: 43% of adolescents expressed they were "very concerned" about the pandemic (42) while Carroll et al (41) reported that, according to parents, almost half (49%) of children had very little concern about COVID-19, 38% were somewhat concerned, and 7% were very much concerned. Browne et al (59), the only longitudinal study from Canada, reported that male children's mental health problems worsened significantly during the pandemic. No significant differences over time were observed for females.…”

Ontario COVID-19 and Kids Mental Health Study: a study protocol for the longitudinal prospective evaluation of the impact of emergency measures on child and adolescent mental health during the COVID-19 pandemic

“…21 This is further compounded by the lack of knowledge regarding the impact of EMs on the potentially more vulnerable proportion of children (1 in 5) 22 with pre-existing MH disorders as well as children with neurodevelopmental disorders (NDD) diagnoses (ie, autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD), attentiondeficit/hyperactivity disorder (ADHD)) who are 3-6 more times likely to develop MH difficulties. 23 To date, research on the impact of the pandemic has suggested both deleterious [24][25][26][27] and beneficial 26 effects on MH in children with previous MH and/or NDD diagnoses. For example, authors have suggested that children with a previous depression diagnosis may experience exacerbations of feelings of loneliness and despair due to social isolation, whereas youth with social anxiety may experience improvements in MH 28 29 secondary to reduced social exposures.…”