Debate: Is there a true global children and young people's mental health crisis, fact or fiction?

Abstract

Despite lurid headlines suggesting a Tsunami of mental health conditions among children and young people (CYP) unleashed by the pandemic, our major problem is the lack of robust data. The McGill living systematic review screened approaching 50,000 abstracts by the end of April 2021, of which only 594 met the inclusion criteria; only 4 of the 79 with data extracted thus far relate to CYP, all from outside the United Kingdom (see https://www.depressd.ca/covid-19-mental-health). Prevalence estimates are extremely sensitive to sample selection, and measurement weighting can only partially address selection bias; however, large the sample and non-probability samples lack a theoretical basis for statistical inference.The mental health of CYP was deteriorating prior to COVID-19, while outcomes for those with poor mental health may be worse this century compared to earlier cohorts (Sellers et al., 2019). Only a quarter of those with a mental health condition were in contact with Child and Adolescent Mental Health Services (CAMHS) in the national survey of 2-to 19-year-olds in England conducted in 2017, which struggled with long waiting lists, despite rejecting 1 in 4 referrals (Crenna-Jennings & Hutchinson, 2020).So what do we know about the impact of the pandemic and the resulting restrictions in the United Kingdom? In the July 2020, the follow-up of the national survey was carried out. The number of 5-to 19-year-olds with a probable mental health condition increased from 1 in 9 to 1 in 6 (Vizard et al., 2020). The increase was seen in boys and girls, all age groups and all regions of the country, while young women remained at particularly high risk (1 in 4 vs. 1 in 8 17-to 19-year-old boys). In contrast, two repeated surveys of 13-to 14-year-olds conducted in October 2019 and April 2020 revealed no change in symptoms of anxiety, depression or well-being, but significant improvements among those scoring above clinical cut-off points in October (Widnall, Winstone, Mars, Haworth, & Kidger, 2020).Strong cross-sectional associations between poor parental mental health and poorer family functioning with probable mental health conditions are worrying, given parents with small children were particularly vulnerable to deteriorating mental health (Pierce et al., 2020), and poor parental mental health predicts subsequent emotional disorder in their children (Wilkinson et al., 2021).

How did parents’ experiences in the labour market shape children’s social and emotional development during the pandemic?

“…Compared with research into learning loss and children's educational outcomes, there have so far been fewer studies exploring how children's well-being and socio-emotional development changed during the pandemic. Most of the research that has been done, though, suggests that children's mental health has on average worsened through the pandemic (Ezpeleta et al, 2020;Bunn and Lewis, 2021;Waite et al, 2021;Ford and Cross, 2021).…”

The ecology of youth psychological wellbeing in the COVID-19 pandemic.

“…Yet a raft of mixed findings from research within the United Kingdom led researchers to conclude that “(D)espite lurid headlines suggesting a Tsunami of mental health conditions amongst children and young people unleashed by the pandemic…” …. “most of the UK’s kids are probably OK…” ( Ford & Cross, 2021, p. 2 ). Indeed, some children experienced an improvement in their mental health difficulties during the lockdown phase of the pandemic, and some families have welcomed quality time together.…”

“…The convergence of factors known to impair optimal youth development associated with the pandemic has resulted in ominous warnings about its serious implications for the psychological wellbeing of children, young people, and their caregivers ( Gruber et al, 2021 , Holmes et al, 2020 ). Against a backdrop of the increased prevalence of youth mental health difficulties in many countries ( Ford & Cross, 2021 ), the negative psychological consequences of the pandemic have been highlighted as a challenge across developmental periods that might extend long into the future ( Gruber et al, 2021 , Holmes et al, 2020 , Humphreys, Myint, & Zeanah, 2020 ).…”

Long-Term Effects of COVID-19 Pandemic on Migraine in Adolescents. A Retrospective Analysis of the Population Attending the Headache Center in Different Phases of the Pandemic

“…Although these restrictive measures helped to prevent and control the rapid rise of COVID-19 and have now been lifted, the community continues to deal with the virus. The dramatic changes in people's lifestyles and the loss of daily routine, together with the fear of infection, have led to an increased rate of anxiety, depression, and feelings of loneliness [3][4][5][6][7]. Despite the higher risk of mortality among the older population, the COVID-19 pandemic impacted mostly young people's mental health [8][9][10][11].…”